top surgery: the basics

Top surgery is an aesthetic procedure performed on the chest to remove breast tissue and achieve a masculine-looking chest; top surgery for transgender females is the aesthetic procedure that creates feminine breasts or increases their current breast size. Typically male chest reconstruction is performed on female to male patients but can be offered to non-binary people. Top surgery is one of the few forms of treatment for those diagnosed with 'gender dysphoria'. Other treatments include- bottom surgery (gender-confirming surgery) and hormone replacement therapy (HRT). 

If you're looking to get top surgery, you have several options to choose from, depending on your preferred gender. 

Female to Male (FTM) & Female to Non-Binary (ftn);

• Double Incision with nipple graft
• Periareolar 
• Key-Hole Top surgery

Male to Female (MtF) & Male to Non-Binary (mtn)

• Breast Augmentation
• Augmentation mammoplasty

Generally, breast augmentation is much cheaper than any FTM surgery as breast augmentation is a common surgery done at most aesthetic clinics. The patient won't require to go to a transgender specialist for this surgery. On the other hand, transgender-males must visit a transgender specialist clinic to get top surgery (in countries like America, this is different). 

Average prices for each surgery:

Ftm top surgery; £8000 (depending on chest size)
Breast Augmentation; £6500

Depending on where you live in the world, you might be able to get your surgery covered by your health insurance or via the National Health Service (NHS). It's worth checking with your insurance whether they'll cover the costs for surgery before booking your first appointment. 

Even though I live in the United Kingdom, I personally did not receive care under the NHS. At the time, I waited for three years for my first appointment, so I decided to go private. Mr Inglefield, who works under the London Transgender Clinic (LTC), performed surgery on my chest at Queen Anne's medical hospital. I would 100% recommend the LTC for their exceptional services and aftercare that I received post-surgery. 
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Preparation for your surgery is essential! Post-appointment, the surgeon may require you to; stop taking your testosterone; have a breast x-ray; have a breast examination; eat healthily; stop taking ANY recreational drug, alcohol or cigarettes. Though do not panic if you don't want to stop your hormone treatment, generally you don't have to stop taking your HRT as it has no medical evidence of hindering your chest healing. Be aware that you may have drains coming from your chest post-surgery; these can become annoying if you don't wear an oversized t-shirt (try not to wear a shirt that goes over your head - you will not be able to raise your arms).

You may be required to stay overnight for your surgery; if you're having surgery under the NHS, then you will be there over three days. Ensure that you pack enough clothes for an overnight stay, even if you're not planning to stay it's always good to pack an extra pair of clothes if you want to wear a more oversized shirt after surgery.

You should expect to be in pain after your surgery, and you will be given strong pain medications to ease this pain for the first two weeks. I was given co-codamol four times a day; do not take any strong medications without consulting your GP first as you may become addicted to the medication. Shooting pains will happen for at least three months after surgery, you shouldn't have to take any medications for this, but paracetamol is more than enough to ease these pains. You may be uncomfortable from the drains, it's uncommon for the drains to hurt but from my own experience, they irritated my skin so much that it began to hurt. However, I did have my drains on for an extra week due to excessive bleeding. Drains are important because they prevent your chest from building up blood which could require another surgery.

Going back to everyday life after surgery can take some time, the clinic will provide you with a time ratio of when you can ease into certain activities again, but you will be required to take between 4-6 weeks off work.

It's important to remember that in some countries, such as the U.K, you will need to be diagnosed with gender dysphoria and have a psychiatrist note to have top surgery as this is a major operation.

-Cody

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