My Oregon medicaid knew I was getting top surgery because I am transgender, but told me if I wanted it within a year instead of a decade from now, I'd have to get it coded as preventative for breast cancer and have all of my breast tissue removed. I'm okay with that (do have a ton of cancer in my family), but any advice I give has to be taken with a grain of salt because my surgery was atypical for a transman.
Dogears are one of the most common things requiring followup, and it looks like you've already got that covered. I have a small one on the left side, and my insurance won't pay for revision because it was caused by an emergency re-incision and clot removal after my autistic daughter punched me in the chest a few times shortly after the first surgery. That's not at all a normal complication, but I'm not sure that insurance would treat any complications as normal even if they were.
If it matters to you, you should discuss very clearly whether you are more concerned with aesthetic appearance or preservation of sensation. If I had been able to pick my own surgeon I would have prioritized nipple feeling over nipple placement. I have seen multiple cases where aesthetics were paramount, but nipple necrosis (minor or extensive) happened anyway. Same for the other way around, sensation being prioritized but left patchy or extensively lost to nerve damage.
If your psyche is at risk when you are out of your element and around strangers, you may want to ask (or warn) ahead of time about how good the surgeon or your hospital and their staff are at using the correct pronouns. I have a deep voice and an unmistakably male name, and I often forget that I'm even trans because it hardly ever comes up, but when I go to the hospital I get called "she" and "maam" pretty often. I assume it's hard to see past my medical charts and my basic anatomy, and I don't blame the staff for that. There have been times in my life when it would have been really hurtful to deal with, though.
I can't think of anything else that isn't obvious. My hospital refused to release me to another adult when they learned that we were planning to take the bus or train home, and we waited for hours until the drugs wore off enough for me to lie to them and tell them we had a car. That seems a quirky and uncommon problem, but keep in mind that the hospital will want to know how you will get home and who will take care of you while you recover.
Regardless of all the details and whether you remember everything you want to ask, congratulations.
This is such a wonderful step and I'm glad it's on your horizon.
