Most patients, if healing permits, are able to return to work after 1-2 weeks after top surgery with some limitations. It is essential to your healing that you take it easy, and avoid heavy lifting above 5 lbs and engaging in any other strenuous activity. A good rule of thumb is that you should not be breaking a sweat during the first 3 weeks of healing.

Coupling top surgery with additional procedures such as body contouring–liposuction and/or pectoral silicone implants–is possible. Combining multiple procedures into a single surgery may lower the overall expense and recovery time. However, this may carry a higher risk of complications. Consulting with your surgeon can help clarify potential risks and your candidacy for multiple procedures.

Joining top surgery scars in the middle of the chest is a technique requested by some patients to ensure chest flatness by taking out excess skin. If the appearance of a joined scar is not appealing to a patient, other techniques can be used to tighten skin and reduce the chance of dog ear formation. For example, surgeons can extend the incision under the armpit, use chest liposuction and/or curve the incisions upward in the middle of the chest.

Many insurance plans will cover the costs of gender-affirming top surgery. To secure coverage, you will likely need a letter from a mental health provider that states you meet WPATH guidelines or a referral from a licensed primary care provider. Requirements depend heavily on your individual plan, and it can be helpful to reach out to your insurance provider. At the GCC, you can leave the insurance worries to us. Our insurance advocacy team has a 90% success rate in securing approval for patients

Top surgery generally varies in cost from $8,500-11,500 and includes surgeon’s fees, anesthesia fees, operating room fees and post-operative garments. This accounts for buttonhole technique and you can expect your procedure to fall within this range. The cost of your individual surgery can vary, and your surgeon can give you a more specific quote after your free consultation. Insurance coverage or grants can significantly reduce the cost of surgery.

The double incision and buttonhole techniques both leave one or two horizontal scars at the base of the chest. However, the buttonhole incision differs in two key aspects: (1) complete chest flatness cannot be achieved and (2) there is a greater possibility of maintaining nipple sensitivity. Double incision will create a flat chest presentation, while buttonhole creates two “mounds”. The “mounds” of tissue left behind can help ensure that the nipple stays attached to its original nerve and blood supply. Note that if you wish to undergo double incision to achieve complete chest flatness, sensitivity may be preserved through nipple-sparing or nerve reconstruction methods.