I'm way more concerned over secondary characteristics (hairline, voice, fat distribution) than I am about having a package.
I have a packer (in the mail... *checks watch for the billionth time*), and a binder, and no interest in getting surgery at this point in time. I'd consider top surgery, someday, when I'm rich and maybe actually want to expose my chest in public; but not lower surgery. Too expensive, inadequate for my desires, and too many complications. If I can't be completely satisfied, I'd rather use something fake that I can change if it sucks, than spend thousands of dollars on something that I can't change at all that might leave me unable to get off or even leave me incontinent.