Two Opinions On Surgery
At this point, I’ve written a fair bit about the surgery that I had to shed my moobs. I’m extremely happy with the results thus far, but that hasn’t stopped me from being extremely curious about the healing processes of basically everyone who has ever had any remotely similar surgery.
This has led to some interesting discoveries. First, there’s evidently a whole lot of controversy of the subject of drains: which is to say, a lot of people don’t want them, and seem miffed when surgeons require them. Second, quite a few of the people who wind up with the exact surgery that I had seem to want their incision lines to be perfectly straight.
I don’t mean to be a jerk about it, but neither of these positions seem terribly well-considered to me.
In short, people don’t like drains because they’re uncomfortable. I’m not arguing, there: they are uncomfortable. The only reason I bothered taking any of the opioid painkillers prescribed by my surgery was so I could sleep with the poky-arsed drain lines annoying my intercostal tissues.
Given the minimal amount of drainage I produced, I legitimately could’ve gone without—but I’m glad they were there, just in case.
All too frequently, I run into an argument that goes, “Well, Bob didn’t have drains, and he was fine.”
The problem, there, is that it’s really quite difficult to predict who’s going to be like Bob, or like me, and who’s going to wind up with massive swelling that could’ve been prevented by installing a couple of drains for a week or so.
Surgeons can control their technique. What they can’t control is how our bodies react once all is said and done.
Some, like Imaginary Bob’s and like mine, just go, “Oh, no worries, I’m on this healing thing,” without any major drama.
Others go, “OMFG WHAT IS THIS WHAT HAVE YOU DONE AAUUUGHHHHHH!!!” and promptly kick up an inflammatory tornado, producing great gouts of fluid that can turn into seromas which are also quite uncomfortable, and which then require (you guessed it) drains anyway.
I’m a big believer in the idea that prevention is better than a cure.
I think the path my surgeon took in my particular case was just about ideal. D was hoping we could start for home on Monday evening or Tuesday instead of Wednesday evening or Thursday, so the doc suggested a compromise: if my drainage levels were good (read: minimal), we could have the drains out on Monday. Given that my surgery took place on a Thursday, this seemed like a really good compromise.
As it turned out, I experienced almost no inflammation and drained almost nothing from the word go, and the drains did indeed come out on Monday. Yes, they were annoying while they remained, but let’s be frank: roughly 4.5 days of moderate discomfort is preferable to the risk of epic swelling accompanied by potential weeks of discomfort. (To be fair, pain perception varies tremendously, and the drains might actually be a lot worse for some people than for others—but for most people, they’re basically just an annoyance, and a temporary one.)
Some surgeons (mine included) use drains for essentially everybody. Some decide on a case-by-case basis. Some don’t bother at all. Regardless, when it comes to this kind of thing, it’s worth considering that surgeons undertake a decade or more of specialized schooling to learn their skills—and, especially for cosmetic surgeons, it’s in their best interests to do whatever is going to get the best results.
In short, with a few exceptions, they generally have more insight into what they’re doing than their patients do, and it’s probably in our best interests to give due consideration to their surgical preferences.
For some reason, a lot of guys seem convinced that curved incision lines scream “BREASTICLES!”
In fact, I don’t think they do, and here’s why: curved incision lines follow the anatomical shadow of the pectoralis major. To the uninitiated, they’re not necessarily going to shout, “Yes, I had breast reduction surgery with removal of extra skin!”
- Exception: the rare cases in which an ill-advised surgeon makes them too curved—but, honestly, my jury’s really out as to whether that actually looks more unnatural than a perfectly straight incision does, since I’ve seen it so rarely even in my endless trawling of post-surgical pix.
Under ideal circumstances, they nestle in the literal shadow of one’s pecs, where they will eventually camouflage themselves as an extra measure of definition. And, of late, as surgical techniques have improved, ideal circumstances occur more frequently than one might imagine.
Perfectly straight incision lines, meanwhile, look unnatural. The human body is not a straight-lines kind of place. Straight incision lines depart rapidly from the anatomical shadow of the pectoralis and advertise themselves as exactly what they are—evidence of surgery.
The human eye is more likely to notice them simply because they contrast so sharply with the curvilinear nature of even the most masculine of human bodies (to wit: none of us are actually built like Minecraft sprites).
Even under ideal circumstances, perfectly-straight incision lines don’t camouflage themselves at all.
My incision lines aren’t straight. I wouldn’t want them to be straight. If anything, I wouldn’t have minded them being just a bit curvier towards their lateral ends—but, once again, my surgeon knows what he’s about. He’s been doing this for a long time.
I’m sure there are plenty of folks who will disagree with me on both these points—and, ultimately, I’m not telling them they’re making the wrong choices. People get to make their decisions based on their own bodies and their own long-term goals.
I just hope that, in making these decisions, there’s more to the decision-making process than “drains are uncomfortable” and “male bodies are made up of straight lines.”
Regarding point the first, that’s true, but they’re also temporary, and if they’re too horrible you can have them out early.
Regarding point the second, that’s really not true. Even Arnold Schwarzenegger is made up of a series of curves with varying radii. Ask any artist, or any robot who wants to look more human.
A note on all this: I recognize that there’s a pretty strong dose of privilege involved in the fact that I feel comfortable writing this.
I can assume that, while they’re kind of visible now because they’re still pretty pinkish, my curvilinear scars will eventually hide in the anatomical shadow of my pecs because I’m a dancer and an aerialist and a semi-mesomorph who puts muscle on at the drop of a hat. Even after three weeks sitting on my butt(er), and thusly at the least-defined I’ve been since I got back from my illness-and-holidays binge-eating tour of central Kentucky, I still have more definition in my chest than a lot of people will ever have. I get that.
Likewise, my work both demands that I be extremely fit and begets extreme fitness, and at least part of my rapid and unproblematic healing comes down to that. Maybe I would have felt differently about drains if I’d had to cope with them for more than 4.5 days (though, honestly, if you’ve got a lot of drainage, it’s probably a good idea to have drains).
On a different axis, I grew up in an extremely privileged setting which afforded me the opportunity to purchase all the anatomy books and drawing materials my little heart desired, and I have a very visual mind. It’s easy for me to say “scars should be curvilinear because bodies are curvilinear” because I’ve spent my entire life poking around with images and models of what human bodies look like beneath their skin and a brain that happens to be very good at storing and regurgitating that information (but which can never freaking recall a person’s name when I really need it to >.<).
So there’s that, also.
Lastly, a lot of the guys who have this surgery are trans, and every single opinion I have is founded in the fact that, as an intersex person, I face a different set of challenges in life than transfolk—one that overlaps with trans experience in some ways and is fundamentally different in other ways. For one, I may occasionally get misgendered in public, but I don’t have to put up with people constantly questioning my right to identify as a male.
- Curiously, exactly twice in my life, someone has asked me, “Why would you choose to live your life as a gay man when you could just be a woman if you wanted to?” Both times, it was another femme-y gay man who asked … and, in both cases, one who had grown up in a part of the United States that is actively oppressive and deeply repressive towards gay men in general and especially towards effeminate gay men. The region in question also tends to do a lot of conflating sexual orientation with gender identity. Neither of these guys had ever seen me unclothed, nor did they possess a clear concept of the fact that being intersex didn’t mean that I had “both sets” until I explained: in my case, it primarily means that I’m an ideal dish for a gentleman who prefers dainty Vienna sausages, so to speak, which isn’t quite the same as being able to just up and declare one’s self to be female even if I wanted to. And now you know way more about my body than you ever wanted to. You’re welcome.
Since transguys comprise a significant proportion of the folks who have this particular surgery, I feel like it’s probably worth acknowledging that I’m operating from a different vantage point, and that it colors my decision-making process. I think the same probably goes for non-IS cisguys: the set of my general experiences with being a guy differs from theirs as well.
There’s an extent, of course, to which everyone’s experience with gender, and with walking around the world as a gendered being, is different. Before it was corrupted as an insult, the phrase “we’re all individual snowflakes” meant exactly that: every one of us is the same in some ways and different in others, just as snowflakes share some basic characteristics and differ wildly and beautifully in other ways.
What I’m talking about, here, are collective experiences that shape the way we see the world: just as my upbringing in a forward-thinking part of the country prevented me from asking myself, “Why wouldn’t I just want to be a girl instead of being gay?” Those options, for me, have always existed on two different spectra.
So, anyway. Those are my caveats. I’m sure things are even more nuanced than that, but I need to wander off and do some errands now, whilst the day is young.