Update on Brooke’s Surgeries

It has been just over 6 months since I had my vaginoplasty and about 2 months since my breast augmentation so I would like to provide an update.

Bottom Surgery

At 6 months, I’ve really started to get used to having my new parts.  Most of the time it is easy to forget what once was, but rarely a day goes by that I’m not amazed at what I now have. It’s kinda hard to forget the change as I’m reminded every time I need to use the washroom.

Now that everything has healed, there is little change day-to-day. I’ll still expect some small, almost imperceivable differences as the scars will hopefully become less visible and the swelling will continue to improve.

One of the biggest differences for me at 6 months, and anyone that goes through GrS Montreal for bottom surgery, is the decreased frequencies in dilations from twice a day, down to one.  You wouldn’t think this would make such a difference, but getting my evenings fully back does make the whole day better.  My routine is to get up in the morning and then complete the only dilation of the day and then forget about it until the next day. I won’t see another reduction in frequency until I’m at the 1-year mark, but I feel like I can survive at once a day for now. It’s hard to imagine completing the 4 dilations a day like I did right after surgery.

I do have a couple of concerns about the result of the surgery and the biggest concern to me is the lack of sensation/enjoyment around the area.  There are still a few numb spots, and nothing really feels good down there.  It doesn’t feel bad, it just doesn’t feel good like I imagined it too.  It is very common for the sensations to return to normal slowly and in some places I’ve read, it can take up to a year.  I’m hoping it does come back sooner than that though… for obvious reasons. My second more minor concern is that, according to my family doctor that completed an internal examination, is that there may be hair or two growing within the canal. There was always a risk that this might happen as GrS Montreal does not require full hair removal prior to surgery as they cauterize the hairs as part of the procedure. I’m not sure what complications that this may cause down the road but I have been told that these can be removed with tweezers, which doesn’t sound like a whole lot of fun.

Top Surgery

For the first month after breast augmentation, things just look and feel a little funny. When the implant goes in and under the muscle, it just pushes everything up.  With that and the swelling, the placement and visual is just all wrong.  Now that I am about two months in, the shape is getting closer to normal but there is still a ways to go.  I believe it takes 6 months for them to settle to their final position.  You can see from the image that I was given (these are not pictures of me), how the shape will change over time. The second picture from the left is similar to how it looked right after surgery, and the third from the left is closer to how it looks now. The swelling also makes everything very tight early on.  The skin is stretched and there is little give to the shape for the first few weeks.  I’m just now starting to be able to move and push into the shape.

The instructions I was given when I left the hospital in Montreal was that I would have to wait until at least 1 month before I could start wearing a normal bra.  The one that was given at the hospital is a little oversized and only somewhat supportive.  The instructions also said that I would have to wear this day and night for the first 2 weeks and only after the second week, I could take it off in the evenings.  I found this challenging as it was not very comfortable. There is also the need to wash it more frequently as it was using it all the time.  Luckily, in the times where I needed some support but also needed to wash the surgical bra, we found an old sports bra that Cathy didn’t use any longer that worked.

About 10 days after the surgery, I had a follow-up call with Dr. Belanger.  This allowed me to ask a few questions about the things I should be doing post-op. She agreed that I should be wearing the surgical bra every day until one month but I could start removing it at night if there wasn’t too much discomfort. She also mentioned that I could switch over to a regular bra at 1 month but avoid buying anything with an underwire until about 3 months.  I also left the hospital with two steri-strips (bandages) covering the incisions made for the implants.  I was given instructions to remove these after 2 weeks if they did not come off on their own. The last thing that I asked about was regarding sleep positions.  I hate sleeping on my back and as I left the hospital I was told that I would need to sleep on my back only for the first 2-3 weeks after surgery.  I used the trick of rolling up a towel and lying on it so there was a bit of a tilt, but it was still not sleeping on my side. When I asked Dr Belanger, she understood where I was coming from.  She mentioned good rest and sleep being very important to recovery so if it would help, I could try sleeping on my side as long as I did not feel discomfort. She did say that sleeping on my stomach would not be possible for a few months as there was still too much risk.  That night, I was sleeping on my side. There was very little pain so I felt this would be the way to go.  I have always been a stomach-sleeper first and side-sleeper second, so I look forward to being able to sleep on my stomach in a couple of months. This is of course, assuming that it will be comfortable at all now that I have a larger mass up front.

One of the branches of conversation that Dr Belanger and I had on the call was regarding the lack of pain. I felt like I had the ability to do more even though there were strict instructions not to lift anything more than 10 lbs for the first month.  I was finding that I was having little discomfort and I told the doctor that I feel like I could do more as there was not much pain or strain. Her response told me what I needed to know. The restrictions were not related to pain though there was some risk of damage to the area if I lifted something very heavy.  The biggest concern was that the use of the chest muscles could force the implants further to the sides of the torso and then there would be a larger than normal gap between the breasts.  That set me straight and I took it easy for the rest of the first month. Having a larger than normal torso for a woman, I didn’t need my breasts to be any further apart than they already were.

After the first month was done, I finally got to go bra shopping. Though my breasts haven’t settled into their final position, the size shouldn’t change much now that the swelling has mostly died down.  It might not seem like a big deal to women in their 40s who are AFAB, but this was an exciting moment for me.  Finally, I was getting a bra that was going to be a normal size, that I could try on in a store.  I didn’t get anything fancy though.  I really just focused on finding out what my size is and finding something comfortable.  At the store I was shopping at, it turns out I’m a 38C.  It’s quite a difference from the 36A that I had been wearing. I’m sure someday I’ll be one of those women who can’t wait to get home to take off their bra, but for now, I’m loving every minute of it.

Funding

I have some good news and bad news. Up until now, there has not been any funding in our province for any other surgeries aside from bottom surgery for trans women. Though it was not likely going to be approved, I decided to go through the process to see if I could get the funding through the provincial health care. I provided as much information as I could. There were measurements that I have been making throughout my journey, my HRT prescription amounts, all of my blood work hormone levels included. I even had letters from my therapist and family doctor to suggest that this was something that I needed. Throughout the process, my therapist reminded me that it was not likely that it was going to be approved, and even if the province agreed it was necessary, they might not provide any funding if the surgery was not performed in the province.

I started the application process back at the end of July. At that time, I already had my consult with Dr. Belanger in Montreal while I was there, and I set up additional calls with the two surgeons in our province that would perform breast augmentation. Before I went to the consultation for either, which would be at my own cost, I did a little research into these surgeons. It turns out they perform many gender affirming surgeries, but most of the top surgeries they perform are for trans men. I was told that it was very rare for them to perform breast augmentation for trans women. That didn’t give me a lot of hope or confidence. On top of that, the consultations weren’t going to happen until March 2025 at the earliest. Then there is the wait time for the surgery. At this point, when I didn’t expect to have any real potential to get any funding from the province, and knowing that the costs were nearly identical, the experience in Montreal was vastly superior, and I could also get in for surgery in Montreal in October 2024, the choice for me was obvious.

Fast forward to November 2024, I just had my surgery in Montreal a couple of weeks prior and I get a phone call from my doctor’s office. It turns out, that my funding application had been approved. I didn’t know what to think. In the letter it states that as I was an “exceptional” case, the province was willing to pay for my surgery. I made a few phone calls trying to figure out what that meant now that the surgery was already done. When I reached out to GrS Montreal, they told me to sit tight, they will see what they could do for me. After a few weeks of waiting and repeated calls for an update, I was finally informed that even though I was approved, because the surgery was performed out of province, I would not see any funding from the province after all.

In one respect, I’m happy that I was able to prove that it could be done. I’m a little upset though that I will not see any financial help. Regardless, I’m still happy with my choice. I needed to make sure I was with a surgeon that is familiar with trans women and our unique situation and body shape. I just wish that there was something else I could do.

So now that I’m a couple months on, I’ve really started to get used to everything.  I still notice my surgeries from time to time like when I’m reaching across myself or getting dressed in the morning.  The absolute best is when seeing myself whole now.  Looking down, everything finally appears as it should.  Just have to lose 20lbs or so… lol.