Realistic Expectations for Top Surgery (Chest Reconstruction and Breast Augmentation)

The plastic surgeon is responsible for setting expectations and informing the patient on all possible risks, compromises, and complications regarding any surgical procedure. These expectations, risks, and complications are especially important when pursuing gender confirming chest reconstruction and breast augmentation procedures, as there is a lot of information spread through the community, on the internet, and by providers. It’s important to recognize that not all of the information shared within and around the community is the most up-to-date or accurate. Here we attempt to give the most thoughtful, informed, and current information regarding preparing for these surgeries, their risks, and potential outcomes. The patient’s support team can also be very helpful in making sure everyone involved has reasonable expectations and accurate information and resources.

It can be helpful for transgender people considering gender confirming surgery to discuss their desired outcomes with surgeons and other medical providers to help them set realistic expectations. A therapist, primary care provider, hormone provider, and anyone else involved in the patient’s regular care should also be involved, as multidisciplinary care can be helpful so all are aware and able to help the patient understand how their body and mind will be affected by undertaking surgery. Seeking community support and engagement can also be helpful for the patient, as talking to people who have already undergone their desired surgical procedures can be integral to a deeper understanding of what is to come.

A Stabilizing Influence

A family member, supportive friend, significant other, or community member can offer important support through this process. If the patient is comfortable with members of their support team discussing their surgery with their surgeon and grants permission to do so, we support communication between the entire care team to ensure the patient is as well-supported as possible.  

Finding the Right Surgeon

Dr. Scott Mosser, and all of The Gender Confirmation Center surgeons, encourages patients to bring along a member of their support team to their initial consultation. He is aware of the special considerations and collaborative nature of transgender health and is willing to coordinate and consult with other medical professionals involved in the patient’s past or current healthcare . He and his team of professionals are familiar with the transgender community of support groups in the San Francisco Bay Area, and can provide resources for pre- or post-op accommodations for patients traveling to the area.

Breast augmentation and chest reconstruction top surgery outcomes both generally have high satisfaction rates. By this, we mean that patients are generally very happy with the aesthetic and functional outcomes of their procedure. Plastic surgery is first and foremost a physical alteration and cannot be assumed to be a “cure” for gender dysphoria or other mental health diagnoses that require specialized providers. Our surgeons get high marks for aesthetic results which can boost self-confidence and make wearing certain clothes more comfortable, but plastic surgery cannot be expected to replace continuing long-term therapy to address emotional or psychological concerns, if needed. For some patients, surgery is certainly all they need to live a happy and healthy life; for others, it is not a cure-all for other issues, gender-related or not.

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