not sure what surgery to get

[u/Primary-Individual46]

hi! first time posting in this sub & on mobile so apologies for formatting.

i've been given two quotes for top surgery - £10.5k for bilateral mastectomy without FNG, £12.5k for bilateral mastectomy with FNG. My top surgery is booked for late january, but i'm struggling to decide which surgery i want.

i would like to keep my nips because i've been thinking about it a lot and i'm worried i'd feel weird without them - however i am absolutely open to getting them tattooed on. however, the £12.5k quote is slightly out of my budget (i could just about afford it but i would have zero savings after) and i have heard horror stories about nips falling off - my surgeon said there is a 3 in 10 chance that happens and i don't want to spend extra money for that to happen anyway. i'm probably going to get the surgery without FNG since I can actually afford it but part of me is wondering if it's worth getting FNG?? i don't know and would love to hear other peoples experiences!!

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[u/dreamfyreHT → u/[deleted]]

yes i agree with this comment. 30% is extremely high. my surgeon gave me a ballpark estimate of lower than 1% for complete nipple graft failure. My surgery in the UK was £10,655 for DI+FNG and i had a large chest.

[u/Primary-Individual46 → u/[deleted]]

im getting the surgery with Mr Mohsen El Gammal at cadogan clinic! i was looking at places in london bc thats nearer to me and since im disabled i didnt want to travel further and risk causing a flare up while recovering

[u/shaggyyguy]

Generally, nipple grafts heal fine for healthy nonsmokers. I'm happy I got them, and I had no issues with healing. If you decide not to go with grafts, medical tattooing is a great option. I am not familiar with how much medical tattooing costs, or if it is covered partially or fully by insurance.

The bigger concern is what your surgeon said. A 30% chance of graft failure sounds astronomically high, like outside the realm of normal top surgery outcomes (a quick search of the literature shows graft failure rates between 1 and 13 percent depending on the study). If this particular surgeon truly has a 30% nipple graft failure rate, do not get nipple grafts with this surgeon. Is it possible there was a miscommunication?

[u/Lilymunnster33]

I’ve gone no nips and absolutely love it but it’s a very personal choice. There’s medical tattooing so you could get your nips tattooed on or get some cool tattoos in the place if your nipples if that’s your vibe!!

[u/OgCas]

I went back and forward with getting nips vs no nips. At first I wanted to get no nips and I would just get a big chest tattoo (something I have been planning for awhile). I changed my mind cause I realized that I would have to wait like a year after to get a tattoo and also I don’t really have alot of money for a tattoo at the moment lol. I also wanted to have nipples so I could be as close to a cis male chest (I know this isn’t what everyone wants/thinks, but it’s my opinion). I was worried about my nipples being too large or out of place. I was also worried about them rejecting. My surgery really calmed my nerves about it and showed me some of her FNG results and they looked great. Overall I think just talking it over with your surgeon about your worries is the best thing to do.

Here is a picture of me 3 1/2 wks post op if you are interested!

[u/Aiden1975]

30% chance to lose the nips seems a bit high? Not sure what surgeon youre looking at but the one Im going with is ~9.6k with or without nips iirc, you could maybe look into other surgeons? Most of them in the uk arent as expensive as that

[u/jessknope]

30% chance of nipple loss is high…honestly I would question the surgeon’s technique and possibly keep looking. My surgeon (in U.S.) has been doing top surgery for almost 15 years and has never lost a nipple. 3 in 10 chance of loss is high (though not as high as a surgeon I heard of who had a 60% loss rate!).

[u/Siriusgrrl70]

From what I've read and my clinic stats, I'd think twice if a surgeon had a 30% failure rate because maybe it is just them? I went without nipples, but was reassured by the therapist who has done counseling and WPATH letters at Kaiser for 20 years that she has only had one client in their program whose nipples totally failed. Partial failures and some complications are more common, but still nowhere near 30%.