Well, I have been on T for 2 years now - and I just had my first consultation in August. My surgeon is in Sydney, Australia.
She basically took a look at my psychiatrist's letter and my medical records and asked me about my medical conditions (I have a heart condition and Meniere's disease) - asked me a bit about my transition so far, my family and whether or not they were accepting, etc. - then she looked at my breast ultrasound films and had me take off my top and binder (very dysphoria-inducing, but necessary). She felt of the lumps and said that she wasn't too worried about them (my ultrasound showed up a number of masses) but that the breast tissue would be biopsied after when I had my surgery anyway so anything nasty (if there) would show up.
Then she had a look at the shape of my moobs and drew on them with a marker and showed me where she'd cut, what bits she'd "lift up" and where she'd be placing my "new" nipples. Then she sat down and asked me when I wanted surgery - then we talked about things like recovery times, etc.
I booked my surgery the same day and now just have to have a second and final telephone consultation in October before my surgery in January.