You’ve Made the Decision to have Top Surgery… Now what?

Top surgery — that milestone that most, if not all, trans masculine folks look forward to and try to save money for. Looking through countless top surgery pictures and stories on Facebook or on other social media platforms, we can’t help but get impatient with our own transition and wonder when it’ll be our turn to feel at home in our bodies like those happy folks.

Top surgery, however, like with any surgery, is not something that you can schedule in a few weeks. If you want things to go smoothly the first time, there are some things you should be aware of and keep in mind that will make planning for top surgery more manageable.

Choosing the surgeon. Top surgery results are truly in the eye of the beholder; what surgeon works for one trans person might not work for another. While you can ask around for surgeons that people went to for top surgery, it’s good to do extensive research on them and see their before & after pictures on their websites. Most, if not all, surgeons have a website for their practice and should have before and after pictures of patients that previously had top surgery with them. If not, Transbucket is a great site that you can look through; the site has filters that you can play around with to see specific results by surgeon, type of surgery, etc. You can also see a previous post made by a fellow writer of top surgeons across the USA.

Consultations. While you can expect to pay thousands of dollars out-of-pocket or have insurance cover it (if applicable), you’ll need to find out how much your surgery is going to cost. Most top surgeries, on average at the time of this post, are generally in the range of $5,800 – $9,000 but every person gets a different quote. In order to find out how much top surgery will cost for you with a specific surgeon along with their current availability, you’ll need to have a consultation with them first. You can call a surgeon’s office or fill an online contact form on their website (if they have one) asking to set up a consultation, and they should get back to you as quick as possible. Once they do, you’ll be asked to e-mail front and side photos of your chest prior to the consultation.

In almost all cases, you aren’t required to travel to have a consultation. However, there are some surgeons (like Dr. Daniel Medalie and Dr. Kathy Rumer) who charge a consultation fee while others are willing to do it at no charge so keep that in mind.

During the consultation,  it’s good to ask the following:

  • What surgery would be right for your chest size and why?
  • Does the surgery quote include revisions or would that be extra?
  • Is there anything I need to buy or pay for that’s not included in the surgery quote?
  • Will I need to be off T and, if so, for how long?
  • How would the process work?
  • How long would this surgery quote be valid for?

Research like you’re in college writing papers. People might have given good reviews on the surgeon they’ve recommended but don’t just take their word for it. Do some looking around yourself on Transbucket. Use the search function in top surgery Facebook groups where people share their results and stories with their surgeon as well as the price quotes they’ve paid (if going out-of-pocket) or what insurance they used that covered their surgery with them (if using insurance). Remember that it’s your body and that you should take care of it!

This is a big point that I can’t stress enough and there are a few reasons for this. First reason being that no matter what these top surgeons tell you, they are, at the end of the day, looking to make money. Top surgery is getting more expensive each year and not many insurance companies (or even plans) cover trans-related care at the time of this post. As the standard of living and demand for top surgery increases, so does the surgery. There’s only a select few of surgeons out there that do top surgery with chest masculinization in mind and with good results.

Another reason is from personal experience. I had a consultation with a top surgeon who gave me a surgery quote of $6,750, my quote being on the higher end of what he charges. Had I not asked my friends their surgery quotes from him, I would’ve probably chosen him as my surgeon not knowing that he was overcharging me. My friends, who had bigger chests than I do, were given cheaper quotes and we were all getting the same procedure too. I did some more looking around and found someone who paid out of-pocket with the same surgeon and he paid $5,500. With roughly the same chest size! Granted, his case didn’t need lipo but if he did, he would’ve paid APPROXIMATELY $6,000 flat.

Thinking it all over, I’ve come down to 2 possibilities for why I got that quote: either he’s realizing that he’s getting more well known in the transmasculine community for doing good work hence why he’s raising his prices or he’s thinking he can overcharge me because I said that I will be traveling from New York City to have surgery with him. I possibly was being asked to pay more for residing in a state known to have the highest standard of living.

Moral of the story: Don’t be taken advantage of.

Surgery costs. As much as I want top surgery to be accessible for everyone, it unfortunately costs a good chunk of money. Not only that, you’d be out of commission for a while when recovering from surgery so on top of the surgery fees, you’d have to cover travel, food, bills and rent because you won’t be able to work for a while. Unless you are financially well off, have parents that are or somehow manage to raise all the money through a donation page, most people are stuck wearing binders until they can raise the money or their insurance plan suddenly covers trans-related care. There are various ways to raise money for top surgery like starting a clothing line, having a garage sale, etc. If you want to raise money through GoFundMe or through any similar donation site, it would be difficult without a social media following or without using your talents and whatever you have to offer as rewards.

If you need help pinching pennies, consider the following:

  • What could I do without?
  • Stop eating out and start cooking all your meals.
  • If I cut out <insert stuff you don’t need like coffee, drinks, etc.>, how much will I save?
  • Could I work extra hours at my job?
  • Are any of my friends working at places that are hiring?
  • Do I need to work another job in order to save up all I need?

Scheduling the surgery date. Generally you would have this worked out at the time of the consultation if you are set on a surgeon; keep in mind that most well-known surgeons have waiting lists and, you need to plan ahead with family/friends/loved ones on who would be taking care of you when you are recovering, and who will drive you to and from surgery. Most surgeons follow the WPATH Standards of Care and require you to send them a letter (or two) from a therapist and/or doctor saying that this irreversible gender-reaffirming surgery is the next step in your transition and that you are of sound mind before you can schedule a date. Most of us look at this letter requirement as a hassle but the letter provides a way for the surgeons to cover their butts legally should a person choose to detransition later on down the road and not be made liable for it.

Despite the mass amounts of planning and money required, top surgery is a very important milestone in most of our transitions, and nothing makes us light up more than seeing ourselves getting closer to the body that we not only had to work for, but were meant to have. Hopefully this post helps you navigate top surgery better. I wish you all the best of luck in your planning!