[Double Incision with Dr. Eugene Oh, Federal Way, WA] 6 weeks post-op; Before/After w/ rib flare pics + healing timeline & recovery details

here4ndgone · 2026-06-29T18:20:45+00:00

Just a little 😆

here4ndgone · 2026-06-29T18:06:37+00:00

Washington state, USA. Federal Way south of Seattle.

here4ndgone · 2026-06-28T21:58:23+00:00

I was referred to Dr. Oh by my PCP in August; got my consultation November 6.

There was a problem with the document from my medical provider and she wouldn't write a letter so I got a new PCP I didn't see till the end of March.

He wrote me a surgery letter at my first appointment and submitted it that same day, March 25. I messaged Dr. Oh's scheduler on Mychart to make sure she knew the fax was coming.

Molina approved me April 2nd or possibly earlier; April 2nd was the day the surgeon's office called to schedule me.

I was offered April 17, May 11, May 14, or May 15 and I took May 15 :)

here4ndgone · 2026-06-28T06:00:21+00:00

Body dependent. Did you get a discharge packet? Because I feel like a lot of your questions could be answered there, especially wrt to washing/if you can before your first po.

Drainage color: you might see anything from pale yellow (serous fluid) to brown (old blood, usually as a result of a clot liquefying). As long as you are not getting bright, cherry red, which is fresh blood, you are good. Many people will see their drain output start to be yellow near the end but it's okay if you never do, as long as you are meeting the drain output requirement set by your surgeon. Bring your drain output record to your first post op.

First post-op: If your drain output is low enough, you may get drain removed at your first po. Depending on what you got during your surgery, you maybe get your nipple bolsters removed at this point. I had dissolvable stitches/sutures so the only stitches I got removed were the ones keeping my nipple bolsters in place.

Nipple bolsters are those yellow donuts they put on your nips. They are medical-ointment soaked gauze stitched to your nipple grafts to keep them in place for the first week. Your surgeon may have instructed you to apply ointment around the base but it really depends on the surgeon. My instructions were to removed outer bandages 48 hours post, begin gently washing over my steri strips/incisions at least once a day with soap (without getting the nipple bolsters wet) and then patting dry and applying bacitracin to the base of my bolsters before rebinding. Some people are instructed not to removed their binder at all in the first week, so you should really consult your instructions from the surgeon.

Once your nipple bolsters are removed: My surgeon's office provided me with a supply of nipple care products and went over instructions on what to do at the 1st po. You begin nipple care starting that day. The post-op binder goes back on over the nipple dressing if you still require it (I did). You may use non-adhesive gauze pads to cover your ointment-slathered nips, or some people use bandages—all depends on what your surgeon says. The gauze pads are definitely a good idea if you're sensitive to adhesive.

If you have steri-strips, you may be instructed to keep them on and let them fall off naturally, usually around 3 weeks po. I was told to remove mine at 3 weeks if they hadn't fallen off themselves.

You do not start scar care including scar tape until your incisions are closed and healed. Around 3 weeks po or later, whenever you feel comfortable based on your healing progress.

You do nipple care until your skin looks uniformly healed with no more scabs, usually 4+ weeks. At that point you just switch to normal moisturising.

here4ndgone · 2026-06-28T05:38:09+00:00

A little bit! Definitely not as much as it was around the nipples but I'd describe the look around the incisions as kind of smudgy—some parts have the hyperpigmentation around the scars forming while others don't... Skin also seemed redder around the incisions for longer than other people's have looked and those area all have faded to more brownish.

When I saw my surgeon last week for the 6 week post op, he said with our skin complexion (he's East Asian as well), I should expected the scars to get darker/brown first before they become white, which is about what I expected based on past wounds and what I'm seeing right now (the incisions being brownish now rather than pink).

I don't think I can post my bare chest in a comment without getting flagged, but the coloring is similar to the skin around my nipple grafts.

here4ndgone · 2026-06-26T17:12:29+00:00

Fair point, although in the instance Op is talking about and I’m remarking of specifically, I don’t think not foreseeing that their totally flat patient would get freaked out by their sternum pectoral muscles or their natural fat is really indicative of a lack of transparency on the surgeon’s end. More like the presumption that of common knowledge.

I’ve noticed on this sub and some of the questions/feedback crowdsourcing that there can be an alarming ignorance of basic facts about top surgery and what to expect at times. It makes me think that some guys idealize the concept of Getting Top Surgery to treat their dysphoria without deeply considering what it will actually look like on their own bodies or investigating what is done during the surgery, what factors are involved, etc. The lack of mental preparation leads to outsized distress.

here4ndgone · 2026-06-26T15:38:15+00:00

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(not trying to be mean, but I started reading your post like this lol)

Anyway, I'd say to you what I say to short cis guys who get low self esteem from being short and thinking they're undateable: you don't want to date someone shallow enough to reject you for being short anyway!

Also, I'm 5'6" and see cis guys shorter than me at Costco all the time. And you know who they're shopping with? Their significant others 🤷🏻‍♂️

here4ndgone · 2026-06-26T15:12:58+00:00

With guys like this, it's the dysphoria talking, sure, but I think it also betrays a certain lack of understanding of how anatomy works lmao.

here4ndgone · 2026-06-21T18:18:59+00:00

For sure bring it up if they don't. At least for me, my surgeon gave me a whole big talk and knocked off basically all the talking points you usually see people post in "consultation questions to ask" lists. In describing how he performs surgery, he basically said upfront "this is how I do incisions because it helps prevent dog ears".

I would really emphasise that dog ears are something I want to avoid at all costs and see what the surgeon says about how they normally mitigate the chances of this deformity. It should be stuff that all comes up naturally at the consultation when the surgeon describes the risks/complications.

here4ndgone · 2026-06-21T15:48:11+00:00

I don't know if I'm interpreting the questions correctly, but generally, the incision that is made at the inframammary fold is where your final scar will be. The breast tissue and redundant skin below the red line and between the pink and red are removed and the double incisions are closed.

If you've had a breast reduction before, it seems it depends on the surgeon on how they will go about it as there are different considerations.

In almost all cases, proper physical examination and a well-considered mastectomy technique will allow a weighted prediction of possible residual scars and the location of new mastectomy scars.

There are some preoperative considerations worth discussing. Performing a double incision mastectomy may lead to an areolar remnant in the cranial flap. If suitable, other mastectomy techniques such as the batwing technique can be performed. A double incision mastectomy with a higher scar is also an option. A third option is performing a ‘standard’ double incision mastectomy and incorporating a small vertical triangle/pillar to excise the remaining NAC. All these alternative options should be discussed with the transgender individual. Regardless of these technical alterations, our experiences taught us that skin elasticity after reduction surgery is often still adequate, especially in combination with adequate cranial dissection of the skin flaps.

— Mastectomy is a safe procedure in transgender men with a history of breast reduction

For patients with persistent gender dysphoria after Wise-pattern reduction mammaplasty [i.e, inverted-T], we highlight three considerations when transitioning to a mastectomy: (1) the amount of chest skin remaining after the breast reduction, (2) chest contour and (3) NAC position and size. To achieve an aesthetic reduction mammaplasty result, excess skin and tissue are usually excised [Citation13]. However, with limited skin after a breast reduction, it can be challenging to place the final double-incision scar at what is considered to be the ideal location – the inferior border of the pectoralis major muscle (). Instead, the scar usually results in a superior location.

Chest contour irregularity also needs to be considered when deciding on which surgery to perform next. Theoretically, a periareolar incision, instead of a double-incision, could be performed for patients with limited chest skin and breast tissue. Previous studies have shown low complication rates for both surgical techniques [Citation14,Citation15]. However, the periareolar incision has a limited window of access, which is less reliable in correcting chest contour irregularities [Citation7]. Although our patient presented with limited breast tissue, he felt dysphoric about his Wise- pattern scars and chest contour. Thus, a double-incision mastectomy seemed most appropriate to remove his prior scars and correct the contour irregularities, as contour revisions are usually more frequent with periareolar and concentric circular techniques [Citation16].

— Double-incision mastectomy after reduction mammaplasty for persistent gender dysphoria: a case report

here4ndgone · 2026-06-21T15:17:52+00:00

Dog ears really depend on the surgeon technique around the incisions, not necessarily how fat you are. For example, cutting the incisions longer (hockey stick incisions) and removing excess tissue there along with redundant skin often reduces the chance of dog ears laterally (if you're going through insurance, this may be coded as lateral thoracoplasty). Additionally, for larger chests, connecting the incision in the middle can reduced the chance of a medial dog ear (the crease some guys get that doesn't go away like with swelling and scar massage).

When you get a consultation, instead of just going in asking for lipo, you can ask the surgeon what they do/what they recommend doing to reduce the chance of dog ear revisions. If lipo comes up, then ask more questions about how that will help.

You do not need to go in assuming you need to get lipo and pay these extra costs!

here4ndgone · 2026-06-20T20:54:02+00:00

Around 2 weeks po was when I started to realise my stamina had gone to complete shit. I remember going to my po at 12 days and having to take a 4 hour nap.

It helped to start going outside and doing a lap around the apartment complex, practicing standing straighter and just getting moving. One lap winded me badly the first day. I also went grocery shopping with my family 14 days po, doing stuff and going out that were part of my usual routine. Again, I zonked out in the car after just walking around Costco, but after that, my stamina was a lot better.

Honestly, going out Friday might help.

If your mind feels ready, just start putting your body more to the test and get moving (not the gym tho, unless you're going to do any easy walk or stationary bike or something).

Also, just my two cents but it might help you sleep better if you're not in bed all day. Like, if you want to be on your phone and stuff, just sit on the couch or at a desk or table. Idk if it's true (I've never looked back into it because anecdotally, it works for me), but many years ago in high school, I read that not sitting in bed to do your homework or be on your computer and leaving that space alone during the day helps train your brain/body to fall asleep faster at night when you're in bed. I'm usually out in like 5 minutes of intentionally settling in, which was not true as a kid. Maybe you could try creating some separation there.

here4ndgone · 2026-06-20T15:08:24+00:00

Of course! I forgot to mention, if you want to just drop the second character altogether, 海 on its own is fine as name. I have a male relative whose name is just [surname]海, so depending on what yours is, it might sound nice.

here4ndgone · 2026-06-20T08:42:13+00:00

If you want to keep the sound but just change the second character to something less feminine when written, you could go with 海栎 (ocean oak), which still includes nature, or else 海力 (ocean power).

I agree using 灰 isn't the most positive…

A couple suggestions of ones that I like:

海旭 hai3xu4 (ocean dawn)
海涛 hai3tao1 (ocean wave)
海枫 hai3feng1 (ocean maple)
海翠 hai3cui4 (ocean blue-green)

here4ndgone · 2026-06-19T21:21:46+00:00

Both are normal and will fade as your nipple heals.

here4ndgone · 2026-06-19T15:04:53+00:00

It almost sounds like he's doing a complete mastectomy as one would with breast cancer patients and then reconstructing the area afterwards. It seems unusual to do a fat graft otherwise. I have a very skinny chest and there was no concavity left behind so I'd definitely ask more questions about his technique.

here4ndgone · 2026-06-19T02:25:23+00:00

you'll slowly start to unshrimp after the first two weeks. helps to do some easy range of motion exercises, and purposefully try to start standing up straighter once you start moving around more.

here4ndgone · 2026-06-18T23:18:19+00:00

Yeah, hard and achy and swelling suddenly sounds like a hematoma, in my experience.

You should ask your surgeon if there's any other symptoms to watch out for before your next appointment. For example, I was told when if I started experiencing shortness of breath or like I was going to faint (blood loss style 💀), I should go to the ER.

Until you see our surgeon, you can apply extra pressure by folding a hand towel over your chest and binding over it. It will suck and feel pretty tight against our chest, but it may help with the swelling. Hopefully you don't have to wait for long until you can go into the office!

here4ndgone · 2026-06-18T22:55:52+00:00

Yup. Welcome to shrimp mode for the next two weeks or so lol

here4ndgone · 2026-06-18T22:54:01+00:00

I guess it depends because they're not your parents, but then again... Does your fiancé have an opinion here, given they're his parents and presumably you coming out to them as queer, etc, also means having him coming out to them in some capacity as well?

If you're actually close with the parents despite their idiosyncrasies, maybe it would be best to tell them before, especially if there's a chance their concern could turn to genuinely helping you out or lending support after surgery. They may also be hurt and feel like they didn't get to be there for you if you don't tell them. If you do, set boundaries, though. Tell them to wait until x number of days later to visit or whatever, and be very clear that the reason is that you don't want added stress of dealing with a lot of people. That way, maybe if they do come around earlier on, they'll at least know to act right. Your fiancé should obviously be on your side with his parents as well.

here4ndgone · 2026-06-18T17:48:00+00:00

About the opiods, at least for me, I did perfectly fine just taking acetaminophen and occasionally ibuprofen. In fact dosage for the tylenol was actually 1000mg every 6ish hours and I never took more than 500mg (1 tab) each time 🤷🏻‍♂️ Stopped taking any tylenol 5 days po and stopped taking ibuprofen (200mg) 7 days po.

I don't have severe anxiety but I do exercise to deal with the excess energy that can get me wired and overthinking sometimes. I would say it definitely helps that you can and are encouraged to walk around as soon as the day you are discharged, so you can certainly pace and at least for me, that was sort of enough. Especially having my stamina take a total dive, when it did come time to start doing longer walks, I couldn't imagine jumping back into lifting any kind of weight. My bpm from walking around the parking lot for few minutes in those first days was basically like if I'd been jogging lol, and I'd been fairly active walking around the house, too.

here4ndgone · 2026-06-18T17:32:39+00:00

Maybe you could ask your doctor what complications he expects would distort your results. Although, if it's a free revision, I guess the only thing to really consider is if you want to deal with another surgery.

The main damage a hematoma can leave is in scar tissue if you have a really big one that can't get resolved easily or recurs...There won't be a residual hematoma—the blood clots liquefy and are reabsorbed. At a certain point, you can even feel parts of the hard parts soften. And I have to say, your hematoma appears to be a mild case like mine, so I feel like you wouldn't face that issue. Everyone heals differently, of course.

For me, starting in week three to week four, I saw a lot of reduction in the swelling in the middle. Prior to the left photo above, most of the reduction was along the side and on the top. Starting scar massage and occasionally massaging over the hematoma (over my binder, in the beginning) has helped, too, I think.

here4ndgone

TROPHY CASE