Hi guys,

I'm doing my best to plan ahead. I know without a doubt that I want top surgery and that I want to be on testosterone. I am trying to make the best plan (for me) possible. Is it better to have top surgery after you've started taking T? Or, is it better to have top surgery, and then start taking T?

If there those of you who have your experiences with either/or, it would be great to hear!

Cheers 

I'm pretty sure that nowadays it doesn't actually matter.  I've seen a lot of guys having surgery before starting T.  I was on T for two years before having mine, though. 

I've heard different stories of why it's "better" to be on T before having surgery - but I don't think that they're necessarily true.  I know that it seems like most surgeons don't care either way whether or not you're on T, as long as your treating mental health professional believes that surgery is the next step in your transition.

Hi Kreuzfidel, thanks for the response. Yeah, I'll be interested to know what the psychologist/doctor say. I'm not too worried either way, I'd just like to make an informed decision. Thanks again for taking time to reply

As Kreuzfidel said, it does not effect results and surgeons don't seem to care.  They can just as easily find the pectoralis muscles whether they are large or small.

I had my top surgery first, but that was because I wasn't sure if I was going to take testosterone and socially transition to male.

If I knew for sure I wanted to transition back then, I'm sure I would have started testosterone first because I would have wanted to get the ball rolling.  However, I was able to bind to the point where my chest was pretty flat.  I can see if I had a breasts I couldn't hide, that I would get surgery first.

There is no right or wrong.  Do what is most comfortable for you.

I heard that it can be better for *some* guys to go on T first.....provided if they are very skinny, work out, and have very little "boobage" to begin with, but again, it's debatable, and personally, I don't think it matters too much.

Personally, I would prefer to go on T first, but my social and financial circumstances kind of prevent that, so I am getting my top surgery done first.  If it is still a major concern for you, I recommend getting a consultation/askng your preferred top surgeon what do he/she recommend you do first.

I did top surgery first. I think it would be better down the road to get it now if you can afford it or you will be one of those guys 5 years on T with boobs and no money. Not fun.

It is entirely up to you...

Reasons to have the surgery first might include:  financing, insurance coverage, unbearable chest dysphoria, access to preferred surgeon, scheduling concerns (work, school, etc), unsafe or uncomfortable binding, or just that you WANT it now.

Reasons to start T before having surgery might include:  financing, possible shrinking/loss of breast tissue on T, anticipated weight loss or gain, desire to build more muscle before surgery, scheduling concerns, access to preferred surgeon, uncertainty about wanting or needing top surgery.

And you may have other factors that influence your decision...But it is just that, YOUR decision.

Personally, I had top surgery about 3 months before starting T.  I was fairly large chested and extremely BOTHERED by that!  They just needed to go... I have no regrets.

There is no medical prescriptions - You can do in one way and another. But I think it is better to stay for a year or even more on T - to see one more time: do You need all of this or not. Just for social adaptation. Hormonal changes are reversible, and surgical...  not so easy.

Thanks for the info guys

With all of the confusion and self doubt happening in my life right now, one thing is certain, I want top surgery. I am super dysphoric about my chest.

7 years ago, I had breast reduction surgery for medical reasons. When I was speaking with the surgeon about what size I wanted, I said to him that I wouldn't be disappointed if my breasts were not at all there... He laughed at me and said "that would look silly". Every time I see my chest and my scars, I feel like cutting them open again. I am sorry if I've offended anyone saying that, it's just how I feel.

When it comes to taking T, I get very excited. I want to build my muscles and have my voice drop. I want grow a beard...where I work, it is a very, very, very trans/homophobic place to be. I really have to get things in order before I proceed with transitioning, especially (for me) starting T. I'm not even sure if I can safely transition at my work. But maybe I have built this all up in my head? Maybe my coworkers will be supportive? Ugh....that's a whole other topic now isn't it?...I guess what I'm maybe realizing (as I'm re-reading this) is that maybe top surgery would be the best first choice for me.

I wanted to be on T first so I could build some muscle before surgery. Added 2" to my chest in 3 months. As others have said, though, the choice is yours. I really wanted my top surgery asap, but December was the soonest I could justify the expense, AND get my mom to come and handle my aftercare. The T is kicked in now, top surgery done, and I'm getting more regular "sirs" now from strangers.

-Jay

If there is a chance you will loose your income then yeah top surgery should be done first. It's not cheap. T is affordable working any job for the most part (just the T not counting blood work).

Really interesting reading this. Most places where I've looked have always assumed that you'd be on T first - although I think I saw something in the UK guidelines about top surgery if they felt it would be best in a minority of cases or something. It had really been bothering me as there's no way anyone would ever call me sir with my chest. As much as I'm looking forward to my voice dropping and stuff I wasn't looking forwarded to being a bearded guy with a huge chest! They're definitely a huge focus of my dysphoria and I just want them off.

This has been reassuring!

Quote from: AndrewG on January 25, 2015, 11:51:49 AM
Really interesting reading this. Most places where I've looked have always assumed that you'd be on T first - although I think I saw something in the UK guidelines about top surgery if they felt it would be best in a minority of cases or something. It had really been bothering me as there's no way anyone would ever call me sir with my chest. As much as I'm looking forward to my voice dropping and stuff I wasn't looking forwarded to being a bearded guy with a huge chest! They're definitely a huge focus of my dysphoria and I just want them off.

This has been reassuring!

I don't know if you are in the UK, but it seems as though the NHS has an order in which you do things (if they are paying for you).  I would ask someone in the UK before you get too excitecd.  You don't want to be disappointed!

My therapist told me right from the start that I could have surgery before taking T. She of course recommended that I wait 6 months, I'm almost done with my 3rd month and will be asking for a top surgery letter. I do believe at this point I am doing well on T and would like to get top surgery out of the way. I see it as the next step. I've already legally changed my name, waiting on my letter to change gender marker on dmv card, dr's nurse is getting re-certified to write off letters, shouldn't be much longer. I decided to wait for top surgery since I was still saving money. I'm almost to my goal but seeing as though my therapist is always booked solid for a month in advance I figured it was safe for me to ask for it at my next appointment next month.