Chest surgery before T?

[Peep]

mostly i was wondering how many guys regardless of country had their chest surgery done before any hormones?

I was reading an NHS scotland guideline in prep for visiting my GP tomorrow, and i noticed this:

"Bi-lateral mastectomy and FtM chest reconstruction:
For transsexual men this procedure is usually the first surgery performed and for some patients it is
the only surgery undertaken. The procedure can take place during the preoperative 12 month
experience provided it has been agreed in their treatment plan with their GIC and referral is
accompanied by one assessment from an appropriately qualified professional.
Testosterone can make the binding of breasts more uncomfortable, whereby some patients
experience breast growth and increased sensitivity, thereby raising the issue of having this
treatment prior to hormone treatment"

the NHS England resources I've read seemed to make out that hormones were a must before surgery.

This info comes from a document that's from 2012 so it may not be up to date (but it's the only one i can find specific to NHS scotland)

[Tysilio]

There aren't any hard and fast rules about it. Many surgeons recommend that if you do plan to go on T, you do that a year or so before chest surgery, at least for DI. The reason for this recommendation is aesthetic, not health-related: your chest muscles will develop when you're on T (especially if you're working out), and if they're better defined, it's easier for the surgeon to place the incisions correctly.

But I know plenty of people who've had chest surgery without going on T first...

As to the issue of whether "some patients experience breast growth and increased sensitivity" on T -- according to my doctor, at least, that's a sign that one's T level is too high, so that some of it is being converted to estrogen. In other words, it shouldn't happen if the T dosage is correct, and so it shouldn't be a factor in deciding when to have surgery.

[HeyTrace19]

I had chest surgery about 4 months BEFORE I started T, as I was not sure I wanted the T, but knew that the surgery was a definite for me.  My chest is fine, my pecs have developed some (with a lot of push-ups), and I believe it was the perfect choice for me...

[Peep]

Hmm i suppose I'm happy as long as i get to choose. T first makes things faster then I'll do it that way...

[randomdude5]

I had surgery before T and my chest turned out very nice actually.

[LaneD]

I had surgery in April 2014 and just started T 3 weeks ago (October 2015) my results are really good.  For me top surgery was the most important thing at the time.  Im read as male and my chest was what gave me the most stress.  Now T is important to me because people just think I'm 16 when I'm 29.  Not to mention how much I want a deeper voice and facial hair 

[Jak]

Surgery in six weeks. Not on T and no plans to so so. Hypertension...

[sam1234]

Traditionally, T is usually started before surgery. One reason is that most of the changes brought on by T are reversible while surgery is not. It may depend on a state by state standard. I transitioned back in '89 in N.Y., and at that time, the rules were very specific. First T, then mastectomy followed by OVH and finally phalloplasty. At the time, you had to be on T for six months before any surgery could be done.

a lot of things have changed since then, most of them for the better. I agree that having breasts is emotionally traumatic. People have different ideas as far as how far they have to transition before they are comfortable. Even with T, F to Ms tend to look younger than their chronological age. Without T, the body will continue to distribute fat in a female pattern and you won't have facial hair. If there are medical problems, people can't always do what they want. I knew one guy who didn't want to give up smoking and lost a nipple as a result. He wanted a phalloplasty, but decided smoking was more important. Everyone is different.

I find it comforting to know that teens are being allowed to begin living as males now. That gives them a chance to integrate into male society sooner. I guess I'm a bit off the subject as far as knowing if you can have surgery without T, but I think it is more about the individual now than it used to be.

sam1234

[Peep]

One reason is that most of the changes brought on by T are reversible

haaa fact check on this please

[Alexthecat]

Traditionally, T is usually started before surgery. One reason is that most of the changes brought on by T are reversible while surgery is not.

This reasoning always pisses me off. T makes the permanent changes. If you cut off your boobs and then decide you want them back later they can easily put implants in.

[sam1234]

I can't totally agree with that. Clitoral enlargement may or may not be permanent. Voice changes are more apt to stay, but there are women with deeper voices and not all people have significant voice changes if they had a lower pitched voice to begin with. Body hair often diminishes. When my old Dr. dropped my T to below low normal, I lost hair on my arms, legs and face and I've been on T for 26 years. My body began to form curves again.

Yes, you can put implants in, but for many women, implants are not the same as having "real" breasts. Scars and nerve damage may effect future intimacy. For M to Fs, once the penis is gone, its gone. For someone who finds that they really were not a transgender, I seriously doubt that trading a natural penis for a surgically formed one is going to be acceptable. For an F to M that realizes they have made the wrong choice and wants a baby and to breast feed it, implants are not going to produce milk.

Its a controversial issue and I'm sure its a button that causes a lot of emotion. My comments were made from what I had been told by Dr.s and have experienced when my T dropped to clos to nothing. They were not meant to offend or upset anyone. If they did, I apologize for tromping on some feelings, but I can't say that it changes my own belief.

sam1234

[Peep]

No one is offended; I would just be careful with presenting personal experience as universal fact. From what I've read, clit changes, voice changes and some of the hair growth/loss are permanent, and things like fat distribution and menstruation are not.

Personally I would say in terms of detransitioning, growth of a micropenis would be harder to live with for someone deciding to begin IDing as female.

[chance]

I haven't had anything yet but plan to start with top surgery. That is if insurance/SOC allows it.


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[sam1234]

Peep,

Not all of it was personal experience. Some was told to me by Doctors, but that is a hair that doesn't need splitting. Point taken.

sam1234

[TrojanMan]

I had surgery a year before I got on T. Personally it didnt really make a difference. I always feel like when we get top surgery our nipples are higher than cis men's nipples are, mine are kind of in the middle of my pec. It seems like cis nipples are usually on or near the bottom of their pec. Maybe being on T first would help this? I've never really seen a double incision surgery that had the nipples in the anatomically correct spot, only key-hole.


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[sam1234]

There may be additional factors to consider. The expertize of the surgeon, size of the breasts going into the surgery etc.
I had double incisions. After the swelling went down, the nipples looked like a cis guy's would. At the time I was doing a lot of weight lifting, and worked more on the upper aspect of the pecs. I don't know if that made a difference or not. When I stopped lifting, I saw a change in the appearance as far as asthetics. My surgeon was good, removing extra skin and making the aereola smaller as well.

Since then, I've had a number of procedures on my chest, not trans related, but to implant a battery for my peripheral nerve stimulator for migraines. Whether or not my nipples would have returned to their optimum position if I had kept up the weights is kind of moot now with all the scarring. Kind of ruined the landscape.

sam1234