Getting the girl things done!

[Beverly]

Hey y'all (Southern girl here ?),

 

Reading other girls' gender affirming pre-op and post-op surgery experiences has been helpful to me, so I feel a responsibility to share mine. After jumping through all the legal and WPATH hoops, and with the stars and planets finally aligning, my breast augmentation is scheduled for August 10 and full-depth vaginoplasty is scheduled for August 18, assuming I test negative for COVID-19 48 hours before surgery.

 

UNC Healthcare, affiliated with the University of North Carolina in Chapel Hill, began a transgender surgery program last year, and wow, they already have 250 patients. I'm thankful to be one of them. The trans health program director/nurse navigator is a trans woman, an RN, and this is very reassuring to me. The surgeon is experienced, the program is well organized, and they handle everything for you, including getting insurance approval and coordinating care among the different specialties. I couldn't afford to do this without insurance help, and thankfully Blue Cross/Blue Shield of North Carolina covers both top and bottom surgery with the appropriate documentation and diagnosis of gender dysphoria from three healthcare providers. Fortunately, I have two awesome therapists and a primary care doc who have been with me every step of the way through medical and social transition, which I began three years ago. They require permanent hair removal from the surgery area, and I began that torturous process over a year ago, which allowed me to get surgery scheduled relatively quickly after my initial examination/consultation.

 

Needless to say, I'm counting the days and hours, and finding it hard to focus on much of anything else as it's about to get real. I'm not looking forward to the difficult recovery, but finally feeling emotionally whole and getting what I consider a terrible birth defect fixed is well worth the anticipated physical pain and discomfort. I'll post updates at key points in the process, which will hopefully be helpful to anyone considering this big life changing event. I really appreciate this forum and the sense of community it provides.

 

Lots of love,

 

Beverly

[Cyndee]

Hi Beverly, I think it's wonderful you are able to move ahead this summer !! Especially given what our health care system is dealing with right now, consider yourself very fortunate indeed Just stay healthy, and your dates will be here before you know it.

 

Best wishes and thanks for sharing here....

 

Cyndee

[Jani]

Thank you for this uplifting update Beverly.  Wonderful news indeed!  You are fortunate to have a skilled transgender health coordinator and insurance that takes care of the financial aspect.  I know the wait has had its ups and downs but the date will be here soon enough.  Stay healthy.  Stay calm. 

Jani 

[SaraAW]

Congratulations! That is great news. 

[Susan R]

On 7/3/2020 at 6:40 AM, Beverly said:

Needless to say, I'm counting the days and hours, and finding it hard to focus on much of anything else as it's about to get real.

Beverly, You have got to be in a constant euphoria with all this happening soon. The steps getting you to this point make this even more amazing. You’ve come along way and now have everything ready to roll. I am so happy for you. Please keep us updated here if at all possible. These updates give us all hope and let us see that dreams can be accomplished with a little effort taking one step at a time.

 

I wish you the best on your surgeries with a very quick recovery and the outcome you’ve worked so hard to obtain.

 

Warmest Regards,

Susan R?

[Beverly]

Hi friends! Today was a big milestone in my gender affirmation journey as my breast augmentation (BA) surgery was performed successfully at UNC Healthcare in Chapel Hill, NC. For my in-state trans friends, I want to share that Blue Cross Blue Shield of North Carolina will cover BA with a properly documented gender dysphoria diagnosis following the WPATH protocols. It's not written in their policies yet, but they just in the past few months started approving this surgery for trans members. The UNC transgender health program director handles all the insurance pre-approvals, so I didn't have to do anything to make it happen.

 

The surgery is done at their ambulatory surgery center, meaning outpatient surgery, and it was a very pleasant experience. Everyone is so friendly and down to earth there, and they take really good care of you. I got along with the nurses so well in preop that I actually enjoyed it. I'm legally female and that's how I'm listed in my medical chart in their system. Sometimes this creates an opportunity for me to "educate" a staff member about what it means to be a trans person, as it did today.

 

The nurse going over my medical chart with me in preop came to the gynecological questions all women must answer, so at that point, of course, I had to tell her that I was transgender, because "no, I don't have my period regularly" and "no, I haven't had a hysterectomy."  After a long pause as she gave me a puzzled look over her face mask, she was really sweet and genuinely interested in learning about it. She said I was her first trans patient and she had recently moved to North Carolina from Montana, where she said the odds of running into a trans person, my paraphrasing here, were almost zero.  I admit that I live a stealth lifestyle, as in I'm a woman, period, exclamation mark, but when I do get an opportunity to share with someone and normalize the experience for them, I take it. 

 

I'm pretty sore right now 12 hours after surgery, but I have pain meds and the pain really isn't that bad. When I first woke up from general anesthesia, it felt like a truck was parked on my chest, and I was very uncomfortable, but with the IV still in I got relief pretty fast before I was ready for discharge. The surgeon was going to do my surgery periareolar, making the incisions under and along the areola, but because they are small, he did it inframammary, or under the breast where it folds over to hide scarring. The incisions are no more than two inches in length, and he used absorbable stitches and wound glue to close them. I'm not feeling any pain from the wound site. Most of the pain is muscular, since the silicone implants are positioned in a pocket created under the breast muscle.  I can't lift my arms over my head or lift anything for a few days, but other than that, I'm good to go. Unless there is a problem, my post op follow up is August 28.

 

I didn't go really large in breast size, because I wanted a natural look. I was a full 'A' cup bra size from the HRT, so I went up two sizes to a full 'C' cup. I'm 5' 7", 160 lbs, so that size will be in good proportion to my body frame. My left breast was a little larger than the right breast, so my surgeon used a 375 cc implant for the smaller breast and a 350 cc implant for the larger one to give them better symmetry. I won't be able to judge how they turned out aesthetically for a while because of the swelling, and the implants always sit a little high at first before they settle down over a couple of months. I had to sneak a peak, so I undid the Velcro medical-grade compression bra closure on the front and let the wound dressing fall to the side. I have to say I'm going to be very happy with my decision to enlarge my breasts after they had stopped growing. Larger, symmetrical and firmer breasts make many women feel more feminine and sexy. I know they'll give me more confidence, especially in a bathing suit, and I love going to the beach.

 

So, it's been an exciting and tiring day, meds are kicking in, and it's bedtime.  I'm very excited about my new girls, and so are the men in  my life. Next up is gender affirmation surgery, aka vaginoplasty, next Tuesday, August 18. I'll be in the hospital for six days before discharge on August 24.  I'll post about that when I can. Take care everyone and lots of love and positive vibes your way!

 

Bev

 

 

 

[Susan R]

1 hour ago, Beverly said:

I'm pretty sore right now 12 hours after surgery, but I have pain meds and the pain really isn't that bad. When I first woke up from general anesthesia, it felt like a truck was parked on my chest, and I was very uncomfortable, but with the IV still in I got relief pretty fast before I was ready for discharge.

I appreciate this very good description of what it will feel like in the early part of BA recovery.?

 

1 hour ago, Beverly said:

I was a full 'A' cup bra size from the HRT, so I went up two sizes to a full 'C' cup. I'm 5' 7", 160 lbs, so that size will be in good proportion to my body frame.

 

...my surgeon used a 375 cc implant

More great information. I tried on seemingly every size of silicon prosthetic and the 450cc and 500cc were the sizes that looked good for my body size, shape and frame but settled on the 500cc. I am a small B cup now (a few B cup bras do not fit) I was a tiny bit concerned as I left the Drs. office that I may have chosen a size too large. Based on your stature and your frame and the size you picked, I think I’ll be ok. I’m 5’ 10”, 175lbs so I’m hoping it will feel like a large C or D cup with my larger size.

 

1 hour ago, Beverly said:

I'm very excited about my new girls, and so are the men in  my life. Next up is gender affirmation surgery, aka vaginoplasty, next Tuesday, August 18.

Yes, I’m sure you’ll get all the attention you need from the men in your life. You deserve to be happy! This is great that your getting the bottom surgery done close time-wise. There’s much less overall recovery needed. If your feeling up to it, send us all an update or two on this BA and the upcoming Vaginoplasty. I am so happy for you, Bev and wish you a quick recovery.

 

My Best,

Susan R?

 

[KayC]

Congratulations! @Beverly!  very happy for you, and thank you so much for passing along your results and experience with your BA procedure.
Wishing you a speedy recovery and similar success with your follow on surgery on the 18th❣️

[Jani]

@Beverly this is great news!  It sounds like your experience was delightful all around.  Good news about your insurance.  Rest well and enjoy your new figure!

Hugs, Jani

[Kylie]

@Beverly Wonderful news! I had sought out care with UNC HealthCare but they were unable to work with my insurance, partly due to me working with another Health Care Organization in the state. Plus they had limited luck with Cigna in the approval processes. A bunch of red tape and factors of cost! So, that is why I came to Texas for my GCS. My surgeon actually told me last week the surgeons at UNC Health did their training with her and her partners! How cool!

 

Best of luck in your recovery. I look forward to following along with your progress! 
 

Kylie

[Heather Shay]

Congrats @Beverly

[Beverly]

Thanks ladies, for your support! Day two, I've slept through most of it, since the meds cause drowsiness. I don't mind that. I don't feel any pain at the incision sites, and they look very good with no bleeding whatsoever. However, my entire chest is very sore, and any body movement causes discomfort. I'd compare it to the soreness you feel in your muscles the next day after a hard workout. I'm certain the meds are dulling any pain that might be there.

 

I took my medical compression bra off to change the wound dressing for the first time. My breasts are larger than I had visualized a 'C' cup, but that's because of some swelling that always accompanies this surgery. I'm excited about my new profile and can't wait to head to the beach, which won't be until the end of September while I recover from gender affirmation surgery next week. I'll keep providing updates whenever I have something of interest to share about the experience of top and bottom surgery.

 

Lots of love, Bev 

[Jani]

Wonderful news that you are healing well.  I imagine your experience with the size is common but soon they will feel and look normal to you.  Rest well! 

Hugs, Jani

[Emily michelle]

Great news that is great to hear you’re healing well 

[Beverly]

Hi everyone! Sorry for the delay in reporting on my bottom surgery nearly two weeks ago at UNC Health Care. It was a day that was a long time coming since the day after I got home from a tonsillectomy when I was four years old, and I asked my mother to take me back to the doctor to get my other problem (male genitalia) fixed. I guess I reasoned that if you can remove tonsils, you can remove anything, LOL! My mom calmly replied very matter-of-factly "oh, honey, they don't do that."  Well, after all these years, yes, they do do that!

 

I was discharged after five days in the hospital, and so glad to have the IVs removed from each hand and no more blood tests twice a day and injections of blood thinners and pain meds. I felt like a human pin cushion. I won't go into specific details about pre-op and post-op stuff here, but you can private-message me, if you're considering bottom surgery and have questions. Of course, every provider will do things their way, so your experience will likely differ from mine in the details. My surgeon uses the penile inversion method, which is the most common.

 

The experience is not fun, but it's soooo worth it. I feel amazing, like a newborn, and seeing myself in the mirror as I should be seen is a liberating feeling. I'm no longer chained to a body that doesn't fit my true gender. No more dealing with dysphoria and concealing what I consider to have been a horrendous birth defect. To sum up my emotions, YAY, I'm a free woman at long last! 

 

My first post-op follow up was last Monday, where they removed the bolster from the vaginal canal. Oh, my gosh! That was such a relief. It felt like I had a football stuffed in there, and I had to walk like a wounded Penguin. The bolster maintains the shape of the canal and allows tissue to adhere where it's supposed to in the pelvic cavity to help keep it open. Of course, I will have a dilation regimen starting tomorrow to maintain width and depth. My surgeon uses a bolster that is like a cylindrical balloon (actually a condom), which can be expanded with air and filled with foam material. To remove it, the air is vacuumed out and the foam shrinks as the bolster is slowly removed.  It's kinda cool, really, and I think I like this idea better than a mile of gauze stuffed in there. 

 

The only complication was that my urethra (the tube we all pee through) had a thin area so the surgeon grafted new tissue there to reinforce it, and I've had to keep the catheter in longer while this healed. My second follow up is tomorrow, where the catheter and surgical drains coming from the right and left Labia (Vulva lips) and attached to small plastic bottles will be removed. Hallelujah! The drains keep swelling to a minimum and shorten healing time. It's yukky gross and isn't fun juggling all these tubes and accessories dangling from my body when I do anything other than lie in bed, but it's needed and only for a short period of time. The long-term result is definitely worth the short-term aggravation. As I said, I'm not going into a lot of detail about pain management, meds, appearance, and simple things made temporarily difficult like having a bowl movement, but you can private message me, if this level of information will help you.

 

The transgender health program at UNC Health Care has only been in existence for just over year, and interest in their services is blowing up according to the program director who spoke to me after my surgery. They currently have 250 patients, most waiting for surgery. Permanent hair removal in the surgical area is a requirement they have, with which I agree, and this takes six months to a year before you can be cleared for surgery. Hair growth inside the vaginal canal is not desirable from a comfort or infection and hygiene control standpoint. Fortunately, I started the year-long process well over a year ago and was deemed ready to go at my first consultation on June 1.

 

So far, I'm happy with my experience, from the nice new hospital and large private room with great TV, beautiful views of sunrises outside my large picture window, awesome friendly staff giving me care around the clock, and the food was restaurant quality and like getting prompt room service whenever I ordered from an extensive menu. My medical team is great, which includes my surgeon Bradly Figler, a resident MD, a PA, physical therapists, nurses and nursing assistants. I've agreed to being a resource/contact for new patients with questions about the experience.

 

One thing I was surprised about is that not everyone I've encountered in the system outside the immediate surgical and primary care team, either in the hospital or outpatient clinics, is clued in that their patient is transgender. I guess this is because the transgender program is so new to a large academic system and so many are involved in your care. I'm legally female and that's how my medical chart reads, so for some it's just assumed I'm having vaginal reconstruction or some other similar female surgery. They really are similar to the naked eye post-op. All humans are female the first six weeks or so in the womb, so it's more a matter of rearranging the sex organs than creating something new. Being in pain, tired and always enjoying gender affirmation, I just rolled with it. This was especially so with top surgery, which I had a week prior to bottom surgery. At every healthcare interaction women are asked about their period (menses). Being a nurse myself, I'm familiar with all of this, so I know when to disclose and when to just let it slide to get through the standard patient check-in and chart reconciliation process.

 

I think being a healthcare professional helped me sail through all of this without issues or a lot of stress, and I know it greatly lowered my anxiety levels, but I can see where many trans patients may experience a lot of pre-op and post-op anxiety. For this reason, it's important to stay in close contact with your gender therapist throughout the process and have a good support system of friends and or family in place. In short, this is no picnic, it's major surgery, but it's WELL worth it! In spite of the temporary discomfort and aggravation, I wake up happier and more confident every day, and that's an awesome feeling. Keep focused on your amazing transformation and new life, always looking forward to claiming the pot of gold waiting at the end of a rainbow after a very long storm.

 

Take care friends and lots of love,

 

Beverly

 

 

[Jani]

5 hours ago, Beverly said:

Well, after all these years, yes, they do do that!

Yes they do in deed!  

 

Interesting use of a bolster rather than packing.  Sound like its easier to install and remove.  What a wonderful thing to keep your personal data private outside your primary team.  I like that.  

 

I know its been a long wait but you've arrived!  Congratulations, I'm so happy for you.

 

Hugs, Jani

[Kylie]

Congratulations! It is a wonderful feeling! Even though I’ve been a nurse some 10 years, I have felt/still fed completely clueless around the entire process I’ve went through this last month. Bless my poor Nurse at my surgical center in Texas - she gets regular emails from me; sending photos since I’m all the in NC! 
 

But she has been wonderful! Hope you continue to heal wonderfully!

[Beverly]

Thank you, Kylie and Jani!

[Susan R]

I’m so glad everything went well for you, Beverly. Your experience sounds so exciting (sans the pain and discomfort) and I can imagine what it might feel like to wake up each morning knowing you’ve tackled this huge milestone. Thank you for your wonderful update. Like the others, I’m so happy for you.?

 

Congratulations,

Susan R?

[KayC]

Congratulations @Beverly!  Happy for you and that everything went so well.  Thank you so much for sharing❣️

[Abi]

Hi Beverly, 

    I am sure you are ecstatic with joy. It is very helpful to know how this went for you and the other ladies that have reached this goal. The knowledge you bring to those of us that may not really have a full plan in place yet is priceless. I may very well be one of the people that asks you more in a PM later. For now, rest, reflect and rejoice. 

 

Best Wishes for a quick recovery,

Abigail

[Bri2020]

I am actually crying right now I'm so happy for you. What a wonderful experience you seemed to have had.  I'm starting HRT Wednesday so have a year at least until I am where you are but you've made me so hopeful that my experience can be as good as yours. Thank you for sharing. Oh, thanks for the heads up on just getting started on electrolysis down below.  I've started on the face but yea, I should start genitals if I want to stay on schedule for bottom surg.

[Beverly]

Thank you, ladies, for your support and kind words. Monday the catheter and surgical drains were removed, yay! I'm still sore and tender in the surgical area and the normal post-op swelling is there but diminishing slowly. Started the three-times per day dilation routine. That's going well, so far. I'm pleased with the depth they were able to obtain. I'm able to get around and drive myself, but I'm not overdoing it. Going to start walking some in my neighborhood tomorrow. Watching a lot of TV and staying busy with the boards I'm on and lots of Zoom meetings. Post-op self-care is a full time job, lol!

 

Lots of love,

 

Beverly

[Heather Shay]

@BeverlyWow - I wasn't aware of your surgery but wanted to add my congratulations and happiness that all went well and you are healing well. What an accomplishment. So proud of you.

[Kylie]

@Beverly I agree, this is such a full-time job! Hope your recovery goes smoothly.