What to Expect At Your Top Surgery Consultation
WHAT IS THE CONSULTATION FOR?
The Top Surgery Consultation is a big part of gender-affirming care where you will meet your potential surgeon and both of you will be able to assess if you’re going to be the right fit for each other.
At the consultation, your surgeon will typically use it to get more information from you. They’re likely to inquire further about your health and medical history, understand your goals and preferences, manage your expectations and establish what procedure/s you’re most eligible for based on your anatomy, your identity and your goals.
The consultation is also meant to be an opportunity for you to ask any questions you may have about the surgeon’s procedures, inquire about their previous experience with other patients and potentially view more pictures of their results.
WHAT SHOULD I WEAR?
Wear whatever you would be most comfortable in but it might be more ideal to have an outfit with a separate top and bottom since you would have to take your top off at some point. A romper, dress or similar one-piece outfit may still work if you would be able to fold or roll down the top portion of your clothing.
While there’s nothing wrong with wearing your binder to your consultation, I personally opted to wear a sports bra since squirming out of one is slightly easier than squirming out of a binder. That said, it wouldn’t really matter as long as you’re able to change into the medical gown once it’s time for the examination.
What should I bring?
A notebook or device that you can use for taking notes. The Trans Care BC site has a nice Top Surgery workbook that may be helpful, even if you aren’t based in British Columbia.
A list of the medications, prescriptions, supplements, etc that you regularly take.
Pictures and examples of what you’re hoping for if you have very specific preferences for what you want your ideal results to look like.
If you’re based in BC, bring your Services Card. Otherwise, bring any necessary insurance documents required in your area for your procedure.
You can bring a support person if you wish, just be sure to inform the office and doublecheck what their policies are around support persons.
Write down questions you want to ask so you don’t forget!
While you would most likely be able to call or email the surgeon’s office after the consultation if you have any followup questions, it helps to have them prepared beforehand so you know what you want to ask and can potentially lessen your anxiety around the consultation and the procedure.
Here are some examples of questions you may want to ask
How will limited mobility post-op affect your ability to maintain your regular testosterone dose if HRT is part of your gender-affirming care?
How long would you potentially need assistance with caring for any pets or dependents?
How much time off work would you need based on your specific job and typical duties?
Why do they consider a particular surgery technique a better option for you over other techniques?
Will you need to remove your piercings before surgery?
Will you need to shave before surgery?
How long should you wait before travelling home if you will have to go out of town for your surgery?
WHAT HAPPENS AT THE CONSULTATION?
Step One - Getting Checked In
Once you get to the surgeon’s office, you’ll most likely check in with reception and fill out paperwork requiring your name, medical history, prescriptions, insurance information, etc.
Step Two - Examination
After getting checked in to the surgeon's office, you’ll be asked to change into the medical gown. The surgeon will step out so you can change and your support person can either stay with you or step out, depending on what you would be more comfortable with.
Once you’re in the medical gown, the surgeon will do a quick examination of your chest to see the size, how the tissue sits on your chest, how good your skin elasticity is, and they may take measurements and may touch your chest (with your permission).
Some surgeons may opt to take photos (with your consent).
After the examination, you may choose to stay in the gown or change back into your own clothing for the rest of the appointment. Your support person may be called back into the room if you had asked them to step out for the examination.
Step Three - Discuss Procedures and Eligibility
Now that the surgeon has a better idea of your anatomy, they’ll be able to go over what procedure/s you would be eligible for. They will also go over the risks and the potential complications involved in your surgery and explain what you may need to prepare for and discuss your aftercare plan and instructions.
In my case, my surgeon noted that because of how close my breast tissue was to each other, I would have to expect that my scars would go all the way across my chest as one long incision.
Additionally, my surgeon recommended additional liposuction at the armpits. It was optional, but he said it would help the overall appearance of my chest. He noted that it wouldn’t be covered by MSP, so I did pay out of pocket for it.
After discussing the procedure itself, the surgeon will go over aftercare instructions and give their recommendation for how much time off from work you may need.
Recovery times vary from person to person of course, and there are multiple other factors to consider, but typically, for more sedentary desk jobs, especially if working from home, about a week or a week and a half off from work may be enough. For more active jobs that involve a lot of standing, moving around and lifting, at least a month or longer may be better for your recovery.
Step Four - Questions
At the end of your consultation, the surgeon will give you a chance to ask any questions they may not have covered yet. This would be when you can ask more specific questions about your preferences or how your daily routine would be affected or how your medical history might affect the chances of complications.
Depending on your surgeon’s office and what their policies are, you may be able to book a surgery date at the end of your consultation, or you can ask for a second consultation if necessary. You may also opt for a consultation with another surgeon before you decide to commit to a surgeon and a surgery date.
If you don’t end up booking your surgery on the day of the consultation, you would likely have a call with the office later on to book your surgery.
About My experience
To access gender affirming care, I went through Three Bridges in Vancouver.
I filled out their intake form and got on their waitlist in February 2021
I had my intake appointment and Surgery Readiness Assessment in March 2021
I got a call from Trans Care BC in April 2021 and was asked which surgeon I wanted to have a consultation with
I had my consultation with Dr. McKee in May 2021
I had my surgery at False Creek Healthcare Centre on June 23, 2021 with Dr. McKee as my surgeon.
References
https://www.vancouvertopsurgery.com/consultation
http://www.phsa.ca/transcarebc/Documents/HealthProf/Chest_Construction_Surgery_Workbook.pdf