Top surgery often leaves the chest completely flat, but for some men it would look weird if they didn't have a little bit of man boob. Are there any surgeons who make the best normal looking chest for fat guys? Also, will surgeons not do top surgery for men who are obese until they lose weight?
Hey there! Fat person looking into top surgery here :D
I've seen a lot of examples of fat folks who had top surgery and their final result is a very flat chest that looks a bit out of place. Which, I think for a lot of folks is a personal decision because it can be hard not to see any tissue left behind as being breasts, even if it doesn't appear that way to other people. But it is also something that I see more with certain surgeons that others, and definitely has to do with their personal techniques and aesthetics.
I've been researching this a lot because I think a completely flat chest would look very strange on my body and I would be more comfortable with a surgeon who leaves a little bit of tissue behind. You see this more commonly with surgeons doing the pedicle technique, because that technique requires the surgeon to leave a bit more tissue than usual. The surgeon who is most well known for that technique is Dr. Steinwald in Chicago (whos photos are in the ftmsurgeryinfo yahoo group, transbucket, and on his website as well as a few other places on the web). I've found a few other surgeons who do this technique but there are less photos of their work online.
My understanding from speaking with a couple surgeons is that most surgeons should be able to leave some fat and/or tissue if you request it. I know that some surgeons are a bit wary of doing so, having done so many revisions for people who went to inexperienced surgeons who left more tissue than they wanted. But I think that as long as you come in with a very clear idea of what you want and discuss it with your surgeon, they should be able to accommodate your needs.
I've been saving photos of cis men (and a couple trans men) who have chests that aren't 100% flat. When I finally choose my surgeon, I will be bringing in photos of the chests that I like and that I think would look the most natural on me. Surgeons often suggest you bring in examples of what you want, and I think especially so when your request is somewhat unique. Fatnudes.tumblr.com is a great place to find lots of awesome pictures of guys with not-flat chests. It also makes me feel a lot better about my chest as it is, to see so many cis guys with bods that are not all that different than mine : ) Reminds me that sex is a spectrum!
To find surgeons whose work on fat bodies you like, I would suggest searching through some of the photo-focused top surgery forums and finding examples of fat folks that you like. Even if they're not exactly what you want, just knowing that a surgeon has experience with fat folks is good. I've been trying to compile a list of surgeons who are best with this, but I don't have any solid answers to give you right now.
To answer your last question, there are some surgeons who have weight limits (ugh) and some surgeons who have BMI limits (super outdated irrelevant ugh) and some surgeons who encourage their patients to lose weight before surgery (triple ugh!). That said, there are also a lot of surgeons who will work with your body as it is, which is awesome. It's definitely a question to ask your surgeon about. During consults I've just asked very frankly "Do you have a weight limit? Do you feel confident and comfortable operating on fat people?"
jeez sorry im so long-winded.