Questions to Ask your Top Surgeon: The Anything and Everything Post
By now we’ve posted numerous articles on questions and concerns regarding top surgery, and have answered some of the more obvious questions surrounding this surgery, but what about those hard-to-answer-super-in-depth-almost-too-personal-but-you-need-to-know questions? You certainly don’t need to have all of these questions answered, but they are seldom thought about but still wildly important when selecting your surgeon. Some of these may seem obscure and unhelpful but collectively, you can really find out a lot of useful information about the surgeons you are considering going to and one may just push you to the surgeon that’s right for you.
Here’s a list of those questions you could ask your surgeon before you go under the knife:
A) Questions About Your Surgeon
1) Where did they graduate from medical school?
2) Where did they go for their plastics residency?
3) How long have they been performing this surgery?
4) What is their motivation for doing trans*-related healthcare?
5) Did they know anyone who was trans* before they started doing top surgery?
6) Did they have another surgeon who is currently practicing after whom they modeled their technique? Can you see some of those person’s results?
7) Are they currently involved in a legal case brought to them by a former transgender patient?
8) What is their patient-satisfaction rating? How do they know if their patients have been happy with their results? (Do they even care to find out?)
9) How many top-surgeries does the surgeon do per year?
10) Will the surgeon be happy about being promoted on blogs/websites/forums/face-to-face groups/listserves as having provided this kind of trans*-related healthcare? Is the surgeon happy about being associated with the trans*community?
11) Has the surgeon been to any trans*-related healthcare conferences?
B) Questions About The Procedure
1) What is their most popular procedure (double incision, peri-areolar, keyhole)? Why?
2) What are the chances of retaining nipple sensation?
3) How do they decide where to place the nipple grafts if they use them? Do they have supporting literature for why they place them where they do?
4) How do they decide how to shape the nipples? Is this something that can be personalized? (i.e. would they make smaller/larger nipples than they normally do per the patient’s request?)
5) Do they absolutely under all circumstances use drains?
6) How long will the patient be under general anesthesia?
7) Who will be back in the operating room with the surgeon?
8) How long is the patient required to stay on location for post-op recovery?
9) What is the physiological criteria to be eligible for peri/keyhole?
10) What surgical tools does the surgeon use to perform top surgery? Lipo?
11) Where does the surgeon place the bilateral scars? Why?
12) What about revisions? What is the percentage of their patients that have had to come back for revisions?
C) Questions About Financing
1) How much does it cost? How much of that total cost is the surgeon’s fee? The facility’s fee? The Anesthesiologist’s fee?
2) If they are strictly against options involving insurance coverage, why is that?
3) Do they have financing options via a bank loan?
4) How much of the surgery cost is expected prior to surgery? How far in advance?
5) What happens if your surgery date has come and gone and you can no longer afford your surgery?
6) Are there ways to lower the cost of the surgery?
7) Is one surgery option cheaper than the other? Why?
8) Does the total cost include post-op medications?
9) Does the total cost include future revisions?
10) Does the total cost include pre-op consultations?
D) Questions About Recovery
1) What pain medications will be prescribed? If the patient is allergic to the preferred medications, what will be prescribed in their place?
2) How long does the patient need to stay in the area? How soon could a patient, assuming the best recovery outcomes, leave the area? Is this flexible and catered to the patient, or is it a standard across the board requirement?
3) What are the patient’s chances of developing a hematoma? How will that be taken care of in the event that it occurs? What is the cost for care of something like that?
4) What other surgical complications are possible?
5) How soon after surgery can a patient be on a plane?
6) What is the recovery time line? How long until the patient can go back to normal life activities?
7) What kind of diet would aid in proper healing?
8) How long until the patient can be out in the sun/in a tanning bed?
9) What kind of skin/scar care does the surgeon recommend? Does the surgeon sell this product on site? Is there a place to find the same product cheaper?
10) If there is major swelling, how long should a patient wait for it to go down before they contact a medical professional? Can the patient contact the surgeon’s office about complications even after having left the area?
11) How long after surgery can a patient resume erotic-play (whatever that means to the patient) with their nipples?
12) What does skin necrosis look like and how would a patient recognize that their skin is dying? What should a patient do if their skin appears necrotic?
13) Is the surgeon willing to write a doctor’s note for missing work/school or limiting activities at work/school?
14) How long after surgery until the patient can consume alcohol?
E) Questions About Preparing For Surgery
1) How far in advance should a patient quit smoking before surgery?
2) Does the surgeon require the patient to be off of testosterone before surgery? If so, how far in advance?
3) Does the surgeon prefer patients to be on testosterone prior to surgery? Why?
4) Should the patient fast before surgery?
5) Should the patient shower or not shower right before surgery?
6) What kind of soap should the patient wash with before surgery?
7) What foods can the patient consume during their fast (jello, ice cubes, etc)?
8) Is it beneficial to the procedure to lose as much weight as possible before surgery?
9) Will there be a pre-op physical that the patient will need to be in town early for?
10) What kind of blood work is needed prior to surgery? Why?
11) How far in advance can the patient book the surgery?
F) Miscellaneous Questions
1) Does the surgeon’s facility have any deals with pharmacies nearby?
2) Does the surgeon’s facility have any deals with hotels nearby?
3) Does the surgeon’s facility have a brochure on things to do in the area that are compatible with the patient being post-op?
4) Does the surgeon have any recommendations for good local cuisine?
5) How does the surgeon come up with the pricing of the surgery? Do they feel they are competitive?
6) What is the percentage of business that comes from trans*-related surgeries?
7) Do the nurses/other physicians in the office have any special training in treating trans*-patients?
8) Will the surgeon/surgeon’s office refer to the patient with their preferred gender pronouns and preferred name even if it is not on all of the patient’s official documents (They haven’t legally completed those steps)?
This is a near, but not completely exhaustive list of potentially important but often forgotten questions to ask your perspective top surgeon. Since many of us pay for this care out of pocket, please be sure to give your top choices as much scrutiny as you care to. In the private market, goods and services must be dealt with by competition and our surgeons must know that we hold them to the gold standard because of it. Don’t waste your money on a surgeon you know nothing about, you deserve better than that with your near 10K investment.