Here's the fast version: January 29th I have a breast augmentation scheduled.
Two weeks ago, I had a consultation.
The doctor was on the list of plastic surgeon with extensive experience working with trans women and good reviews and offered the earliest consult; he and his team seemed very nice. We took measurements. Talked about options. Discussed my goals. Seemed successful.
On the last page of the paperwork, in the last minutes of the consult, came the buried lede: the doctor only works with BMIs under 35, you will need to lose 80 lbs before we can schedule your surgery
We can refer you to our partnered weight loss clinic on the 3rd floor for a diet, exercise and medication regimen, and if you pay a $1000 deposit, we'll fit you into the schedule ASAP when you hit your target weight.
I was crushed. Obviously! It was the worst case scenario for my emotions, the thing I was worried the most about. I lashed out at myself, I hurt my own feelings, I tried to convince myself it was stupid to be doing this at my age.
My friend Kayli, who I brought to the appointment with me, said I saw your face when you saw yourself in the mirror with the sizers in, and that was gender euphoria. I believe you'll find a way to have your dream, one way or another.
Fuck.
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I just turned 42. And I realized, very suddenly, that if the worst doesn't happen, I'll spend another thirty or forty years in this body. I need to make friends with it. I need to finish my electrolysis (in process, and the end is in sight!). And once I do that, I can think about other, more subjective and personal aspects of transition.
My boobs didn't come in that well, not like some trans women experience; maybe I waited too long to go on progesterone or my levels were too screwy in my first few years, before I fired my hormone doctor and got a new one. I don't know. My breasts are tuberous, which is more to do with potatoes that tubes; they are too narrow at the base and point downward. It can happen to cis women too, just more rarely.
They are small. They don't have an upper half and they don't go in towards the middle hardly at all. Small for my size, which is 6'2" with a 50" chest. They might look ok on my friend Quinn, who probably weighs the 80 lbs the surgeon wanted me to lose.
And I'm fat. Big ass, big hips, beginning of an apron belly. I can deal with being fat. There are beautiful fat women; but with a 50A chest, that's not what I look like.
When I saw myself in the mirror, I looked like my mom; like my older sister. I looked like myself.
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I wallowed it in for a little while, and then I realized that they had my height and weight before I even came in and could have checked my BMI beforehand; that their measurements would be useless if I did lose the weight; that it was, in fact, a scam. I got angry. Anger gets me moving.
So we called the other clinics and asked if they had BMI restrictions. Most of them did. Laura found a place in SF that explicitly didn't, per their website, if I wanted to travel. And we found one here in Denver that didn't have a specific one, but judged by overall health the anesthesia risk.
The doctor was booked out for weeks, but they could get me an initial nurse visit on Tuesday to find out if it was worth going on. We took it. Then the doctor had an unexpected cancellation, and it became a full consult.
The doctor told us at the beginning she was having a great day. She thought her dog was dying and had to be put down at 4 years old. The vet clinic had called and said it was an auto-immune condition, that it would take treatment and might shorten the dog's lifespan, but the dog would still live. She said she was -- and she seemed -- giddy.
She explained the reason for the BMI limit isn't the surgery; it's the anesthesia, and some doctors don't want to take the risk, based on the numbers. I carry my weight lower, not on my chest or around my rib cage, and she works in a hospital if anything goes wrong, not a private clinic. She told me she was okay with the risk if I was.
She listened to the old plan, and told me what she would do differently. She told me I could and probably should go bigger than the other doctor had recommended, if my goal was proportionality with my body. Because she was thinking of them on my body, not 80% of my body.
She explained how we would deal with the narrow base and downward tilt of the the existing breast, which would make it a little tricky to add an implant without a 'double bubble'; a mastopexy for lift and an self-dissolving internal bra to keep the implant from sliding too low for a few years.
We talked about the options for materials and for size in the wide base and projection we were discussing; the differences between saline and silicone, and why silicone is mostly what they use now, but why saline might make sense in my case or might not.
She brought up some light hand lipsuction under my arms to give the implant a better 'stage'; she looked at her nurse and said, 'I can do it while I'm in there, we don't need to tell the hospital about that part.'
She brought up a couple of times that after 40 I should be getting mammograms, and that I should get one before the surgery. She warned us that her prices were higher because she works out of a clinic.
Her estimate was $3k more than the other doctor, and almost all of that was the internal mesh. (The other doctor's prescription for that issue was 'tape.') The liposuction was not on the estimate.
The earliest appointments were in January. That would be me 9 months to heal before our vow renewal. She said I should take a week off of work, maybe 10 days, but would feel fine in two weeks. That in two or three months I could resume normal clothes and lifting, pushing, etc.
The deposit was 25% of her fee, not the overall fee; less than a flight to San Francisco. I looked at Laura, who was there to keep my feet on the ground and give me a second opinion. She said I should go for it.
January 29th I have a breast augmentation scheduled.
romaincrisis
snowghoul
2087
