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Mr Andrew Yelland
Consultant Breast Onco-plastic & Cosmetic Surgeon

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Before Chest Reconstruction Surgery

For any kind of surgery you need to be both physically and psychologically ready.

PREPARING PHYSICALLY

Physical readiness involves being in a reasonable state of general health and completing any pre-surgical requirements as advised by your surgeon, such as quitting smoking or slimming down to an optimal body weight.

It is also important to have a post-surgical plan in place to ensure that you have a safe place in which to recover and friends, family, or other caregiver to assist you in the first few days of recovery.

If you regularly wear binding to minimise the appearance of your chest then you should mention this to your surgeon as it can sometimes affect the health and suitability of chest tissue for certain FTM surgical options.

You may be advised to reduce the amount of binding prior to surgery to allow your skin to breathe.

ACHIEVING A HEALTHY WEIGHT PRIOR TO SURGERY

Transmen with excess body weight may not be ideal candidates for FTM surgery and some surgeons may choose not to perform chest reconstruction unless you can achieve an optimal weight.

Although there are increased risks to do with surgery in general (such as anaesthetic and respiratory complications) a major reason that surgeons prefer to operate on someone at their near optimal weight is because this can dramatically improve the aesthetic result.

The surgeon can more closely contour your chest in proportion to your body and reduce the risk of leaving dog ears under the armpits.

Symmetry is also better achieved in patients who are not carrying excess weight.

PREPARING PSYCHOLOGICALLY

Physical readiness is not the only consideration with chest reconstruction surgery however, as mental preparation is also very important.

Ensuring that you understand the profound effect that your surgery can have on your sense of identity and self is vital as expectations need to be realistic to avoid disappointment after any initial post-surgery euphoria abates.

Take time to discuss your priorities with your surgeon and remember that non-trans men do not all have identical chests so there is no standard model for FTMs to aspire to.

DISCUSSING YOUR OPTIONS

Looking at pictures of previous patients can give you a realistic view of the outcome of different procedures.

It may help to concentrate on those with a similar body size and shape to yourself in order to see how their surgery has affected them.

Some transmen are more concerned about retaining touch sensation and others with achieving as natural a look as possible making different procedures more likely in each case.

Removal and transplantation of the nipple (a nipple graft) is not a reversible process and requires careful consideration.

The more the nipple is moved and resized the more likely nerve damage and loss of sensation.

GOING INTO HOSPITAL

If you are undergoing chest reconstruction alone (without any FTM genital surgery), you will be admitted to the clinic on the same day as your surgery.

Patients will require pre operative tests prior to their admission. We try and combine this with your initial consultation before surgery, especially if you do not live locally.

As the procedure is performed under general anaesthetic you will usually be told not to eat or drink anything after midnight the night before your operation.

You will also be given guidance on when to cease any medications or hormone therapy with blood-thinning medications such as aspirin usually stopped for ten days or so prior to the procedure.

It is important that your surgeon knows all of the medications, whether prescribed or otherwise so as to minimise risks of complication.

Some herbal and nutritional supplements may interact with anaesthetic or cause poor blood-clotting, for example.

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