Help Young Trans FtM Get Much-Needed Revision to Top Surgery

Hello, everyone! This is new to me because I honestly feel really embarrassed asking for financial support of any kind from strangers, but one thing has led to another and I don’t really have much choice at this point. Thank you so very much in advance for hearing my story.

I had my first top surgery at 19 (I am now almost 22) through my primary care provider. I could not and would not ask for financial assistance from my parents as they do not support my transition. My partner was with me every step of the way and continues to be as I am writing this. They know that I had wanted a flat chest before I even knew what being transgender meant, and I was ready to feel comfortable in my own skin. We were both really excited— albeit nervous— for this next step in my transition. Unfortunately, things didn’t go nearly as smoothly as I would have liked.

I decided to go with a particular surgeon from my PCP’s network after seeing his results for a technique called peri-areolar top surgery that leaves minimal evidence of scarring. For someone whose ideal chest was “cis-passing,” this was my dream procedure. I scheduled a consultation with this surgeon in which we discussed surgical methods for me. The surgeon expressed to me that both double incision and peri-areolar were options that could work for me. Against what I would now choose given my experience, I elected peri-areolar incisions. My surgeon was very clear that peri-areolar had a high rate of revision that I may need to explore in the future, and I expressed my understanding.

The day of my surgery came and I was beyond excited (and nervous.) It was as much of a celebration as my partner and I could make it at the crack of dawn driving to the hospital. We said our goodbyes once the surgery team started my intake. They put me under for the procedure and found that my nipple-areolar complexes were unusually small and they had to make additional lateral incisions to deliver the tissue. My partner consented to this as my next of kin. I was sent home and recovery was unremarkable from that point on.

I first saw my results at 48 hours post op. My partner took off my dressings and I did not feel joy or elation or anything at all, really. I felt numb. I knew that my results at this point would look gnarly and unfinished, especially given the type of surgery I had chosen, but there was pretty significant loose tissue and excess skin that I could see already. I waited and waited and waited for it to get better, holding onto the hope that maybe it really was just swelling and that it would get better with time. That’s what my care team told me, anyway.

I scheduled my second postoperative appointment in hopes of addressing the bumps on my chest that I had noticed. My surgeon was rather dismissive of my concerns, saying that my chest looked really good considering we had gone with keyhole. When I attempted to raise concern about residual tissue, he said that it could be anything from swelling to it having been my rib (even though it was definitely tissue given the fact that it was squishy.) I asked if working out or losing weight could help with the appearance of my chest. He essentially told me he didn’t know. I left the appointment feeling very slightly better about my results, but still in the dark.

My concerns only grew over the following months. Some time about a half a year after the last appointment, these felt enough to warrant another postoperative appointment. I again expressed concern over the obvious bumps on my chest and asked if they were residual tissue. My surgeon confirmed this to be true, and that he leaves some tissue to create a more natural appearance of the chest contouring, which I knew to be a common practice. This amount, however, was excessive. I asked him if there was anything outside of surgical solutions that I could exercise to help with my results aesthetically, and he said that there was not. When I attempted to ask about a potential revision, he told me that he would not consider a revision for my case. I left this appointment feeling stuck and hopeless.

Because my insurance provider is rather niche and would only cover providers within this network only, I then scheduled a consultation with another surgeon in the network. He agreed to review my case with their board of plastic surgeons. After some time, he got back to me and stated that if I were to lose the ~10lbs I had gained since my original surgery, they would assess me for a revision. At this point I feel it important to mention that my BMI was and continues to be normal. However, I have struggled with disordered eating behaviors in the past and this left a super sour taste in my mouth.

I’ve always found it really difficult to advocate for myself. I spent a good amount of time happy that I could finally wear flat shirts without binding and miserable because I hated the way my chest looked and I did not feel comfortable swimming shirtless, being alone shirtless, etc; all things that I was so excited to do after my top surgery. I started to look in local groups and forums for people who have had top surgery in my area and discovered that, lo and behold, I am not the first person who’s had this experience— and certainly not with the same surgeon. I spoke with someone who experienced the same issue as I had, with the same surgeon as well. They went to a private clinic nearby and got a revision with incredible results. I decided to book a consultation with the clinic, which takes us to today.

I was really scared for my consultation at the private clinic today. I was afraid that the doctor would look at my chest and dismiss the concerns I had, as had happened so often before. What I got instead was complete understanding. She saw my results and said aloud what I had been thinking for these past years. In fact, she has had MULTIPLE patients come in for revisions from this particular surgeon. I felt so validated by her assessment of my results. She immediately formulated a plan to get my chest to where I would like it to be. It’s going to involve more scars than I would have originally liked, but my primary goal at this point is male chest contouring.

I am simultaneously so happy, relieved, sad, and anxious. Happy because I’ve got a plan in motion, relieved (and sad) that I’m not crazy and my results do suck, and anxious because I have no idea how on earth I am going to afford this. It’s a really strange feeling. My problem lies in that my estimate is $12,620 for the surgical plan highlighted by this private clinic. I’ll admit I almost died when I saw that number, as I earn $18 an hour (18.50 starting soon) and am only now transitioning back to working full time. I am exercising pretty much all of my options; saving up, crowdfunding, probably going to sell some stuff to make a bit of cash, even considering taking out a loan with my credit union. I am desperate lol. This is where I am at and am determined to make my body somewhere I can call home after all. Thank you to all of you who have read this far and anything helps, truly.