Top surgery question.

[Sauce]

So I was talking to my therapist about top surgery. She asked if I was interested and I said yes ASAP. Finance very fortunately shouldn't be a problem but my therapist and I both know I will be starting college in the spring. I am hoping to be on T in about 2-3 weeks from now but she said I would have top surgery next summer? I haven't spoken about this with her yet but if I were on T for about a month or 2 is there any chance I could get top surgery before school? Maybe in November or December of this year? I would like to heal a decent amount before starting school but I do also want to know why this would or wouldn't be a good idea? The permanent changes aren't the issue I am looking more towards how would T early on affect my top surgery? I have seen guys on here a couple months on T who have already had top surgery and I figured since I have the time off right now, I don't see what the problem would be?

[vandalrivera]

shouldn't be a problem, from what i've heard. some surgeons don't require that their patients be on testosterone at all. who are you thinking of going to?

[emil]

in fact, doctors recommend that you go off T at least 4 weeks before surgery because it may lead to excessive bleeding during surgery.
i had top surgery and am not/never was on T. (In my very personal opinion, it does make sense to get the surgery before the T-induced fat redistribution takes place, because they'll do liposuction as well and that way you can decide to go off T later without having to fear regrowth.)

While some people's boobs shrink on T, that doesn't usually affect the choice of surgery method (say you shrink from a C cup to an A cup, then there'll be a lot of loose skin, so you'd probably still need to go with DI).
Also, the breast tissue becomes more dense on T, but again, that doesn't really affect surgery.

[Sauce]

Thanks for the responses, I'll definitely bring up some of the theories with her and do a little bit of my own research on the side just to understand the topics a bit better. As for the surgeon, she has her own HRT dr., psych tester, and surgeons but it is ultimately up to me on who I pick as a surgeon. Having her own group of dr.s made it a lot easier for me. I have looked around but can't remember the name of the surgeon I liked the best work of, however the patients I had seen were pre-t or on t for many months so I'm sure that particular dr. is flexible with being on T. I do workout out now so working out on T won't be a problem, hopefully that may help with the pec line as kvall stated above.

[emil]

it is true that working out your pecs makes it easier for them to locate your pec line, but you can work out pre-T , right?

About going off T before surgery: doctors here in Germany all recommend it and my doctor even wrote a letter to my GP emphasizing that you should be 4 weeks off T and not have taken aspirin for 2 weeks. both affect blood clotting - although testosterone only makes your blood coagulation change towards normal male blood coagulation, and men do get surgery as well, so you could argue that cis guys can't reduce their T-levels before they have surgery either....but then again, i lost quite a bit of blood during surgery and fainted twice after surgery and felt really weak for a week or so....and if i had been on T i would have lost even more blood...and that wouldn't have been fun. So i guess you'd have to weigh up the mood swings and other troubles you get from going off T and the prolonged recovery time on the other side of the coin.

[Sauce]

I had told my therapist I work out and she told me to avoid working out my chest until I start T. She said it pushes your chest out more? And obviously I'm trying to avoid that but I haven't been doing my chest since she said that.

[wheat thins are delicious]

She said it pushes your chest out more?

Yes, when you build your pecs, your breasts appear more perky. 

[Sharky]

It will still push your breast out post T. Even more so because you will be gaining muscle easier and quicker.

[RyGuy]

As far as I know, only one surgeon recommends going off T (Fischer) and that's just due to her observations of relatively fewer hematomas and not any hard data.

mcginn does as well and she's practically a genius. there is plenty of "hard data" that testosterone complicates the clotting of blood. why chance it with a pretty major surgery?

[xAndrewx]

What they mentioned is correct but just to point out if you're like me and know you have a lot of fat on your chest gaining muscle there could help get rid of some of the fat and make them smaller but yes, what is left will stick out more.

[RyGuy]

I meant that there wasn't hard data that trans men have fewer hematomas if they go off T before top surgery. But thanks for pointing out that other surgeons have brought this up (to emil as well). Why risk it? Some might predict, based on their experiences with their hormone regimen, that going off T will put more stress on their bodies than they are willing to cope with.* Some who are not yet on T might also have the timing for when they can both start T and have surgery align, as seems to be happening for the OP. Thus people in that situation would be left deciding whether delaying either T or surgery is psychologically feasible for them.

*For example, I was off T during my surgery, but not by choice--my prescription got delayed in the mail. I've discovered that when off T, my muscle spasms in my back/shoulder get much worse. So I was in a lot of pain (of a type that doesn't respond to the medication given for post-surgical pain) that could have been avoided if I'd been on T at the time.

well it was annoying as hell to be off t for a month- seriously i felt like a 55 year old menopausal woman. but being off my hormones wouldn't kill me and bleeding to death during surgery would. you just have to weigh in your mind what you think is a rational sacrifice. if your doctor or surgeon tell you to do it though you definitely should.

[RyGuy]

Yeah, I just wonder if there are other factors, or ways in which being off T can otherwise complicate things. E.g., testosterone raises red blood cell concentrations, so perhaps this offsets volume of blood loss. Not sure whether studies have been done comparing this.

(By the way, aren't trans women frequently told to go off their hormones for surgery?)
Totally.

i think generally trans women are on hormones for quite some time before they have lower surgery, and wouldn't that render their original organs less useful? maybe stopping their hrt regimen wouldn't bring about an increase in that much bodily testosterone. i don't know, i'm just speculating. i stand by what i said though that if your doctor is even remotely legitimate and he tells you to do something for your own safety, do it.

[Robert Scott]

I just had a couple surgery consultations --- all of them said being on T doesn't matter.  They all said to work out your chest before hand though so they make sure when they place the nipples that they don't fall off the muscle.

I am likely going to have chest surgery first then hormones.