top surgery

[DapperButch]

Originally Posted by cathexis

Guess I was a bit worried in the office. He told me the WPATH documentation he needed before going any further. You wrote that it concerned you when he seemed unfamiliar with WPATH. Please explain.

Didn't ask the questions you recommended, He seemed reluctant to discuss it any more in depth before receiving the WPATH and other medical records? Will print out the list for Jan. visit. Do many plastic surgeons take telephone questions?

You mentioned that you were familiar with other medical centers. I live in NY way up near Montreal, Canada. The closest large US cities are Burlington Vermont (3 hrs.) and Albany New York (5-6 hrs) . Yes, I truly live in the boondocks of a small dairy town. Don't ask how or why this Chicagoan got stuck here. I'll tell you sometime, if you're curious.

Thanks for all the advice. I'd be lost without it.
Btw, do you know of any trans support groups in either city. We are saving up for Albany, though.

I'm sorry, I assumed you knew what WPATH was. WPATH informs the Standards of Care (medical care) for trans people. It is where all things spring when it comes to care for trans people. I looked back and I can't tell from your post if he had never heard of WPATH, or just wanted a letter from your therapist.

http://www.wpath.org/

Why are you saving for Albany?

I have to be honest with you. The number of people doing top surgeries have increased quite a bit in the last few years and I have not kept up with them. I could talk to you about bottom surgeons all day long, but not top surgeons.

I found this, however:

http://www.topsurgery.net/surgeons/medicare.htm

I would not assume all of these people still take Medicare and I would not assume that this list is up to date. There are probably more surgeons who take Medicare. I can tell you that Berverly Fischer no longer take Medicare.

Call your closest University hospital and see if they have a surgical trans health program. If they do, you can be pretty sure they will take your Medicare. It will be harder to find a private practitioner who takes Medicare since they pay so poorly.

Are you on FB? If so, the best thing you can do is join a top surgery FB group and the guys there will have everything you need to know. I can find out the name of the "main one", if you want. I bet that within one post of giving your location someone there can tell you the closest person to you who will take Medicare.

With all that said, it seems that you haven't asked the questions you need to ask your current provider in order to rule him out. But, his reluctance to discuss is a huge red flag. Why wouldn't a trans provider assume you would ask how many surgeries he has done and to ask to see pictures? YOU are the consumer. He is providing the service. I can't help but wonder if he has only done a couple and doesn't have any pictures. Anyway, I wouldn't move any further with this guy if he didn't answer these questions to my satisfaction. Don't let him intimidate you.

Remember, you want a surgeon who specializes, or at least has some decent experience in doing FTM top surgeries. Nothing else matters. Trans people often feel like they have to take crumbs. That we should be thankful that there is someone out there who will do our surgeries. Well, guess what? Shit has changed and there are now qualified people who will do them, who care about our community and want to do them. Unfortunately, some trans people still don't have a choice, based on their location, and that sucks (no money for travel). Insurance is often a sticking point, too. However, don't feel that you have to accept this provider without at least getting some of your questions answered to your satisfaction. With all of this said, I am not saying that one shouldn't accept a provider who is new to it and is eager to learn...sometimes that is the best you can get. Just DON'T forget to ask about free revisions. Do all your research about other providers before you next appt. with him so you know your options going in.

Good luck.

[cathexis]

The doc is affiliated with U Vermont, Montpelier (capital city). They have an active youth trans program. At least they are familiar with the care. Went to the Jan. appt. It was just a check in to tell me that everyone (therapist, surgeon) appeared to be onboard.

It lasted about 20 mins. He knows that I live 3 hrs. away. Every appt costs 100 dollars in out of pocket expenses that I don't think can be re-cooped. Next (hopefully last pre-op) hoop is that Anesthesia wants cardiac and IM clearance based on my medical hx before surgery.

He wants to see me again after getting that. Will call the office to see if we can Skype that visit. Really not thrilled about spending 6 hrs and the cost for a 20 min visit.

[Bard]

OK guys seriously now thinking about top surgery and do plan on talking with my endo on the next visit the binder is just a pain at times and even though being not um a lot I mean I can go with out but I just am getting to a stage where I am self conscious
I am also getting cysts from binding ugg most likely be able to do the keyhole just so much and well I am nervous so thought ??

[DapperButch]

Originally Posted by Bard

OK guys seriously now thinking about top surgery and do plan on talking with my endo on the next visit the binder is just a pain at times and even though being not um a lot I mean I can go with out but I just am getting to a stage where I am self conscious
I am also getting cysts from binding ugg most likely be able to do the keyhole just so much and well I am nervous so thought ??

Hi, Bard.

I am not sure what you are asking? I have never heard of someone getting cysts from a binder, so I would check that out.

You mentioned keyhole. The most internationally known/respected keyhole/peri areola surgeon is Beverly Fischer in Timonium, MD (close to Baltimore). Unfortunately, she no longer takes insurance. Her double incision is $9,500. I don't know what her keyhole/peri is, but it would be a bit more than the DI. She is also an amazing person. Has been doing top surgery since the 1990's.

Many guys think they can get keyhole who really can't. If there is any droop to your breast, you should plan on it not being a suggested procedure.

Also, I didn't know you were on testosterone. I didn't see it posted anywhere. Can I ask when you started? Congratulations.

I would suggest before you get super excited about a top surgeon that if you have trans health insurance that you call your insurance company first to see who is in-network. Hopefully, they won't have ANY providers and then you will have your pick of the litter (as long as your preferred surgeon is willing to work with your insurance).

[nhplowboi]

I am wondering if anyone knows much about Dr. Melissa Johnson? I would rather go to Dr. Garramone but would have to arrange time away from home if I choose him. Johnson is a short car ride away.

[DapperButch]

Originally Posted by nhplowboi

I am wondering if anyone knows much about Dr. Melissa Johnson? I would rather go to Dr. Garramone but would have to arrange time away from home if I choose him. Johnson is a short car ride away.

Melissa Johnson is very good and carries a great reputation in the community. Check out transbucket.org for pictures of her work.

I assume you know you would only have to stay for 7 days in FL if you went to Garramone, right?

[DapperButch]

Bard,

I don't know if you have read my extensive ramblings to cathexis, but one thing I listed was this site: http://www.topsurgery.net/

It will give you a solid foundation when starting the process of looking into top surgery.

I forget to tell you that when you contact your insurance company for providers, you need to ask them to send you information on what is required for them to pay for your surgery. Look on your insurance website for trans health coverage which will also have the information.

Without a doubt both your insurance company and the surgeon will require at least one "letter" from a gender therapist saying that this surgery is medically necessary. Make sure that when you see said therapist that you give them a copy of what your insurance company wants in a letter and what the surgeon you have chosen wants in a letter. This way the therapist will make sure to have all of the information needed for both parties. Otherwise, you will find yourself returning for another letter.

If you don't have a gender therapist you can look for a gender therapist who will meet with you for an evaluation and write a letter for you. Usually this is out of pocket, rather than using insurance. Make sure you also find out the therapist credentials required for the insurance company and surgeon.

Let me know if I can help in any other way.

[nhplowboi]

Thanks for the info Dapper, I will check out transbucket. Unfortunately, a week away from the store and farm would take tremendous planning.

Originally Posted by DapperButch

Melissa Johnson is very good and carries a great reputation in the community. Check out transbucket.org for pictures of her work.

I assume you know you would only have to stay for 7 days in FL if you went to Garramone, right?

[Bard]

Originally Posted by DapperButch

Hi, Bard.

I am not sure what you are asking? I have never heard of someone getting cysts from a binder, so I would check that out.

You mentioned keyhole. The most internationally known/respected keyhole/peri areola surgeon is Beverly Fischer in Timonium, MD (close to Baltimore). Unfortunately, she no longer takes insurance. Her double incision is $9,500. I don't know what her keyhole/peri is, but it would be a bit more than the DI. She is also an amazing person. Has been doing top surgery since the 1990's.

Many guys think they can get keyhole who really can't. If there is any droop to your breast, you should plan on it not being a suggested procedure.

Also, I didn't know you were on testosterone. I didn't see it posted anywhere. Can I ask when you started? Congratulations.

I would suggest before you get super excited about a top surgeon that if you have trans health insurance that you call your insurance company first to see who is in-network. Hopefully, they won't have ANY providers and then you will have your pick of the litter (as long as your preferred surgeon is willing to work with your insurance).

Thanks Dapper been on for over a year now and taking my time with this as I do, yeah I had cyst before that was removed and when I had started feeling some pain and such had my doc check she feels small cyst but test came back clear soo just thinking this is the next or best step for me in the information gathering stage right now and will talk to my endo she had mentioned some surgeons in the area she works with for the trans community here for when and or if I wanted any being small if you will and no drop so I guess we will see I just want to make sure this is the best thing as it has been on my mind a lot thought I would reach out honestly I think it is all part of the processes that each goes through when becoming

[cathexis]

Originally Posted by Bard

Thanks Dapper been on for over a year now and taking my time with this as I do, yeah I had cyst before that was removed and when I had started feeling some pain and such had my doc check she feels small cyst but test came back clear soo just thinking this is the next or best step for me in the information gathering stage right now and will talk to my endo she had mentioned some surgeons in the area she works with for the trans community here for when and or if I wanted any being small if you will and no drop so I guess we will see I just want to make sure this is the best thing as it has been on my mind a lot thought I would reach out honestly I think it is all part of the processes that each goes through when becoming

Years ago, wish that my doc had made such a recommendation when a solid cyst was found. Instead it was determined as benign based on an in surgery pathological eval. I had signed consents for mass removal, subtotal mastectomy, or radical mastectomy. Sure wish I'd had a pick one from column A, then one resolution from column B. Let's see...no cancer...subtotal mastectomy.

Too bad life doesn't work like that.

Wish I could choose binder vs surgery; instead,

I've basically got renal failure vs relief from gender dysphoria
OR
Heart problems vs feeling better about my body

If you're younger, I'd look really close at surgery as an option.

Turning back the clock is not an option later.

Instead, many must put Justice's blindfold on and weigh the best you can