Top surgery but not on T yet? Good idea or not?

[LatrellHK]

So I want to get top surgery but the little issue I have is the fact that I'm not on T yet. I thankfully have an appointment in April (which IS far but way better than nothing) and I'm excited and all but my breasts are causing me issues. The biggest one being going to the pool, which is something I absolutely love but haven't been able to comfortably do in almost two years. So I wanted top surgery and wanted to know if I needed to actually be on T to get top surgery or and if not, is it even a good idea or should I wait? I pass as male without T as is and feel this will help me even more. I'm also a little guy, 115lbs and 5'6, and have always been flat chested but my breasts are a weird size where unless I'm wearing a sports bra AND binding, they're kind of noticeable (especially with dress and t-shirts).

So just curious if it is or is not a good idea/possible. If anyone has personal experience I'd love a little of your personal experience. Otherwise opinions are good enough.

Note: If you're using the prof. picture as a base, I guess it's okay. It's about a year and a half - 2yrs old and the only thing that's really changed are my glasses.

[Peep]

It is physically possible, there are guys here who've done top surgery before T. Some guys I think NEVER do T.

It's actually recommended in my country (NHS Scotland guidelines) to have top surgery before T, because they want to stop us binding as soon as possible, and because sometimes building muscle makes the breast area larger (the pectoral makes the boob seem bigger). That's not to say it always goes that way round though.

I don't know if you need to be on T to gain access to top surgery, however. It depends on the system you're part of - I'm pretty sure if you're going private you'll be able to decide, if you're using insurance or NHS etc you might have less choice...

[FTMax]

Hi Latrell,

It is totally possible to have top surgery before going on testosterone. It is not a pre-requisite in the Standards of Care, which most surgeons follow. You would just need to figure out which surgeon you would like to go to, and see what their requirements are as far as referrals. Most likely you would need 1 referral from a mental health professional stating that top surgery is the next appropriate stage in your transition.

As far as aesthetics, T may make it easier for you to build muscle in your chest which could potentially give you better results post-op. But ultimately the difference it makes is very little if any.

I know there are a few guys on the board who have gotten top surgery before or without being on T, so hopefully they will chime in.

[darkblade]

 Might be a good idea to try and build up your pecs before you get top surgery (I think I've read here and there that it helps), but otherwise you should be fine.

I know someone who was/still is unsure about whether T is the right thing for them, but were sure they wanted top surgery, and that's what they did. I didn't get to talk to them that much, but from what I understand, their chest was what bothered them the most at that time. Now it's their voice (I think), so they're considering T more seriously.

[Alexthecat]

I did top surgery and haven't been on T.

[Bimmer Guy]

I did top surgery a year before T.  I wasn't sure if I was going to socially transition, so that is why top surgery before testosterone. 

Garramone told me it doesn't make a lick of difference before or after being on T.

I can see myself doing the same thing (top surgery before testosterone), even if I knew I was going to take testosterone and socially transition.  I think having chest hair while still having female breasts would have made me even more dysphoric than I already was.  The incongruence of the two would have made things worse.

[FtMitch]

As someone who has always had so much nipple hair that it might as well be chest hair (seriously, I got gorilla nipples going on for some unknown reason that is not T related... just unlucky from a female perspective, I guess) I agree that it is a strange sight... But I personally am more interested in the results you achieve from T than those from top surgery, which is the reason I did T first (and I MIGHT be trying to avoid going under the scalpel for a little while longer, haha).  Also, you can always wax or shave chest hair, which is what I used to do with my nipples.  But, honestly, I don't think it matters unless you have an insurance policy that requires HRT before surgeries.  My insurance covers transgender surgeries, and allows you to start HRT and have top surgery any time with a therapist's letter.  It's only bottom surgery that requires living as a male for a year's time to have it, along with TWO therapist letters.  Which makes sense, considering that bottom surgery is both more invasive and more expensive.  So unless your insurance plan (if you have one) demands it, there is no reason you need to take T before having top surgery.  It really is a personal choice. If it will make you feel less dysphoric, I say go for it! 

[LatrellHK]

All of these are good responses, so thank you all! And FtMitch, thanks for the info. I was unaware of that and am glad you told me. I've been looking up information and costs lately. I'm also incredibly hairless (and praying T does SOMETHING in that department) so I don't worry about hair on me to be honest. I just hate my breasts it so freaking annoying and a good ole nuisance. But thanks again for the info and responses, I'll be sure to post how everything goes if something happens.

[HeyTrace19]

I had top surgery BEFORE starting Testosterone.  Best decision I ever made...transition or not!  I started T a number of months later.  My surgeon did not require a letter, and I paid out of pocket.  It was very relieving for me to have that weight off my chest!!!!  If you just cannot stand it anymore, then go for it!  It is YOUR body, and you need to find the best way to live in it.  The choice belongs to you.

[LaneD]

I also got top surgery before T.  It made my life a million times better.  My chest is what caused me the most stress and it needed to go.  My results are really good as well. Really it's up to you and what you want and what is best for you

[Muscle Matt]

I think you should just do whatever feels right. People seem to be happy doing it either way, and get good results.

For me, I was borderline for qualifying for successful Periareolar surgery. I worked out and used creams and such to try to lose as much chest fat as possible to guarantee good results for myself. I know some people don't have a choice in what surgery they qualify for, but I've had a very rough life, and I'm very suicidal all the time without the problems of gender dysphoria. I honestly don't know if I could mentally handle having large scars across my chest if I don't need them. I couldn't lose much up top, and have been so anxious about surgery (I plan to have it in Feb/March).

However, I am just over a month on T now and (somehow) have actually been losing weight, not gaining, and my chest is getting significantly smaller now (I probably lost half a cup size in the past week). I'm going to continue trying to get it to shrink as much as possible, and it's slowly giving me more peace of mind about surgery outcomes. So for myself, I'm glad I got to start T first. At the same time, I'm also glad that I'm going to have saved up enough money for surgery just in time to get it done shortly after starting T. I have scoliosis and asthma and binding is a severe challenge for me, so I'm glad I'll be able to get surgery before or around the time my facial hair might start coming in/changes might start becoming more obvious.

I know all my reasoning may sound complex and over-thought, but this issue is a real big source of anxiety for me, and this feels like the best course of action for myself.

Good luck with whatever you choose to do, and congrats on being so close to finally starting this journey of change!