So remembering how daunted I felt when I first set out on the road to top surgery in terms of educating myself, making the right choices, finding the right surgeon etc, I thought it might be a good idea to write up a few key points now that it’s all behind me.

At the end of the day, I’m very happy with my result and extremely glad that I did really take the time to thoroughly explore all of my options.

I wouldn’t say it was a smooth or straight forward process and it was a solid year of research, traveling to the other side of the globe, a bunch of consults with different surgeons all of whom told me VERY different things, and a whole lot of money even before I went under the knife. There was also the emotional rollercoaster of feeling hopeful, terrified, excited, defeated, angry, frustrated and scared but ultimately now, extremely joyful and happy with the outcome.

In my specific instance, what confused and complicated the process, was that I wasn’t sure if I should go peri or double incision and was getting vastly varying opinions on this from surgeons from “you’re on the fence” to “no way peri will work for you” to “you’d be an idiot not to go peri as you’re a great candidate for it.”

I myself was very keen to go peri, even if it meant multiple surgeries, and in the end, that’s what happened.

Some things I learned along the way and which I’d like others who still have this ahead of them to be aware of and think about:

Surgeons can have very fragile egos. It’s super important that you ask a lot of questions in a consult, but be aware that in order to get the best responses, you more often than not, have to do some very serious ego massaging. They absolutely don’t like to admit that they may not know everything and put up defenses very quickly if you phrase something in a way that they perceive to be challenging their skill/knowledge/omnipotence.

Surgery in this field still has a long way to go.  And that’s pretty much just a supply and demand thing. If chest surgery for trans men was as common as breast implants, we’d be getting amazing results, but as it currently stands, the few surgeons that are doing this kind of surgery aren’t necessarily great surgeons (though some of them are!) so really do your research and homework! I found was a great resource not only for figuring out which surgeons got great results but also, which ones to definitely stay away from. I do see the calibre of surgeons that are doing this kind of surgery getting better and better over the coming years as we gain more social acceptance, and even over the past two years, it’s been great to see some new players come onto the field, my surgeon included.

Know your deal breakers. Such as when one Sydney surgeon said to me after I asked her if she enjoyed working with the trans community, “Oh, yes I love working with the trans community! They have such low expectations.” (yep, that’s a verbatim quote…) Yours many not be quite as overt as this, but trust your gut instinct!

Stick to your guns! If you’ve done your research, you should be able to engage in a well informed dialogue with your surgeon, so if he suggests something that you don’t agree with or have reservations about, DON’T JUST GO ALONG WITH IT! Had I done this, I definitely would not have gotten the results I did. This can actually be really difficult especially when they do it to you right before surgery to just say “yeah okay, whatever you think” but do not let them put you under unless you 100% agree with what they’re about to do to your body!

Don’t just choose “close to home.” This is the first day of the rest of your life after all, and if there just are no good surgeons doing this kind of work near where you live, see that as an opportunity to broaden your options even if it means traveling all the way across the country or even the world.

If it HAS to be close to home, but you don’t feel there’s any great options, then research information from the absolute best in the world and get your surgeon to take it on board (much easier said than done believe me, as this was the route I went.)

Be prepared for more than one surgery. Though this mainly applies to peri, it’s often also the case with double incision. In my instance it took three, though probably could have been done in two and if I was really picky, I’d have a fourth as then you’d never be able to tell I’d had surgery.

So in summary, seeing my research extended globally, I’d like to just compile a very short, world wide list of the surgeons that, had time and space and money been no obstacles, I would have chosen for surgery based on result I have seen and interactions with their offices:

Dr Cori Agarwal* (Salt Lake City, United States)

Dr Miguel Delgado (San Francisco, United States)

Dr Janken Hoffmann (Munich, Germany)

Dr Daniel Medalie (Cleveland, United States)

Dr Richard Bartlett (Massachusetts, United States)

With this list, please keep in mind that my bias was towards finding surgeons that would do peri, so had I known that I would definitely go double incision, this list would have looked different. Had I gone double incision, my decision would have been clear cut:

Dr Andy Ives (Melbourne, Australia)

Out of every surgeon I saw, Andy was by far my favourite in the sense that what I said earlier about surgeons having fragile egos, simply doesn’t apply to Andy. He is extremely open to taking on new information, is very interested in working with the trans community and actively seeks to improve his knowledge and skill in this area at every opportunity.

In the end, the surgeon I ended up going with was Dr Steve Merten in Sydney. Steve is still pretty new to this type of surgery, though he has a very solid background in breast augmentation and gynecomastia surgery (and I very much felt in the end that him being new to this surgery was a good thing, as unlike other surgeons in Sydney that are doing a pretty sub par job at this surgery because they don’t think they have anything left to learn, he was still receptive to understanding that there could be a better way.) As long as he stays receptive, he’ll only get better and better from here on in, so I’d definitely highly recommend him.

I will also include some before and after shots here, though you’ll need to click this link to access them. I was very reluctant to post these but understand the importance of them in terms of being able to make informed decisions. I ask that they please NOT be circulated in any other context other than this article!

*Note: I’d like to update this article to also include Dr Cori Agarwal from the University of Utah, Salt Lake City. She has done some revision work on me and I really can’t speak highly enough of her. By all accounts she is great for both peri and double incision and will work with you to achieve what is the most important to you (minimal scaring, nipple sensitivity etc.) and is also really good about doing revisions at minimal cost. Knowing what I know now, I’d put her right at the top of my list of recommendations.