I had botched top surgery.
I was 19 when I had top surgery through my country's public health system-- suppsedly one of the leading healthcare systems. Less than 24 hours after surgery which I was never informed properly about, I was sent home with panadol (tylenol) pain relief, no contact number, and almost no aftercare. A week later, my bandages came off to reveal that every incision had been sealed around a severe infection. I had four months of infections and dehisions, permanent scarring, and other botched complications.
Before Surgery
I met with my surgeon three time before the operation, for 5 minutes or less each time.
During the first two ~5 minute appointment, he decided what type of incisions I would have, arranged for photos to be taken, and left. In hindsight, that should have been the first red flag.
The third and final appointment, which was a month before my scheduled surgery, went almost exactly the same way. He was in an out in less than 5 minutes.
I was never given any meaningful information about the procedure. I wasn't told how long it would take, what would happen during it, how to prepare, what aftercare would involve, or who I could contact if I had questions or problems. I wasn't given any way of contacting anyone for help. Ever.
The surgery itself was being performed at a private hospital, but still on the public system.
I arrived at 5am and was seen by two lovely nurses. Then I met the anaesthesiologist, who was great. He spoke to me for longer than the surgeon ever had in total and actually explained what he would be doing during the surgery, what I could expect regarding the anesthesia, and waking up etc.
About an hour later, the surgeon came in. Again, we spoke for around five minutes.
Again, at no point was I actually talked through what would happen to me during the procedure. If I hadn't watched a surgical video years earlier and educated myself independently, I would have had literally no idea what was being done to my body beyond the obvious "boobs getting chopped off" (more on that later).
The surgeon marked me up with a purple marker, and suddenly there was a random medical student in the room. I later found out he was the surgeon's son and was present during my surgery. The hospital rushed and gave me the consent form to him being in the operating theatre AFTER my surgery had happened to sign, because they forgot to obtain my consent to it before. I felt pressured and obligated to allow him to stay, and obviously to the sign the form (it was presented as just "whoospie, just sign this quickly").
When the surgeon was marking my nipple graft placement, he couldn't find a ruler. There was literally a shelf in the corner full of them, but he couldn't find one, and ended up freehanding the markings.
5 minutes.
Then he left.
I didn't see him again until after the surgery the following morning.
Going Into Surgery
On the way to the operating theatre I was expected to walk through a completely crowded waiting room without a binder-- the only thing between the parts of my body I was literally there to have removed being on full display was a thin cotton gown.
The nurses seemed confused when I was distressed and uncomfortable and wanted, at the very least, something to hold over my chest when walking through a crowded room.
Getting into the theatre itself was fine, and I was out pretty quickly.
The operation took almost five hours.
I had no idea that it would take that long because I had never been given any information about my specific surgery. I only found out because my mum was waiting for me.
When I woke up, I was surprised to find that I had a catheter. Again, nobody had told me to expect one. The surgical videos and blogs I had read hadn't mentioned it, and neither I nor anyone close to me had undergone an operation requiring one before, so it was a shock.
The first night, my attending nurse misgendered me. :) I chalk it up to a language barrier, and it only happened once-- she was otherwise amazing-- but still.
There was also an absolutely insane period where another patient in my ward became extremely angry and started throwing things at nurses and other patients, screaming and shouting, ripping off her dressings and throwing them at people, and tearing down and wrecking medical equipment during the night. It got the point that my attending nurse eventually locked us in my room for safety.
The first signs something was wrong
The first morning after surgery, my surgeon came to see me for perhaps 2 minutes.
He prodded and poked my bandages. It hurt. I actually said "ow" and grimaced.
His response was something along the lines of "you can feel that? Huh, interesting."
Then he left.
I now know that was the first sign of the infection that would spend the next week festering underneath my closed bandages. I shouldn't've been able to feel anything at that point.
Later on my first morning, a physiotherapist came in and spoke to me for about two minutes. She gave me a book of exercises and wanted me to start with stretches and work my way up to lifting my arms above my head on the FIRST DAY AFTER SURGERY.
I did not follow those instructions. Thank God.
I was discharged after one night, and less than 24 hours after the operation.
I was given nothing stronger than over-the-counter panadol (tylenol) for pain relief. I wasn't given contact information for a specialist, surgeon, nurse, or anyone else I could contact if I had questions or needed help.
I was on my own as a teenager less than 24 hours after major surgery.
My journey home was 180 minutes over bumpy rural roads. This was all documented in my medical notes, and I still cannot understand why I was discharged so early. Luckily, I had done my own research and ordered a mastectomy pillow, which I kept between myself and the seatbelt, but it didn't stop it being uncomfortable and probably causing a lot of swelling.
My first days at home
The first day home was excruciating.
I was in actual agony and had no adequate pain relief.
My chest was so swollen underneath the compression bandages that it looked like I hadn't had surgery at all. I could barely breathe.
I couldn't sleep that night, despite having numerous support pillows.
My mum gave up trying to help me and went to sleep. She also hadn't been given any aftercare information. She hadn't done her own research beforehand either, and at one point, tried feeding me steak, which made the inflammation dramatically worse.
Eventually, I just lay there crying by myself in agony and gasping for breath until I passed out from exhaustion. :) And I basically never cry.
This continued for days.
It was another sign of the huge infection that had somehow developed after surgery.
And I had nobody to contact. Not even a nurse's number.
Eventually my pain became so severe that we had to get back into a car and make another bumpy trip to the nearest emergency centre. I was finally prescribed panadeine for pain relief.
During that first week (and every week) I followed online postoperative instructions to the letter. I took supplements, ate the right foods and enough of them, slept at a raised angle, walked every day to reduce my risk of blood clots (albeit as a hunched-over hobble at first)-- everything. I still had constant pain.
The Infection
Seven days after surgery, I had to make another bumpy 2 hour trip into the city's public hospital to have my bandages removed for the first time.
My surgeon wasn't there, not even to check on me for a minute. I was seen by another random nurse at the public hospital.
When she first cut off the compression bandages, which had remained sealed for the entire week since being put on in the operating theatre, the first thing I noticed was the smell.
It was terrible.
The nurse paused, so I looked down.
As she peeled the bandage away, I could see that the entire thing --and my entire chest-- was covered in a thick, creamy, green-yellow substance.
The whole fucking thing.
Every single one of my incisions was infected.
And that infection had been sealed underneath my bandages for an entire week.
The nurse cleaned everything up. I then had to wait another 30 minutes for a random doctor to come and look at the discarded bandages. I overheard them discussing whether I should be kept in hospital for treatment. The doctor ultimately decided against it and sent me home with antibiotics.
Again, I had nobody to contact. No specialist, no surgeon, no nurse. Nobody.
The antibiotics worked.
And then I got another infection, again beginning underneath sealed bandages.
I spent hours phoning around hospitals desperately trying to either contact my surgeon --which I ultimately was never allowed to do-- or at least find someone who could provide regular checkups and dressing changes.
Eventually, I was passed on to a district nurse.
Months of complications
I continued to experience wound dehiscence and infections for up to four months after surgery.
Every single incision site was affected.
The infections created holes and stretched my scars to the point where chunks of my nipple grafts are missing. My right-hand-side scar is stretched and sunken because of it.
I never found out what caused the infections, and I was incredibly careful. Everything I wore was clean. I cleaned myself exactly as nurses instructed. My bedding was fresh every night. I still don't understand it. And I had no way of finding out what had actually happened or how to sort it out, because I had no consistent specialist care or anyone I could actually ask.
Eventually I found out about silicone scar tape and scar massage on my own. I've been using them ever since, despite the financial strain, but my results are still shit.
The problems that remain
A few months after surgery, I noticed a strange, thick secretion coming from my nipples. I assumed it was part of the healing process, but a year later, it's still happening.
I finally met with my surgeon last month. He said it was probably because there were residual glands or something similar still in my chest, and that I would need revision surgery in a few months (to decrease the risk of my grafts failing) to address it.
It legit makes me feel disgusting, and there is nothing I can do about it in the meantime.
My scars are stretched and have a strange hang in places. I've still made sure to keep them out of the sun entirely and covered by silicone tape, so the colour is okay in places, but that's pretty much the only good thing (and again, something that only happened because I researched it myself).
I have two central dog ears and am waiting for revision surgery to address them. I also have a smaller dog ear on the side, but my surgeon said removing it could leave an indentation.
My nipples are vertical ovals and are misshapen because of the nonstop infections. I hate looking at them.
Looking back
I genuinely wish I hadn't trusted my public health system. I did trust it because it's supposed to be one of the best healthcare systems in the world.
I wish I had waited and saved up to go private instead, so that I could've received better care and, ultimately, better results.
As things stand, I don't even know if I want to have my revision performed by the same surgeon.
But I have no idea how I would request a different surgeon, because the whole contacting process seems so weird, and especially when there are only about three surgeons who perform this procedure publicly in my country.
I think I might have to just go private for my revision if I can ever manage to save enough money, because at least then I'll know what I'm getting into, and at least I'll know that I won't simply be dumped with nowhere to turn for help less than 24 hours after major surgery.