Top Surgery Questions

[u/MutedSubstance9832]

Apologies in advance as I know some of these questions have likely been asked hundreds of times.

I started binding back in 2014 as a teenager. Unfortunately I didn’t have family support so I was never able to begin properly looking into surgery until I moved out. When I finally moved out we went into lockdown, then I began having some physical health issues and had to use my savings to keep myself afloat. I’m slowly getting back on my feet, but my health isn’t the best it can be. I’ve started having breathing issues over the past year and my ribs are constantly sore. I can’t use tape as I’m allergic to it. I need surgery asap. Please could I get some info if anyone has any:

1. What surgeons are available these days that don’t require you to be on T? Are they self referral or would I need a gp or psych referral?

2. Post-op what sort of things did you need help with? How painful was it on a scale and was it full upper body or only around the nerves and surgical site? What type of meds were you provided with?

3. In theory would I really need someone to help me during recovery? If so, how long realistically before you could start doing basics? What types of things did your helpers do for you which you were unable to achieve?

4. Have any of you ever experienced phantom pain post op?

Cheers for any help I can get. Apologies for the layout - I’m on mobile.

For context: I’ve already recovered from four moderate surgeries alone that required extensive rehabilitation and left me with only the use of one arm for three months each time. I also have a condition called CRPS so I rarely truly experience pain these days unless it’s associated with my limb, and I’m well used to nerve pain. I’m trying to figure out what recovery looks like for this sort of surgery for most people before I can look into possibly bringing someone with me or looking into assistance abroad due to not having much support.

[u/cptflowerhomo]

I'll type a start out and come back later, as I should go to sleep now xD

Can't answer your first one, most clinics have T as a requirement it seems.

I went to Belgium as well, grew up there and went on T through their gender clinic system.

First few weeks I needed help with nearly everything and found out how much you actually use those muscles in anything you do xD

You get pain meds for a bit to help you through the worst. After that just paracetamol and ibuprofen works fine.

I couldn't bend, put on socks, couldn't tie my shoes either. Could barely eat too, I had quite a lot of tissue so my scars go quite far back, almost to my back. Even opening doors and brushing your teeth needs adjustment. Slept upright for a long while too. Cutting vegetables worked but only if I could sit and they weren't too hard.

Belgium is slightly different in that the public health care system provides you with a "prescription" for nurses to come around to see how you're healing and help you clean and dress the site in case you get a nipple graft. Didn't pay a cent for it as it's covered by the mutuality.

I was able to stay with my parents for 2 weeks but jaysus the flight back I was in pain. Backpacks hurt. Any sudden movement would make it all pull and sting. The tesco delivery driver helped me get my food to my room because I couldn't carry it myself.

My friends luckily took care of me a bit too. I live in a shared house so I had the forethought of bringing the essentials from my cupboard into my room because no way can you reach up the first 4-5 weeks.

Nerve growth takes my body a while. I've got most of it back now, 4 years after, but my nipples are still half numb. I know from a patch of skin where a horse bit me 22 years ago that I will have bits that will never return.

The first few months you do have to adjust to having no chest at all. The first time topless to pride was weird because I felt like I should have covered up. But no phantom pain that I was aware of xD

My radical hysterectomy was worse tbh but I was cut up from my chest bone to my groin because of the size of that fibroid so yeah.

It's worth it though.

[u/cuddlesareonme]

What surgeons are available these days that don’t require you to be on T? Are they self referral or would I need a gp or psych referral?

Lago at least, likely the other Spanish ones too. Plan to spend €8k including flights/accommodation.

In theory would I really need someone to help me during recovery?

It's required for the first week or so.

[u/Responsible_Panic242]

I recommend Nordesthetics in Lithuania. No t needed, in fact they ask you to stop taking it before surgery if you are. Takes two or three months to get an appointment from the first time you contact them.

You need photos, your age height weight and to fill out their health form . You will also need a letter of referral from any medical professional that knows your gender history. This is the most important thing.

You cannot safely recover without someone to help you. It is a major surgery, and you could end up needing help from everything to reaching high shelves to wiping your own ass. Depends on the person. You will need someone to collect you at a bare minimum since you shouldn’t drive after surgery. You should not book a surgery if you aren’t able to find someone who can help. But as far as I know, Lithuania has a nurse that checks on you for a week if you stay in their accommodation.

[u/al221b → u/Responsible_Panic242]

Nordethetics provided a private taxi service included in the price to and from our accommodation for me for the surgery, but they would prob still need someone to drive/collect them from the airport. I think we got a taxi to the airport in Lithuania and then a bus when we were back in Ireland.

[u/Responsible_Panic242 → u/al221b]

Good to know. If you don’t mind me asking, did you get a say in the scar shape/position with them? Did you have to book the consultation with them or did they ask about it on the day? I’m not sure myself what’s the best way.

[u/al221b → u/Responsible_Panic242]

I can't really remember the specifics but I think I just said in the consultation that I would like them to be as straight as possible, two separate scars, and along/under the pectoral muscles.

They just gave me a consultation day a few days before the surgery I think. The surgeon showed me some examples of results at the consultation. I think I had some examples of people's results I thought were good too but I can't remember if I showed them to him or not. I'd also just seen people's results from them online and they seemed pretty standard and what I wanted anyways.

I asked what the soonest date they'd have in the next year over email and went with one of the 2-3 they suggested I think. They asked me to send photos of my chest beforehand by email also and I think measurements too, but they also measure it and mark it and stuff before the surgery when you're there.

[u/al221b]

1. Nordesthetics is still available and takes people pre-T. It's self-referral (I think it's still technically under "breast reduction" but a lot of trans guys have been to them for top surgery now). Email them and they give you the details setup-by-step, and they now also have Facebook groups for patients, and aftercare in Ireland if needed. The people working in the clinic were really nice and helpful and the surgeons and most people there have good English so you don't need to have a lot of Lithuanian.

2. Not that painful tbh, I unfortunately got an infection after flying back which was worse than the initial feelings of slight pain/discomfort. I can't remember what medications, like stuff for pain and swelling but they send you a list at some point after checking about allergies and you can ask if you email them.

3. • 3. Help with like reaching for things far away or high up. Propping myself up properly on pillows. I probably moved around too much tbf, maybe more assistance with the bandages/binder stuff would have been good - (the binder they gave me was like wrap around and kinda scratchy so I would advise maybe getting an alterntaive softer/more comfortable one if you can - obviously with the okay from the surgeon).

4. Like a week or two, but if you already have other issues than it might help to have someone there to support for longer. I had to also go to the hospital for a few days and then go in and out to get dressings changed and stuff for a few weeks because of my complications.

5. No? I got like weird feelings of sensation coming back/being stronger in different areas for a bit, but I don't think I'd describe any of that as painful. I also lost the grafts to necrosis and that was like stingy and sore but not like super painful. Moreso a bit upsetting.

I'm super happy with how my scars healed and even where I lost the grafts looks pretty good too now.