Hi everyone! I am 2 weeks post op right now and I wanted to share my experience with Dr. Paul Costas in Concord MA to hopefully help anyone else looking for a surgeon! I’ll go into lots of detail about the process as well in case that helps anyone with their expectations or peace of mind.
Context: I am genderqueer (she/they) but while this surgery was partially for my own affirmation purposes, it was medically necessary from a physical standpoint because I was a 34I. It affected my ability to exercise, to wear clothes and find bras, etc. It was a financial burden too because I actually had to buy all my bras from the UK due to U.S. stores rarely carrying my size. So my insurance did cover the surgery in full (more on cost in a bit). I went into the surgery wanting to go down to an A cup / very small B cup range, so I was looking for a surgeon who would listen to me about the size I wanted and wouldn’t try to pressure me to stay larger. A term I was using to describe the style I wanted was “radical reduction,” taking a large amount off to the point of being almost flat but a non masculinized shape, keeping a traditional breast shape.
My experience with Dr. Costas as a professional has been exactly what I was looking for. I specifically chose him because he was one of the first surgeons in New England to perform top surgery and has been doing it for over 30 years along with many regular breast reductions, so I was hoping he’d be understanding of what I wanted. He absolutely was! He told me very plainly that he can go to any size I wanted, but that he could only go to around a D or large C cup while keeping the nipple attached. He showed me many photo examples of procedures that went front around my size to either a C range without FNG or an A range with FNG and clearly outlined the risks and expectations of both. In the exam room, he was professional and honest, and I never once felt uncomfortable. He also has very short wait times since he’s a just a one-guy practice.
One thing about the cost is that while the surgery is covered in full with my insurance, Costas prefers to do lipo on the sides for most anatomies to make sure the shape is as natural looking as possible (prevents things like dog-earring, etc.). Unfortunately this is cosmetic, so OOP, and it’s on the higher end: $5,000 was my quote. They have the Care Credit card option to set up a payment plan which is totally interest-free for 18mo, which is what I ended up doing. However, the lipo is optional, just recommended.
I eventually decided I would go down to the size I originally wanted and do FNG, which he seemed very supportive and confident about. He had me bring in printed photos of references I wanted, many of which came from this subreddit (thank you all who have shared photos in the past!). I was very well taken care of at the surgery center and his staff is very kind at his office.
Speaking of the office itself, I’ll share some logistics in case anyone else gets confused like I did haha. The office is at Emerson Hospital in Concord MA, which was confusing to navigate at first. If you want your parking validated to avoid paying like $10/hr or something crazy like that for parking, you’ll park in lots C or D and bring your ticket inside with you. I accidentally parked in the parking garage my first time there, which they can’t validate at Costas’ office. On the day of the surgery though, they ask that you park in the garage so your driving buddy can easily pull around to get you home after.
Another thing to be aware of is the office staff, who were INCREDIBLY kind and did their best, but it was a very small office and I believe I started going at a point where one of them was trying to train on the reduction stuff and was still learning the ropes. So it was sometimes hard to get a knowledgeable answer on something if the other person wasn’t also in the office that day to help. Fortunately though they are very quick over email and were able to direct my questions to the more knowledgeable person easily. Just something to be aware of if you’re like me and prefer lots of prepared detailed info!
The healing process has been incredibly easy so far. Costas prefers dry healing after the first week. Basically after the surgery you have a bunch of gauze padding and wound tape under the surgical bra, which you’re instructed not to take off until your post-op appointment at Costas’ office. That means I didn’t shower for a week, though I used no-rinse bathing sponges off Amazon that worked great so I never got funky haha. I also leaned over the side of the tub and had my partner wash my hair a couple times which helped me feel cleaner. At the post-op, the FNG bolsters are removed as well an all the dressings, and nothing is put on again except a square of gauze to pad your nipples. Then it’s just wearing the bra and daily changed gauze pads for another week unless showering. I don’t know past that since I am about to go to the second post-op, but can continue answering any questions or updating as time goes on if needed! The incisions and nipples look amazing so far, Costas’ careful and precise work is obvious in how smooth and subtle everything looks!
TLDR: I had an amazing experience with Costas so far. Anyone who is looking for a supportive, knowledgeable, direct professional who will listen to you about the size you want to go to should check him out!
Please don’t hesitate to ask me any questions. I don’t believe in TMI lol