I will post pictures at another time - I want to be able to give a timeline with swelling/healing. Also this post is forever long, I apologize.

I had nipple-sparing double incision with Dr. Mundy at Johns Hopkins in Baltimore on 10/14/24. There is not a lot of info out there about her, so I thought I'd talk about my experience. My overall impression of her: very kind with incredible attention to detail. She loves doing surgery and wants to give her patients the best results possible.

A few facts: Johns Hopkins has a very restrictive privacy policy, so she does not have any results photos available to look at. She is not technically a part of their Center for Transgender and Gender Expansive Health, but she augments them. Her specialty is breast reconstruction for cancer patients/patients with trauma. Her availability for top surgery is much better than Dr. Fan Liang's.

Communication: has been great. Johns Hopkins uses MyChart and I find that system very easy to use. Her team has been very responsive to the few messages I sent using MyChart. It's also very easy to access my appointment times and dates, as well as pre-appointment instructions and notes from completed appointments.

Consult: getting it was not simple, but not awful. I reached out in February and at that time they required an intake appointment prior to being able to schedule a consult (I heard that's going away, which is great, because it seemed pretty pointless). They scheduled my intake appointment for April. However, in March I met their two requirements to skip the intake: 1) they had my medical records (my PCP is with JH), and 2) I sent them my therapist letter (unsecured email, which I did not like at all, but that seems to be standard practice in the industry). Once they had the letter, they cancelled my intake and scheduled me for a consult in May.

The actual consult was good. Dr. Mundy did a brief, hands-on exam and took some measurements. She told me my options - I had not though I'd be eligible for anything but DI with FNG, but she told me I was a good candidate for the "pull-through technique" (aka buttonhole), which she then described to me. At this appointment she did not mention nipple-sparing DI without moving the nipple - she mentioned that at a later consult - which is what I ended up getting. I also had the choice for FNG if I preferred - I was nervous about not getting flat. I did not choose at the consult and she told me that was fine. She also told me she resizes areolas but not nipples. She answered my questions, was kind, and at the end I asked her why she does top surgeries if it's not her specialty. She said she finds us to be some of the happiest, most grateful patients and she loves working with our community.

Scheduling: At the consult, after I talked to Dr. Mundy, I talked to her PA, who asked when I wanted to have surgery. I said October (for work/life reasons, this was my plan) and she was surprised because people usually want surgery soon. I don't know when the first available was. The PA told me the person who does their scheduling would give me a call in one or two weeks to schedule. I received a MyChart message within the week from their scheduler, who very quickly scheduled me for my preferred date in October. At the same time she scheduled me for a second consult and my first and second post-op appointments (1 and 2 weeks after surgery).

Second consult: optional, about 1 month prior to surgery. Initially I was undecided between buttonhole and FNG, but before this appointment I had informed them via a MyChart message I wanted buttonhole. The appointment was virtual but we had some problem with video thing, so they called, which was fine. It was brief, I asked a few questions, and I asked her to run the technique by me again. She told me I had two options: buttonhole and nipple-sparing without moving the nipple (except for slight pull to the outside for masculinization), and that we would decide the morning of during markup. She seemed like she was kind of in a hurry - this is my only critique of Dr. Mundy, occasionally she comes across this way. She still answered all my questions kindly.

Surgery day: I arrived two hours before my scheduled surgery time for pre-op. Pre-op was efficient - the OR was actually running ahead of schedule that day, which they said was rare. The nurses was great, the anesthesiologist and her resident were great, everyone was really nice. Dr. Mundy came in and marked me up. I could tell surgery is really her thing - she was energized and into it, a different energy than in the consults. As she looked at me, she told me she wasn't sure about buttonhole because she wasn't sure I had enough skin for it, and showed me. I asked if my nipples would be two low with regular nipple-sparing, and she said no, your pec wall is about right here, and showed me that too. She then asked if I wanted her to do a nerve reconnection thing that she had been talking to another plastic surgeon about - it would take longer, and it could make me very sensitive for about a month afterwards, but it wouldn't mean leaving any extra tissue or anything. I said sure, let's do it. She asked if I wanted my areolas resized - she said they are pretty close to male size and they fit my nipple - and I said if they are close, let's not mess with it, I don't really dislike them. She circled the areas right below my armpits where you often see that tissue/fat that comes over the top of a sports bra. At my post-op I asked her why, and she said she does it to remind herself to go in up there and score the tissue so it sits flatter to give a more masculine appearance. Once everyone was done, they gave me an IV and I walked back to the OR with the anesthesiology resident. I laid down on the table and they gave me the good stuff and I was out.

Apparently I walked back from the OR to the pre/post-op area with the anesthesiologist, but I don't remember this. Post-op was easy, Dr. Mundy came and talked to me (I think? It could've been her resident, my memory is blurry at that point) and said everything went well. Surgery took way longer than expected - 4 hours! Because of the nerve reconnection thing. There were no problems, it just took awhile. Dr. Mundy is someone with incredible attention to detail and it shows. Eventually they let my friend come back, and once the nurse said I was ready to leave, my friend went and got the car and the nurse wheeled me out to the pickup area in a wheelchair and they helped me get in the car.

Post-op, briefly: sent home with no compression to allow the nerves she reconnected to heal. At 1 week, I got my drains out and began compression (she said to do compression for 2-3 weeks from this point). At 2 weeks, they took the tape off my incisions. I have a third post-op appointment scheduled for 5 weeks. Smooth sailing so far - I'm at about 3 weeks and I still have a little swelling, more on my right side than left. Still wearing the compression vest. I was worried about nipple-sparing DI not getting me flat enough, but I'm already really happy with my results and can't wait to see how it all settles.

Here's a cookie for making it to the end 🍪

Context. Insurance said they would cover a double mastectomy but not a reduction. Surgeon said he would bill it as a double mastectomy. I literally do not have tits anymore. They did not reduce them. They are gone.

He billed it correctly but my insurance isn’t helping me with it because the hospitals bill came first. The hospital billed me as a reduction so my insurance isn’t going to cover any of it and I’m fronting the anesthesia costs too. So I have his bill which is like 3k. the hospitals and anesthesia bills haven’t come through yet but according to my insurance app it’s gonna be around 15k.

I’ve called the hospital asking for them to revise the coding. Idk what to do now I’m just panicking. Waiting and hoping they change it or else I’m going to be paying 17k for a surgery most people pay 7-10k out of pocket for with the best surgeons. I didn’t even get my nipples put back on … thank gods. That would have added another 5k probably .

Anyone know what I can do to get this coded right? What do I do if they decide not to code it correctly …

I have a large chest and will likely need DI with free grafts to get to the level of flatness I'm looking for (which is basically male passing without a binder if I have a shirt on), but I am nonbinary and want to keep my nips the way they are. Is this possible? I've only ever seen DI+FNG results where the areolas and nipples were both made smaller, and I imagine this is the preference of people who want a fully masculinized chest - but is it strictly necessary? Meaning, is it even possible to graft a more femme sized nipple-areola complex, or would the extra tissue make it more likely that the graft would fail?

Wanted to see if anyone has experience with Dr Hazen in NYC? Hard to find many pics in her site and looking for some personal experiences good or bad if you can share.

How does one go about massaging the scars with a fatty cream (Apobase) but also applying the silicone tape? I'm 3,5 ish weeks post-op and using tape. Haven't started massaging yet, I fear the tape would just fall off since it's already sticking so poorly to my skin in the middle 😮‍💨

Hey!

I was just wondering if anyone else has one nipple that sticks out more than the other and... I guess, what your thoughts or experiences are! I'm 3 months post-op and have been waiting to see if the other one pokes out as much, but it doesn't seem to be. I'm not really upset by it, but looking for a bit of community if anyone else has had this as well. The one side definitely shows through when I wear tshirts haha

For clarity, it's not that one areola is bigger than the other. Rather, the one nipple itself is protruding further out than the other.

Thank you! <3

Title says it all. I've been doing everything my surgeon told me to. I'm a little concerned about some of the coloring. Does this healing look normal?

My next appointment is this coming Friday.

My sister’s wedding has just been scheduled around the time I was going to schedule my surgery. I can move the surgery up about 20 days (but sooner gets tricky because of work stuff). So I’m not worried about being able to move during the ceremony. My question is, how swollen will I be? It’s horrifying to think of seeing her wedding photos and feeling like I’m so swollen it looks like I still have a chest. Anyone else on the older side have a good sense of swelling ~20 days post op?

my mom is making an eight hour drive to me so she can see me off the morning of my top surgery next week, and is staying at our house for a few days to help me out during the first few days post-op, both to support me and to take some of the weight of caring for me off of my wife and my boyfriend.

we have a complicated but mostly good relationship, though she is sometimes uncomfortable about overt queerness, and seems to prefer not to think or talk about it too much. it’s a huge deal that she’s coming up to help me post-op, and i have no reason to think she’s going to act weird about it or treat me or my partners poorly. she’s said outright that she just wants to spend time with be and be helpful :o) i’m extremely grateful!

all of this being said, i have a hard time relying on others as it is, so i want to prepare myself for being extremely vulnerable with my mom and asking things of her.

what did you need the most help with those first few days after surgery? what do you think would be the best use of her time and energy? any general surgery/recovery advice? general tolerant and somewhat accepting mom advice?

i have my final pre-op appointments tomorrow morning with the nurse anesthesiologist and breast surgeon (i met with the plastic surgeon who will be doing my nipple grafts and nerve grafts on thursday) and i’m officially in we-gotta-get-this-house-clean-and-organized-NOW mode lol please wish me lots of energy and luck if you can spare it

i'm 1 month post op and had this uncontrollable chest cough every night for the last few days, scared that it'll damage the incisions or at least stretch my scars, are these things that can happen lmao?

On one side of my chest it almost feels like there’s something hard underneath it, where it doesn’t feel like that on the other side(I had di w nip grafts). I’m not sure why and if I should be concerned and contact the surgeon’s office? Any advice would be helpful, thanks!

Edit: it doesn’t look weird or anything just feels weird

Hi, I have my surgery in November and would like to share experiences, preparation and check with each other and go through the motions with others who are close to my surgery date! my date is in November so other people in November or early December would be good!

I have seen this post before and found the idea interesting!

I am a CIS woman who wants a flat masculine chest. I am not a part of the trans community. However, I was told insurance will only pay for top surgery if you're a part of that community.

Can top surgery be covered by insurance for a CIS woman?

Also, are plastic surgeons the only doctors who perform masculinization surgery for non cancer reasons? I want this surgery, but I want to know my options for insurance to pay anything.

I feel my reasons are not solely for cosmestic reasons, but for health reasons too. I suffer from hyperhydrosis (extreme excessive sweating). I wear sports bras only, and when I sweat, my bra gets soaked and uncomfortable.... causing chaffing, cuts that can become open wounds, and scaring.

I feel that if I had a flat chest, I wouldn't have to wear a bra and worry about chaffing and cute due to bras and sweating.

I do go braless at work and at home when I can, but I don't like the saggy feeling and the chance for people to see my nipples. So I feel like if I had a flat chest, I would be free.

Hey all! Anyone have any good or bad experiences with Dr. Dulin? Let me know!

I'm over 1 year 2 months post-op. I'm still dealing with the emotional fallout of a now ex-friend who stretched my left arm overhead when I was still healing, giving me a hypertrophic scar near my left nipple, as shown. The guy later sexually assaulted me, hence now ex-friend.

Every time I look in the mirror I remember his abuse and his shitty personality and worldview and behavior, which makes me want to avoid looking at it. I'm now better suited to handle it and would like some advice.

I'm now looking for ways to help make this scar go down this far post-op.

I've tried treating this so far with microneedling with a stamping vibrating pen on my own, but the results are slow. I've done about 4 sessions total over about a year, with the most recent sessions using 2.5mm needle length to help with the recovery. Last session was just over a month ago, and it definitely feels like the scar is not as raised as before, but has a wrinkly texture when I touch it.

For those who had treatments regarding hypertrophic scarring, what has been helpful for you? Did you try microneedling? What did you wish you knew about handling these types of scars? Would love to hear your experience.

For those who have had their top surgery results compromised by an unexpected healing process where someone else was directly responsible for the problem, how have you been able to move on? I'm planning to bring this up in therapy, but the emotional effect remains. TIA

The pain sucks but I think the worst is over? I can’t wait it get this binder off it’s so uncomfortable. The opioids they prescribed keep me asleep but I really don’t like how they make me feel. The muscle spasms and nerve zaps are NOT comfortable and very strange feeling. I haven’t pooped yet but I think I will soon (lol) I really can’t move much, walking slow, very sore, getting out of bed SUCKS. This is the worst of it right?? 😭

Hey, 32FtN here. So! There's no delicate way to say this, but my nipples are crooked. Not the whole of it with the areola on my chest. Those are placed nicely, but my left nipple is off center within the areola. It's down at the bottom edge on my left nipple. Perfectly centered on my right.

As of tomorrow, I'm eight weeks out from top surgery, double incisions with nipple grafts. Everything else has healed well and looks really good! Still a little puckering near my sternum on both sides but nothing I (and my trans friend who has had top surgery and is also a literal doctor) don't think won't stretch and flatten out time. (He also said my chest looks "incredible" and ngl folks, getting that feedback was a joyful kind of relief as someone with not-entirely-trans-related body dyspmorphia.) Anywho. My right nipple (the centered one) is also raised more than my left, including the areola, and I was also told that will almost certainly flatten down as well.

My nipples are pretty flat compared to the areola and so far don't really get hard or aything, and I doubt they'll have protuberance, and given what my nipples were like pre-surgery, I'm pretty ambivalent to that. It only really stands out because my nipples are now pinker than the areola around them, which is a little more of a fawn brown than they used to be. Which, hey, we love a gradient. Plus, like I said, I'm only 8 weeks out, and as I've had to continually remind myself, that's early as hell in the grand scheme of things.

But this off-centeredness--is this is something anyone has encountered, and would it be possible to just...adjust the nipple? Part of me wonders how the hell they'd do that other than take areola skin above the nipple, take off the nipple, sort of rotate that skin on its axis into place, and put the nipple back.

I also know this isn't something to be done now either way, since again, 8 weeks out from the initial surgery, and while the "main" healing of the scars is done, shit is still healing and settling into place.

Honestly, if it's something that can't or won't be fixed, it's not the worst thing in the world. But I'm wondering if anyone has any insight.

It IS a bit funny (genuinely, not in a dark humor way) that as far as everything I freaked out about going "wrong," this thing happens that I never have heard of and had never considered. Life is silly that way, innit.

I am just over 3 months post op, happy with scar healing, nipple size and placement. Aware I have a dog ear on my right side which I’m sure is an easy fix later on. My left side is a bit bothersome. Cone like swelling, maybe left over tissue? I had a Seroma drained at about 4 weeks post op and it went down considerably. When I got my dressings off at 1 week, I was much flatter on my left side compared to now. Still early days I know, anyone had a similar experience? Cheers

Hi, does anyone have any idea of the wait times/prices for Morris or Mills in Devon? I am stuck deciding between the two of them.

Any shared experiences from going with either of them would be brilliant too. Thanks :)

Hi there,so I was taking a shower and one of my stitches fell out/off of my left side and It doesn't smell or anything nor is it leaking I was just wondering what you would happen to do to help this heal? It doesn't hurt or itch either I did reach out to my doctor as well but since it's a Sunday I don't think they're open to answer me right now So here I am lol I'm assuming keep it dry and maybe a bandaid of some sort so it doesnt get infected But I also want reassurance I didn't mess anything up lol Yes I had my back to the water btw I'm not ready yet for facing forward Also I marked it as nsfw cause it looks a lil gross lol

Does anyone have any silicone tape recommendations I can get in the uk?

The only ones I can find online, like Elamei, don’t seem to be sold by the most trustworthy looking websites.

TLDR; want to see peri results from dr mårtensson as i can’t find any and would like reassurance.

hey folks! i’m getting top surgery with dr tuve mårtensson soon. i am under the belief that i am getting peri-areolar as i am getting gynecomastia and liposuction procedure and i have a small chest. he didn’t explicitly say peri but what he described would happen was very much like peri.

i haven’t been able to find any keyhole or peri pictures of his results anywhere and i was wondering if anyone in this community has received peri/keyhole from him and if u could share the results with me, either here or privately. or if u have a link to someone’s post with the results that i’ve maybe missed. i would be super grateful if anyone could do this!

i am just getting the pre surgery anxieties that it won’t be the results i’m looking for and i’d like to see others results as reassurance.

thanks so much for reading :)

Long time lurker first time poster,

A loved one is finally getting top surgery in a few weeks and I will be the main caregiver. We live together so I’ll be here and I took off work for the first week post surgery.

I’ll be home and close for the first 7 days and then have to go back to work, but we’ll have friends drop in to bring meals and hang out. I’ll be the one dealing with the drains and any direct medical stuff. There will be a couple days about 10 days post surgery that they’ll probably have to spend mostly alone, does this sound okay?

At 10 days post-op, were you able to change your clothes, brush your teeth, and make food? Our microwave is high up but we have an air fryer, oven, and stove that are low enough to reach. We have a great support system so friends will be dropping in for at least the first couple weeks, but I’m curious how much physical support you needed and for how long.

Lastly, anything you wish your caregiver knew beforehand or any unexpected supplies you wish you had? It will be double incision no nips.

Thanks everyone!

About one month post op doing all care as written why tf is it red 💀