Top Surgery Consult - Questions to Ask Your Surgeon
I wanted to share a list of things to ask your surgeon about at your top surgery appointment. I couldn’t find a comprehensive list, so I’ve compiled what I think are the most important things to ask. This was mostly for peri-areolar surgery, however most of the questions still apply to most surgeries. If you are having another type of surgery, you will want to address nipple placement, nipple size, and scar type as well.
******Tell them your goals for the surgery. (size, nipples, scars, etc)
General Questions
Surgeon Specific
If in the US, make sure they are board certified. I believe in England specialists are registered through the GMC (General Medical Council). Just make sure they are. (They should have a certificate showing this hanging on the wall usually, but if not, ask)
How did you get involved in trans healthcare?
How can we make sure I’m the safest I can be to have this surgery done? (You will want to let them know your health history, medications, alcohol use, vaping/smoking, THC use, and if you are vegetarian/vegan)
How many years have they done these surgeries?
How many top surgeries do you do a month? (the more the better because complications are fewer when people do more of the same procedures)
How many peri-areolar top surgeries do you do a month? (Or how many of the specific top surgery you are having do they do per month)
Ask for before/after pictures of surgeries they’ve performed (NOT just group practice photos - photos of their actual patients so you can see their actual work). These should be specific to the TYPE of surgery you are having. If you are having peri-areolar, you want to see those pics. If you are having another type of surgery, you want pics specific to that type.
My Surgery
What type of anesthesia will be used and how long is the actual surgery? How long do I stay in recovery before discharging home?
Where will I have my surgery?
Will staff honor my name/pronouns before/after surgery? (especially if you are going to a general hospital for the surgery….and just having nurses from the hospital take part in your care vs. if the surgeon has their own surgery center which might have more experience with trans healthcare)
Will you be performing the surgery yourself or do you have residents or students that will either assist or perform the surgery under your direction?
Will my procedure include male chest contouring?
Nipple sensitivity - ask for details. How much nipple sensation can I expect? If pierced, do you have to remove before surgery? If not pierced and you want them pierced, how long before you can have them pierced?
Breastfeeding - it will likely impact the ability to do so in the future, but if this is a concern, ask.
Testosterone use before surgery - do you stop it? Tell them all your meds, and ask if you stop any before the surgery and when you restart them
After surgery
Pain control following surgery - what is the plan? What will be prescribed, how often, and for how long? If narcotics use is an issue, ask if there is an alternative plan.
Restrictions after surgery - how much can you lift and when? When can you travel? Will you be wrapped after surgery? How long before the wraps come off? How long before you can shower?
For those with mobility concerns - If I need to use a cane or walker after surgery, when is that allowed and anything I should know?
Drains - what is the care for them and when do they come out? Do you go in the office to have them removed? If they don’t use drains, why? If not, do they use internal progression-tension suture technique?
How long do you need to stay with someone to help you?
What are plans for scar management and swelling after surgery?
If peri-areolar - can you have nipple reduction (if desired)?
Will you have staples/sutures that need to be removed? Does the surgeon do that or your PCP?
If I need to get a hold of you after hours after surgery, how do I contact you?
What adhesives are used? Can I do a strip test prior to ensure I’m not allergic (they just give you some glue or whatever, you apply to your forearm or chest and make sure you don’t react. Adhesive allergies are a bear to deal with, so you want to know beforehand if possible)
Follow up care - how many times do I see you after surgery and what is done at those follow up visits?
When can I restart vaping/smoking?
Complications and Risks
Most common complications and risks (infection, rippling, seroma, hematoma, stitches popping, rippling etc…)?
Do they handle all complications or would you be referred to PCP for care? Ex: seroma needs drained, does surgeon do it or do they require the PCP to handle.
What is a reasonable expectation for scarring? And how can I minimize scarring?
How many patients require additional surgery (percentage)?
How are revision surgeries handled? (How long before they are done, costs - some surgeons do for free but only for 2 years, some charge full or ½ cost, etc.., timeline)
Surgeon’s personal rate of infection?
Surgeon’s personal rate of complications?
The last question:
With my goals for the surgery, do you feel that we are a good fit and that we can achieve my goals?
Make sure they answer all your questions! I hope this is helpful.
