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Top Surgery Consultation Guide | What to Expect

Medically reviewed by Jennifer Richman on May 2nd, 2025.

So You Want to Get Top Surgery. What’s Next?

For many patients, undergoing top surgery to permanently flatten or reduce chest volume is a medically necessary procedure to treat gender dysphoria. Once patients have come to the realization that top surgery is right for them, figuring out how to undergo surgery can be overwhelming.  

For any surgical procedure, the first step is requesting a consultation with an experienced, board-certified surgeon. A top surgery consultation is your space to get to know the surgeon, learn about which procedure options are right for you, and set realistic expectations for what surgery can accomplish for your unique case. In the following sections, we go over what happens in a top surgery consultation and how you can make the most of it.  The consultation, after all, is one of the best ways to choose a surgeon and make a plan for top surgery.

What to Expect During a Top Surgery Consultation

Many patients wonder what happens in a top surgery consultation. The consultation is where you’ll meet your board-certified surgeon, learn about your options for surgery, and address any concerns you may have. The consultation helps you determine if the surgeon is the right fit for your goals.

In a top surgery consultation, you can expect the following: 

• Overview of your medical history: health conditions or illness, previous surgeries, medications, drug and alcohol usage, etc.
• Discussion of your goals and desired outcome for top surgery.
• Evaluate whether you’re a good candidate for surgery.
• What top surgery procedures or incisions may be a match for your goals and unique anatomy.
  

How to Make the Most of Your Top Surgery Consult

There’s no need to worry or stress out about preparing for a top surgery consultation. It’s not a test; actually, you’ll be the one asking most of the questions! We encourage you to be honest about your goals, expectations, and concerns regarding top surgery. For safety reasons, patients must be completely transparent about their medical history and lifestyle (like smoking and alcohol use) to help their care team craft a unique surgical plan that minimizes their surgical risk during and after the procedure.

Top surgery is a permanent decision, so discussing the long-term results you want from top surgery is essential. Coming prepared by thinking about any of the following points can help your surgeon understand how to give you the most satisfactory results possible from your gender-affirming procedure. 

Many patients find it helpful to think about possible top surgery results in three ways:

• Aesthetics: We encourage our patients to bring photos of chests that resemble what you would like theirs to look like. They can be of cis men or top surgery results. There are no incorrect photos to bring in. Are you interested in having a completely flat chest or having some volume to your chest? Where would you like your nipples positioned on your chest? Do you even want to have nipples on your chest? What concerns do you have regarding scarring?
• Sensation: Do you want preserved or heightened sensitivity in your nipples after surgery?
• Functionality: Are you interested in chestfeeding/breastfeeding at any point in your life? 

There are no wrong questions. Your feelings and concerns are completely valid. The aim is to find gender-affirming treatments that align with your goals.

Finding the Right Surgeon for Top Surgery: Checklist of Questions to Ask During Your Consultation

Below we provide a list of potential questions you can ask your top surgeon during a consultation. Due to time limitations, we recommend you pick 2-5 questions that seem the most relevant to you. If you run out of time, you can always send your remaining questions to the medical staff to receive an answer, or request a second-follow up consultation. However, most patients leave their consultation satisfied without asking many follow-up questions.

Before your consultation, consider parts of the procedure you’re curious about and what is most important to you. Below are some questions you can ask the surgeon or medical staff.

Types of questions: 

Procedure Options: Top Surgery Techniques

• What kind of top surgery incision type do I qualify for?
• Which top surgery technique would help me accomplish my goals around aesthetics (e.g., flatness, scarring, etc.), sensation, and/or function?
• Would you recommend chest liposuction as a part of my procedure?
• What are my options for nipple and areola sizing and placement?
• What are my options for scar shape and placement?
• Can I undergo top surgery at the same time as another surgery? For example, body masculinization surgery or non-binary body contouring?

Medical History and Lifestyle Habits: 

Ask your surgeon how the following might affect your surgical result and healing:

• How will my substance use and other lifestyle habits (smoking, recreational drugs, alcohol, exercise frequency, etc.) affect the procedure and recovery?
• Will my underlying medical condition(s) hinder top surgery or the healing process? (If applicable.)
• Are there any medications or drugs I should stop taking before surgery? Are there any lifestyle changes you would recommend I make before surgery?

Recovery:

• How long will I need someone to support me after surgery as I heal? What kind of support will I need? How long do I need to stay in town?
• How much time off work or school will I need?
• Will I have drains?
• Given my medical history, is there anything I should be especially careful of during recovery?

Qualifications (we recommend you ask the surgeon and/or staff about these)

• Are you a board-certified surgeon?
• Are you a member of WPATH? 
• Do you have experience performing top surgery for transgender and non-binary patients? How many top surgery procedures have you performed for trans and non-binary patients?
  • How experienced are you in performing the specific incision or procedure type I want?
• Does your staff receive sensitivity training on working with trans and non-binary patients?

Frequently Asked Questions about The Top Surgery Consultation

How long does it take to get top surgery after a consultation?

On average, top surgery is scheduled 3-6 months after the consultation. However, there are variables, like the surgeon’s unique waitlist and how soon you will be ready for surgery. Some patients may need to make medical or lifestyle changes before being prepared for top surgery. 

Insurance can also slow the process with approvals and documentation. At the Gender Confirmation Center (GCC), we have a dedicated team to help patients navigate insurance. You can learn more about our free insurance concierge service here.

How much does a top surgery consultation cost? Are top surgery consultations free?

The cost of a consultation will depend on the healthcare provider and your insurance coverage. However, typically, the out-of-pocket cost is around $75-250 USD.

At the GCC, we recognize that costs can be a barrier to accessing medically necessary, gender-affirming care. As a result, we offer all of our consultations, virtual or in-person, free of charge to patients.

How can I schedule a consultation for top surgery ASAP?

You can request a consultation through a provider’s website or by calling their office.

It’s important to note that surgeons may prioritize patients who can be processed quickly. That means:

• If you don’t have insurance coverage, you are ready to pay for surgery using your savings, medical credit, or a grant (find options here).
• If you want insurance to cover your surgery, you will need a support letter from a licensed mental health professional so that we can process your insurance claim. 

Do I have to fly into town for a consultation?

No! Most surgeons will have a virtual consultation option for top surgery. That way, you can speak with the surgeon from the privacy of your home.

You may need to submit photos of your chest before the consultation so your surgeon can assess which procedures you qualify for and the results they can produce.