Top Surgery: 1 Year Post-Op Follow-Up and Mini-FAQ

After posting pictures about my 1 Year Milestone, I got lots of questions spanning a variety of topics. I figured it’d be more useful if you can find them all in one place, at least the ones relating to top surgery. Here goes.

How do I go about getting top surgery?

Do your research. I also wrote about the process of getting top surgery a while back.

When did you fully recover from your surgery?

This is a multi-part question. I blogged during the first 7 days of the surgery, after which I went home. By the end of the 2nd week I was fine, and by the end of the first month I was pretty much up and about my usual routine. My physical activity for the first 6 weeks was very limited, and I eased into regular exercise between weeks 8 and 12. As you can see from the pictures, the swelling and puffiness in the chest didn’t really go down until after the fifth month. It really does take about 6 months for things to completely settle.

In the last article there is a timeline of my top surgery blog posts which should cover a lot of the details you might be looking for.

Is your chest presently uncomfortable?

Not at all! I haven’t felt this good in forever, both physically and mentally. It took about 1-2 months before all the pain and discomfort completely disappeared, about 3-4 months before the general soreness and extra sensitivity were gone (which was very minimal), and about 6-8 months for the swelling and puffiness to go down completely.

One concern both of mine and my girlfriend’s was that we’d be uncomfortable with the scars – but it surprisingly wasn’t an issue at all.

Do you have sensation on your chest?

Yes, I can feel pretty much everything – my chest, my sides, even around the scars. In my opinion it feels much better than before.

Do you have nipple sensitivity?

If it’s “do I have sensation in my nipples” – then yes, I can feel stuff the same as before. On the other hand, I am asexual, so I probably don’t experience or care about “nipple sensitivity” as others do – in that way. My nipples were the last thing to stop hurting, they were still a little sore and sensitive for 3-4 months. Other people report that they do retain sensitivity. In theory this is one of the benefits that the T-anchor technique has over the other techniques.

Who was your surgeon?

I went to Dr. Paul Steinwald in Lake Forest / Chicago, IL. He was my top choice and I am extremely pleased with my results and his work.

Which surgeon do you recommend?

Obviously since I am happy about how things turned out I recommend my own surgeon, as I believe it was the best choice for me. There are many other options, and I only have direct experience with one. But from analyzing pictures and reading stories from other people there are a few I would recommend, and a few I would advise against. Just do your research.

How do I choose a surgeon then?

It takes a while to inform yourself thoroughly, then build up an opinion. You can start by narrowing down your priorities: aesthetic, financial, geographic, non-binary friendly, requirements, etc. For instance, if you have a strict budget, then considering a cheaper or local surgeon will take priority over anything else. Try to do some browsing – lots and lots of pictures, and reading about others’ experiences – and then start narrowing it down and picking the ones you like. It’s a long process, and you’ll be learning all the way, so don’t feel rushed.

Should I get a breast reduction or top surgery?

I also wrote about this question here.

The main points to recap are: a) breast reduction is not a “lesser” surgery than a male chest reconstruction, and b) do either one only if that’s what you want. Figuring things out takes time, so give yourself that.

Were you on Testosterone before surgery?


Are you on Testosterone now?

Yes, I’ve been on a low dose of cream-based T for six weeks.

How did you get the letter from the therapist?

I didn’t. I never saw a therapist until quite recently. For many surgeons you don’t need one, and with the new Standards of Care this “requirement” should soon become obsolete.

Did you out yourself or did you lie about your gender?

No, I did not lie. Actually, my surgeon couldn’t care less about my gender, and he didn’t really ask. On the plus side, I did receive a letter confirming it was “gender reassignment surgery,” should I ever require it for legal paperwork purposes, such as for changing my legal name or legal gender. As mentioned above, there are many surgeons who do not specifically require anything gender-wise, only your informed consent.

What was the cost?

Costs of top surgery typically range from $3,500 to $9,000, plus travel expenses. Mine was on the high end.

Did your insurance cover this?

Ha! No. 😦

Can I get it covered by my insurance?

Top surgery and insurance are tricky. I’d say that in the majority of cases it is not covered by insurance. But there are some people who have managed to get their top surgery fully covered, either because their policy is trans-inclusive or they find a way around it. As a side note, it is even trickier to get it with a non-binary identity, but it has been known to happen. What I would suggest is to join the FTM groups listed in the Resources section, search for it on Tumblr, and ask around. Consult an expert, and keep looking for options.

I am in Canada / Australia / UK / another country. What is the process there?

Unfortunately I am not familiar at all with the process in any other country, especially those concerning socialized healthcare. I have heard mixed stories: some people have managed to maintain a non-binary identity and obtain top surgery paid for by their healthcare system, while for others it has been impossible and they’ve had to lie about it. Generally I can guess that there will be more hoops to jump through, a lot more steps to go through, definitely more paperwork, and probably much more time. But do your research, it might just be possible! (If anybody has information to add here I’d greatly appreciate it.)

I have lots more questions!

And I might or might not have the answer, but I’m most certainly willing to chat.

6 thoughts on “Top Surgery: 1 Year Post-Op Follow-Up and Mini-FAQ

  1. I can speak a bit regarding getting surgery in Canada. Our health care system is actually a provincial jurisdiction, so it changes for every province and territory, and in some provinces it can be covered 100% financially, but you need to jump through government hoops and deal with red tape in order to get coverage. Each province is slightly different though, so not all will cover the surgery costs. If you’re not trying to get the government to pay for it, there are fewer hoops, but it’ll cost you. And sadly I have yet to hear of anyone getting a non-binary SRS covered by our health care. What most often happens is individuals will lie on the paperwork to be within the binary system in order to get some trans* care.

  2. I’m a CAFAB transmasculine neutrois (so same situation as you, then…) living in Australia. I’m too young for top surgery at the moment-haven’t really started transitioning at all yet-but I wanted to tell you something about the situation with people outside the gender binary getting top surgery in Aus. I’ve done some research, and one doctor in Sydney-Dr Megan Hassall-has and will perform top surgery on people who aren’t taking T or aren’t male-identified.

    (published on behalf of Hayden).

  3. i think people consider reduction when they actually want full top surgery because they can get insurance to cover that, especially when someone is larger breasted and is having documented medical problems. Getting an insurance-covered reduction NOW can seem imperative rather than waiting til one has the financial resources for a full top surgery.

    1. Yes, unfortunately insurance often only covers reductions and the doctors are too afraid to remove everything. Some relief is better than nothing. Some people switch their gender markers to male and get it covered under gynecomastia, though ironically switching gender markers often requires surgery first.

      But for those who do have the option it’s worth noting that existing scar tissue will not work in your favor.


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