I learned today that some Cigna plans will pay for SRS surgeries. However, it is important to note that one would not have their insurance company pay for top surgery unless they are changing their sex (which is not the discussion here). For the non-transitioning person it is a cosmetic procedure, and thus would not be covered by insurance.

I've met many female identifying butches who have wanted top surgery, but never met any who have actually had the procedure done. I think CAMH is now a bit better for female identifying people who want top surgery, though I'm not sure if the requirements are the same as for trans guys?

Did your current partner have it in Mississauga with McLean, by any chance? That's where I had mine and they're really awesome there, and they didn't seem interested in gender policing. They basically only asked me questions that were meant to make sure I was positive about getting the surgery done. I wonder how long ago it was though that your partner had the surgery (if he did have it there)? I had mine there about a year and a half ago and I didn't need a referral for him to have the surgery done, I also voiced to him that I didn't intend to be on T for the time being. The only thing I needed from my doctor was to have a physical done to show that I was physically healthy enough for surgery, and then a blood test from another clinic.

I was lucky in that I managed to get a student line of credit in the nick of time before banks started becoming stricter on approving them. For those that can still get them, that's probably the best route to go for top surgery if you want to avoid therapists. Especially since there are more and more top rate surgeons who don't require referrals or any of that crap anymore.

This just in...


http://www.washingtonblade.com/2013/...xamine-gender/

I have ALWAYS hated my breasts. They started developing when I was 8 yrs old and I got all kinds of crap, from kids and adults. Damned grown men staring at my chest and damned near salivating. And being sexually stone, makes it worse.

I can't stand to bind, and when I did, it had to be for short periods of time because of high blood pressure. Now, since bypass surgery, it just hurts too damned much.

I'm in the US, no insurance of any sort. So no money for it, either. Besides which, I'm not too sure but my cardiologist wouldn't scream bloody murder as surgery does put a strain on your heart. Though the therapist-waiting for a new one as mine retired and I MISSS HEEEER!-would probably label me as being gender dis(SP?).

Sorry, I'm sick right now and feeling down about EVERYTHING. I'll be SOOOO glad when this clears up!

No
 

BUMP

Bumped this thread since my Butch just mentioned hy has been thinking of it for some time but was unsure how to bring it up.

Hy is masculine of center and has never really cared for hys breast at all.(I sensed this already) but after hy quite smoking, the body weight that got put on went right to that area and has caused a greater discomfort for hym. I saw a few people post that their Butches had reduction to less than As and were happy with it. I am completely supportive of hym and hy is seeing a LGBT therapist that specializes in gender right now, so I think getting a referral for getting this done should be relatively easy.

yup
 

i've definitely considered top surgery. since i've only been butch a short amount of time i don't have binders or boxers and whatnot, and i haven't talked about with my doctor about hormones let alone surgery lol. i've done some looking into it and from what i've found getting the surgery is not easy (i'm not sure what i was expecting, it's surgery after all ¯\_(ツ)_/¯). it's expensive if your insurance doesn't cover it (in the realm of 10k), the larger your breasts are the more sensation you'll lose (i have DD's lmao), and i think you need a letter from a doctor saying you're not having a nervous breakdown and spontaneously chopping your tits off. that being said i look forward to the possibility of being flat chested :onebutch::2butch:

It's on my "... if ever I have more money than I know what to do with... " list. It would be primarily for a comfort sort of thing not really gender related. Hell, even with tits I get called Sir. Iol.

I've considered a reduction but not complete top surgery. It's expensive on my end due to no insurance and I might not survive another surgery, long story on that. But yeah I've hated mine since I was a young kid.

You can get Obamacare, just like everyone else. Although your State has chosen to not do their own exchanges ( because Rick Perry wants you all to continue to be the state with the highest uninsured rate in the country), you can still get insurance (even though it is going to cost you more because...well Rick Perry), through the federal exchanges.

http://obamacarefacts.com/insurance-...ance-exchange/

If you meet the criteria for reduction, insurance will pay for it.

Since the state of Texas is anti trans, Texas does not require insurance companies to provide trans services (so yes, would have to pay out of pocket for top surgery, most likely).

Yes it will cost me out of pocket, quite a pretty penny for anything I need done. I can't afford insurance of any kind right now. So I'm just stuck.

This thread is 90 percent of the reason I joined BFP.

I have never accepted my chest. I always promised myself, if I ever lost the weight (I'm heavy) my "reward" would be to get rid of them. The thing is though I always felt I was weird that even though I wanted a flat chest in public, I wanted a female chest naked... like an a cup. I figure then with a sports bra they will virtually not be there. I even think it may be worth doing now, but I've heard that if you're plus sized the doctor will want you to lose weight first. Plus an ex GF said with my build (she was being kind) I would look rediculous with a cups. I know she may get some flack for that, but I can't help but think she was kinda just stating the facts. The other part of me is getting less and less interested in staying attractive and more interested in being comfortable with myself.

Binders...I wear sometimes, but when you're a DD they reshape and that's about it, there is no way to make it appear that there aren't breasts there. I actually wear a sports bra with a binder over it, because those bastards just reposition themselves where ever they want without the bra on. The will fall plum out the bottom of shorter binders.

Has anyone had a. Reduction that is overweight? I've met trainmen with full reconstruction that looks fine... but would tiny a cups on an overweight female body look rediculous?

Another with DD cups. Considered top surgery often, but also concerned with what it would look like with a heavy short torso.

Anyone tried to get a sympathetic surgeon to do it as a medically necessary mastectomy? Think it might be possible to get insurances to cover it. Am concerned if it would be covered by Medicare.

Does anyone know if top surgery for gender dysphoria is covered under Medicare during this current administration. Aware it was being reviewed under President Obama, but have they reversed any decisions???

I'm not sure about full chest surgery, but the one advantage of having a larger chest is a reduction may be covered for back and neck pain and issues. I am wondering if you are allowed to pick the size though. I've heard that sometimes jnsurance will limit the size reduction. Why they really care I don't know.

Clint, I looked into this back when I was fighting myself over being trans. You can only go so low based on your size. As a DD, you can probably not get smaller than a B/C. I don't know the language to explain it, but maybe you can find more information on google.

Medicare covers top surgery. It used to be near impossible to get them to cover trans surgeries (after they said they would), but now it is easier. It is hard to find a surgeon who will take Medicare. Loren Schecther does, but that is only if you have a secondary insurance. Too, he only takes so many per year since how much he gets is practically nothing. He is in Chicago.

Contact Medicare and ask them for a list. I doubt they will be for travel, housing, and of course you have to stay in the area for one week after top surgery.

Back in the day, surgeons would code it as mastectomies, but no more. The cost is too high.

I posted here a couple of years ago. My long-term ex was heavy and had extremely large breasts. She hated them.

She did not ID as male but absolutely identified as very masculine of center. She liked being called sir and hated that when she turned around and they saw her chest, people would get flustered and apologize, calling her ma'am.

I don't even know what size they were or what the largest size actually is.

She did have frequent back aches and grooves in her shoulders.

She had insurance through her job-a PPO.

She researched plastic surgeons and found one comfortable with reducing them down to less than an A.

The surgery went well. She was in the hospital for at least 2 days (this was probably 20 years ago) and she had drains in both breasts. When she woke up from anesthesia, she felt both breasts that were heavily bandaged (you still could hardly see them) and she cried with happiness.

I did admire them (without touching). They were perfect and very, very, very small. She never wore a bra again and did not need to. She then lost a lot of weight and they never changed size or moved from their perfect smallness.

You do not need to go the route of complete removal unless you truly want to!

Options!

Explore reduction. I saw her again about 3 years ago and in a shirt, I could not see any difference! They never grew and never sagged.

No gravity for her!

From plasycsurgery.org:

Breast reduction candidates

Overly large breasts can cause health and emotional problems. In addition to self image issues, you may also experience physical pain and discomfort.

The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large pendulous breasts can be as important an issue as the physical discomfort and pain.

Breast reduction is a good option for you if you:

Are physically healthy
Have realistic expectations
Don't smoke
Are bothered by feeling that your breasts are too large
Have breasts that limit your physical activity
Experience back, neck, and shoulder pain caused by the weight of your breasts
Have shoulder indentations from bra straps
Have skin irritation beneath the breast crease

https://www.plasticsurgery.org/recon...ion/candidates

I, too would love a reduction. Size a would be A-mazing!

Anya- thank you for the post... I'm glad to hear that so,done went that small who was full figured and you found it attractive.

I have heard that some insurances willl limit the amount of tissue that can be taken. Maybe a size b wouldn't be so bad either. Still could get down to flat with a sports bra... I think. I would like to get rid of my binders though.


If push came to shove, maybe I could save up and pay out of pocket. Yikes, but I have a good job and it may be doable.

When I think of myself, I think of a chest, not breasts. If I had a medical reason, I'd have them removed.

I want a reduction really bad but they wont give me the size I want and I have seen many overweight transguys with full top surgery, they just look like heavy cis male, I'm not trying to be offensive or anything but that is how I see it, from my own experience.

I hope everyone gets what they want and need because some of us won't ever get it.

I want to have chest surgery and not a breast reduction. That's obviously a personal choice for everyone. The older I get the more uncomfortable I am with my chest. So I really do need to come up with a financial plan to make it happen.

If I do get it I'll look like a chubby butch with a flat chest because that's who I am. I think it will be very freeing for me and the aesthetics are definitely secondary to how it will make me feel in my body.

And what's wrong with big butches, FTMs and males anyway?

So that is my observation as well, overweight FTM men with fulll chest reconstruction look just fine... just like any other guy of their size.

Certainly nothing wrong with being overweight... it's my own insecurities combined with what I've heard from a cis females wanting reductions about "medical standards"

i am overweight. I essentially want to appear flat chested to the world and I don't want to really have to "deal" with breasts. But.... I'm not sure I want a male looking chest.

Luckily I was just looking and some pre and post op pics... and I think I was wrong (as well as my ex). There were a few overweight individuals who went really small (like a b cup) and it actually looked just fine to me. So I'm less worried now.

Anya, I do remember you talking about this before. I believe I did not say anything at the time because I didn't want to seem argumentative or like I was being picky. However, I feel that it wouldn't be right to not correct what you are saying this time, because I WAS that hopeful butch with C breasts who went to a plastic surgeon with dreams of getting an A chest. I was disappointed for the next 14 years until I finally decided that I would get top surgery. This was before I decided to transition.

I'm sorry, but, it simply isn't possible that your ex had what is termed a "breast reduction" in plastic surgery, if she was large chested and now has A cup breasts. It simply cannot be done though standard breast reduction procedures.

Your ex had to have essentially gotten a subcutaneous, bilateral mastectomy (most likely), or peri, or keyhole, (aka "top surgery"), and the plastic surgeon left breast tissue because this is what she requested. If she truly had a "breast reduction", her breasts would have increased in size if she gained any weight and they would have probably decreased in size if she did lost weight. Just like any other woman with a breast reduction. However, this did not happen because the surgeon did not leave the fatty tissue that needs to be present in order for that change to occur.

Back then the term "top surgery" wasn't even coined yet. It makes sense that the surgeon even used the term breast reduction. It was also paid for by insurance because it was coded as such.

Some larger trans men/butches leave tissue so that it does not look odd. One could describe their breasts as "A cups", as well.

All day, every day I talk to trans people and gender non-conforming people about their bodies and the surgeries available to them in order to alleviate their distress and/or physical discomfort.

You ex said what she wanted and the surgeon gave her that. They both called it a "breast reduction", because that was the language they had at the time.

Right, they can't give you the size you want if you are asking for a "breast reduction". Every women is limited by how small she can go when she gets a reduction.
BullDog, I know that you do not identify as trans in any way. However, you can get "top surgery" (through your insurance, if they have trans health care benefits), as long as you are willing to say that you have gender dysphoria of some sort and you would feel better with no chest. There are non-binary people (people who don't identify as women or men and/or as female or male), and they get covered.

If you DO have insurance (private, healthcare market place, or Medicaid) and you are in a state that requires that all insurance companies provide trans health coverage, then you have it. Alternatively, you can see if you can find a plastic surgeon who will code it as a breast reduction, but that is very hard to find.

Some people get part time jobs at places like Best Buy, Starbucks, Apple, and many other places so that they can get top surgery. Bigger companies like that also don't give people a hard time when they are trying to get surgeries covered, either. They follow WPATH standards and all that needs to be said is that your chest causes you "distress", and due to this it is medically necessary that you get the surgery.

When I got my top surgery and was identifying as butch, even if my company had trans health insurance I couldn't have gotten it because I didn't identify as transgender. It is different now. It is about the person's medical need to feel more comfortable with their body, if they are in distress about the parts of their body that we connect to a person's "gender".

Thank you Dapper, I definitely need to look into things more, and especially since we don't know how things will change under the current political climate. For me it is definitely a body and gender dysphoria issue even though I don't id as trans or as male identified.

Damn Dapper... thankful for the contribution even though it wasn't what I wanted to hear.

That's why I would rather do top surgery and have none at all, as opposed to dealing with the surgeons BS guidelines.

I would highly recommend this binder:

https://www.gc2b.co/

They came out after I got top surgery, but all of my clients say they bind well (even the really big guys), but are still comfortable. You may find you are ok-enough with this if surgery is something that doesn't work out for you.

Butches have been wearing the Frog Bra since the 1990's!

https://www.titlenine.com/product/frog-bra-320927.do

This though, doesn't get on completely flat when you are working with a DD. However, it is a good choice for working out.

Also, always buy the right size binder and never double up. People believe that it makes them flater, but that just isn't accurate. Don't wear beyond 8 hours, if you can help it.

Well, I won't argue with you either but the facts for her are the facts. It was her experience. Period.

As a nurse, I know very well doctors work with patients to ensure that they are given what they need. This doctor knew both of us well. He had previously removed a small tumor from my clavicle that is a barely noticeable scar now.

I was there and I went with her to all of her plastic surgeon appointments and also was in the hospital with her.

Her surgery was a breast reduction. The surgeon called it a reduction. The anesthesiologist called it a reduction, etc. etc. She was an A cup and her nipples were almost the largest things on her breasts. They were carefully replaced and when I say that they were perfect: they were perfect. She was shocked to find that she had more nipple sensation afterward then she had when they were so large.

She did NOT have a mastectomy.

I was a B cup at the time myself. She was no B cup after surgery.

When the bills came: they all stated breast reduction.

So, her experience may be different from those of other people but it was indeed her experience.

I would not dream of telling someone else that their experience was wrong.

Your experience was yours.

Hers was hers.

Anyone knows that not everyone will find the same experience.

It does seem argumentative when you challenge another's experience.

This is what my ex did. Even though she was told she might not have feeling in her nipples, she did report that she had more than before:

"Although most patients who visit my office are asking how large can they go with a breast augmentation, there are many who are trying to go in the opposite direction. Because of oversized breasts, these patients, both women and men, are asking about small they can go.

For men, the breast enlargement is termed gynecomastia. I am not going to speak further about this topic in this blog, but will devote my remarks to breast reduction in women.

These women suffer from back, neck, and shoulder pain, as well as rashes beneath the breasts, painful bra strap grooves over the shoulders, hunched posture, and many other limitations that affect their ability to live a normal life. They are frequently of a DD cup size or larger, and almost always want to be reduced to a C cup or smaller. They frequently ask, “How small can I go?”

The answer to this question can be given in several ways.

First, how small should they go? A woman who has been quite large for many years will often find a significant reduction in size to be somewhat akin to a mastectomy! Also, women usually are desirous of a balance between their hips and their bust line. Although smaller breasts have their advantages, there may be a mismatch between hips and breasts that may be undesirable.

Second, how small can a person go with breast reduction? The answer to that question has to do with the blood supply to the nipple area. There needs to be a large enough amount of breast tissue on which the nipple sits to provide an adequate amount of blood supply to the nipple.

The blood supply comes through the breast tissue, and if there is not enough, the nipple will suffer from a lack of blood supply that can even lead to its loss. Various techniques of breast reduction are employed that have as their goal the preservation of an adequate amount of blood flow to the remaining breast tissue so as to insure survival of the nipple.

How much breast tissue needs to be left to insure this blood supply? There is not a hard and fast answer. The amount of breast tissue is not really the issue – it’s the amount of blood flow through it that reaches the attached nipple that’s important.

>>>>>Theoretically you could take away almost all of the breast tissue and leave the blood supply behind and you would be OK. The reality is that this would leave a funny looking breast. From a practical perspective, if you are going to reduce the breast by more than 3 full cup sizes (DDD to a C cup is 3 sizes), the nipple blood supply may be endangered.

What do we do in cases where more than 3 full cup sizes need to be removed? I recommend that the nipple be removed, the breast be reduced without concern for the nipple blood supply, and then that the nipple be reattached as a skin graft.

To do this, a piece of skin in the circular shape of the nipple is removed from where the nipple is to go. The nipple is trimmed of all fatty material from its undersurface, and it is then applied to that spot and secured.

Over the course of 5 days, new blood vessels will grow from the breast to the nipple, restoring its blood supply. The new nipple will be flatter, sensation will be reduced, and nursing will not be possible. On the other hand, these issues are worth it for many women who are troubled by large breasts"<<<

My ex had zero problems and though she was stone at the time and it was "look but don't touch" I thought they looked terrific. She did not care how they would look, she just wanted super-small.

An excellent, well-researched, board-certified, plastic surgeon was key.

This doctor was not hers but he did address the info I was looking for.

http://www.drsanders.com/how-small-c...ast-reduction/

Thank you for all this. I'm going to look more into this before I try to get insurance.

I think I've kinda formulate my attack. I'll try the binders Dapper suggested... I've heard good things about them. I went with a zippered style instead though because I'm scare of getting stuck in it lol.... I've heard stories.

Second is just to pursue the reduction and see what size they will do. I'm not sure if it would be worth it if they will only go down to a C, but maybe a B cup wouldn't be so bad.

If none of that proves satisfactory, then I will have to decide... accepted them or consider full top surgery.

Make sure to pick a board certified doctor, please, I have heard stories of trans men and women picking a doctor, then end up having some serious problems.

Anya,

I really don't have an investment in what your ex's surgery was called 20 years ago. I even said it was probably called breast reduction even if it more closely resembled "top surgery", as the term "top surgery" wasn't used back then.

What I care about is C+ butches getting excited thinking they can get a plastic surgeon to provide them with a "breast reduction" that will make them a small A, which can be billed under their regular insurance, only to find out that they can't. Many, many butches and trans men have gone this route over the years and were disappointed. I attempted to go this route. It sucked when I was told that a breast reduction could not give me this. It sucked. It sucked BAD. 20 years ago, even 10 years ago, surgeons would provide top surgery, but code it and bill it as a "breast reduction".

I knew I was taking a risk of you pissing you off and others thinking I am an ass (both which have appeared to have happened), but I wasn't going to let another big chested butch get their hopes up based on the experience of one person from 20 years ago. Well, maybe I couldn't impact their hope, but at least I might be able to suggest they shouldn't assume it could be done.

I'm not going to respond any more to this topic of breast reduction. This is a top surgery thread for butches, to talk about their interest in top surgery. I am not going to continue to clog up the thread with a different topic.

guys...guys...GUYS!

What's with the animosity? Yes, the thread is entitled "Top Surgery for Butches," but why complain about any information that's available and helpful?

I, for one, am interested in reading about anything useful.

lesson learned.

I have a question...Do they still require those who want this surgery to be on T a full year before they will perform surgery? I was told it had something to do with developing needed muscle mass(as far as I can recall).....it's been a long while since I was involved in this so if this isn't the case anymore I'd love to know!:confused: I've been with two pre-op and post-ops and I have to say they turned out magnificent...j/s

Ok, so I just realized where my error may be in explaining things.

I am defining breast reduction vs. top surgery based on the amount of tissue removed and the type of incisions that would have had to be done in order to take someone from that size TO an A. I am not arguing, something like when the surgeon removed your ex's nipple/areola complex and resized it, that they placed it where a female areola complex would be located.

No, this is no longer required. The reduction of gender dysphoria depends on the person. Not everyone feels they need to take T in order to reduce their gender dysphoria.

The muscle part was a myth....I don't know if surgeons fueled it (because they wanted an excuse to not go against WPATH standards), or where it came from. And then it just continued.

I have thought about this for a long time... I naturally make so much T that I already only have small size chest mostly resembles a male chest anyways.. My issue is the scars.. for Me I would not like ha omg the large scars... delema