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Questions To Ask At a Top Surgery Consult
There's a lot to consider when choosing a surgeon for Top Surgery! Once you finally get to your consult day, you'll want to make sure that you use that time with the surgeon wisely, asking every question you can think of that will help you make an informed decision. To get the most out of your consult, here's a list of questions to ask your prospective surgeon.
It's important to remember that these surgeons are WORKING FOR YOU. That's right, you're the boss! It's your right to ask questions and there's no such thing as a dumb question! Regardless of whether or not you're paying out of pocket, your surgery is an investment that will determine what your chest looks like for the rest of your life. If you start feeling rushed during the consult, it's OK to ask to slow things down. If you get pushback for that, consider taking your business elsewhere.
Some surgeons offer an initial phone/Skype/FaceTime consult while others will require an in-person consultation. You'll probably get more out of the latter as that will allow you to review before and after photos in person and get a better gauge of the surgeon's personality and whether or not you think you're a good match to work together.
Bring your questions with you to your consult either on your phone or in writing. Consider asking if you can capture an audio or video recording of the consult so that you can focus on the conversion with the surgeon instead of having to write a lot of things down. That said, having a pen and paper handy in a consult can be helpful as your surgeon may be able to explain certain details with drawings. You can also take someone with you to your consult to help you remember what the surgeon says.
Some of the answers to these questions can likely be found on the surgeon's website so be sure to give it a thorough read-through to optimize your consult time.
Without further ado, here's the list of questions to ask at your Top Surgery consult! Feel free to copy-paste, edit to your needs, and print it out to bring it with you when you meet with the surgeon.
SURGEON EXPERIENCE
Are you board-certified? As a Plastic Surgeon or General Surgeon? (See Surgeon Credentials)
Are you a member of WPATH?
Do you have specific training in gender-affirming surgeries?
How long have you been working with transgender/gender-nonconforming patients?
Do you work exclusively with transgender/gender-nonconfirming patients?
How did you get involved with trans healthcare?
Have you attended any transgender conferences?
How many Top Surgeries have you performed?
How many Top Surgeries do you do per week/month/year?
Will you be doing the surgery yourself or will less experienced surgical residents take part?
Will you provide a letter for getting my gender marker changed on ID documents?
What kinds of gender-affirming practices has your office adopted? Will I be referred to by my preferred name and pronouns?
PROCEDURE
What types of Top Surgery procedures do you offer?
Is there a Top Surgery procedure that you prefer?
What Top Surgery procedure do you think would best suit my needs and goals?
What are my options for scar shape and placement?
Where will the nipple/areola complex (NAC) be positioned?
How big will the areola be? How big will the nipple be?
With Peri-Areolar/Keyhole, can you do a nipple reduction during the initial surgery?
Will you perform Double Incision without nipple grafts? (No-Nipple Result)
Do you use Drains? Why/why not?
Will my surgery include male chest contouring/liposuction? Is there an extra "cosmetic fee" for this?
What techniques do you use to reduce the chances of Dog Ears?
How long will the surgery take?
What type of facility will my surgery be performed at? (Ex. Ambulatory/Day surgery clinic, local hospital, academic medical center.)
Do any of the nursing staff at the facility have specific training for working with transgender/gender-nonconforming patients?
TOP SURGERY RESULTS
Can I see a portfolio of before/after photos for your patients? (If the answer is no, consider finding another surgeon.)
How much long-term follow-up do you do of patients, in terms of determining patient-satisfaction?
How much nipple sensation should I expect?
RISKS & COMPLICATIONS
What is the chance of developing a hematoma?
What is the chance of developing a seroma?
With Double Incision, what is the risk of losing a nipple graft?
What other complications am I at risk for?
What symptoms should I be on the lookout for?
Who do I contact if I think I have a complication?
If a complication happens, what is the protocol for managing it?
There is a family history of breast cancer. What do I need to know about this with regards to Top Surgery?
Do any of my medical conditions increase complication risks?
PREPARING FOR SURGERY
Can I take THC or CBD in the weeks/days before surgery?
Do I need to stop taking Testosterone before surgery?
Do I need to stop taking any other of my medications before surgery?
Will I need to have any blood work done or do any other lab tests prior to surgery day?
Will you be providing detailed, written pre-op and post-op instructions?
Is there a pre-op appointment prior to surgery day?
SURGERY DAY
What type of anaesthesia will be used?
Will I meet with the anesthesiologist before surgery?
How long will I be put under?
Who will be in the operating room?
Will anyone be providing updates to my caregiver during my surgery?
Will I be able to go home the same day as my surgery?
If being released the same day: How long will I need to stay at the surgery center after I wake up?
Does the surgery facility have an on-site pharmacy where my caregiver can pick up my post-op medications?
RECOVERY
If coming from out of town: How long will I need to stay in town after surgery?
If coming from out of town: Do you have arrangements with any hotels for reduced-cost stays for patients?
When will my post-op appointments be?
What medications will I be prescribed after surgery?
I can't take opioids. What are other options for pain management?
Can I take THC or CBD during recovery?
Will I need to wear a binder after surgery? If so, for how long?
When will I be back to normal daily activities?
How soon after surgery can I be on a plane?
When can I go back to work with a [desk job/physical job]?
When can I go swimming?
When can I use a hot tub?
What do you recommend for scar treatment?
REVISIONS
What percentage of your [Double Incision/Peri-Areolar/Keyhole] patients have required a revision?
Do you provide free or reduced-cost revisions if they're necessary?
Are revisions done typically with local anaesthesia or general anaesthesia?
REQUIREMENTS
What letters do you require?
Do you have a BMI requirement?
Do you require a mammogram?
PAYING OUT OF POCKET
What is the total cost? Does it differ by procedure?
Does this include the surgeon's fee, facility fee and anesthesiologist fee?
Does the cost include a post-op binder or any medical supplies?
Does the cost include post-op appointments?
Is there a down payment required to secure a surgery date?
Does the cost need to be paid in full before my surgery date?
Do you offer a payment plan?
Do you accept medical financing via CareCredit, etc.?
How much should I budget for post-operative medications?
INSURANCE
What types of insurance do you accept? (Medicare, Medicaid, private insurance)
How much success does your office have getting pre-authorization for Top Surgery insruance coverage?
If you don't take insurance, is your office able to assist with filing for an insurance reimbursement?
Last updated: 11/14/2022