Top surgery consultation #1
Posted: November 3, 2015 Filed under: top surgery | Tags: androgyny, dr. rumer, gender, gender identity, genderqueer, lgbtq, non-binary, queer, surgeon, top surgery, trans, transgender 14 CommentsI traveled to Ardmore, PA and met with Dr. Rumer yesterday. The consultation went well overall, and it’s prompted me to start looking at lots of top surgery photos online, something I’ve done in the past, but without much of a framework or focus.
She’s located in a college town / upscale suburb of Philadelphia, and her office / house(?) is a white brick old Victorian creepy looking place. Very apt for visiting 2 days after Halloween. There is street parking, and you have to get buzzed in. I was envisioning a medical center of some sort, but this place had the vibe of a hair salon – everything was whites, greys, and black, very sleek and futuristic looking. The receptionist offered me something to drink. I arrived early and was seen by the nurse practitioner right away. She also offered me some water or coffee.
We went over my medical history I had filled out online in advance. I guess I forgot to add in testosterone under “medications,” and she understandably assumed I wasn’t on T. When I said I am on a low dose, she added that information. (Being on T is NOT a requirement for getting top surgery.) She also asked about how I identify, if I could provide a letter from a mental health professional (required), if I have legally changed my name, am I out to everyone in my life, and how long have I gone by male pronouns. There were no issues or clarifications with any of my answers: That I am not FTM, I identify as non-binary, I can get a letter, I have not legally changed my name, I’m out to everyone except work, and I’ve gone by male pronouns for close to 10 years. (That got a “wow” out of her, haha.) I’m glad she didn’t ask me about gender dysphoria or how I felt about my chest, because I wouldn’t have known what to say / didn’t have a statement prepared. Even though it seems like if I’ve made it this far, I should be able to articulate that!!!
She made sure I understood that I would be putting on an oversized paper vest momentarily and that Dr. Rumer would be looking at my chest. Was I OK with that? I said yes I expected as much.
She said she’d be back with Dr. Rumer, and gave me a moment to put on the vest. They re-entered, Dr. Rumer said, “Nice to see you again.” (Presumably because I’d said I’d heard of her through the Philadelphia Trans-Health Conference, although I didn’t go to any of her presentations or actually meet her.) She looked at my chest for literally one second (I’m glad it was so brief) and declared I could go with peri-areolar if I wanted. Is that what I wanted? I said yeah, probably.
From there, she showed me a few slides about what to expect, and she showed me two before and after pictures. The only disappointing aspect of this appointment was I asked her, “Do you have more pictures?” and she replied that she doesn’t really because they are all the same. I was pretty dissatisfied with that – it gave me the feeling that these were the two best that she had hand picked to present. I would have liked to see a dozen examples of peoples’ chests; there aren’t that many online.
Other than that, she was very friendly and personable and she answered all my questions thoroughly.
- What are the odds of retaining nipple sensation? Only less than 1% will not retain sensation. (Those odds seem too good to be believed; I’m not sure I totally believe her!)
- How many appointments are required? A lot! One a week before surgery, one a week after surgery, then a few at different intervals (I can’t remember) and one at the one year mark. For people out of town, most of them can occur over skype if everything is going smoothly. The only necessary travel is for the surgery itself, then a week after, and then a year after.
- Do you have to go off T before surgery? Yes, you have to be off T 2 weeks leading up and 2 weeks post-surgery. Why is this? Because of risks of excess bleeding. I feel resistant about this and still don’t quite understand, but I’ve heard it before and would have to accept it.
- How long can I be out of work? I have a very physical job. She would write me a letter to go back whenever I want, especially since I have sick time accrued and wouldn’t be on disability. I’d probably look at 6-8 weeks.
- Do you resize nipples? She resizes areolas, and nipples retract on their own.
- The total costs she quoted me, including staying 2 nights in her office(?) / home(?) / guest rooms is $7,480. That seems on par with other surgeons, maybe a little on the high side.
I have another consultation on Thursday with a local surgeon. I will be curious how the two compare.
janitorqueer 
I consulted with Dr. Rumer, too. That office scared the bejesus out of me. The staff and everything was great, but you’re right – the office had a very Asimov feel to it. When I finally go forward with it, it’ll definitely be with her.
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Haha, yeah the office is so weird! Have you consulted with anyone else? I’m curious what makes you so sure you will go with her?
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I didn’t consult with anyone else, but I appreciated the no-nonsense attitude and just how friendly and respectful everyone at the office was. It’s close to home for me, too – about 45 minutes – which is a huge plus. My insurance will cover the procedure with an in-network provider, but then they don’t have any providers on the east coast that are in-network and perform the surgery. Her staff is willing to fight with my insurance company to try to negotiate in network rates for me. I currently work for an insurance company, so I know first hand how annoying and how much of an undertaking that can be, so that just shows a level of commitment to excellent care that I can’t argue with.
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Wow, that’s awesome! My insurance won’t cover any of it, but they photocopied my card anyway and said they would attempt to send it through, which was cool.
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The off T for two week thing is frustrating. I’m really glad my doc didn’t require this. I asked specifically as he didn’t bring it up. He said it is not necessary. I was also told closer to 50/50 for nipple sensation remaining intact for ur procedure. When I got a breast reduction initially all sensation came back. The grafted nipples after double mastectomy… Time will tell. There is sensation just more painful than pleasurable. My only semi- regret.
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That’s interesting not all surgeons require you to go off T. And yeah, 50/50 seems closer to the reality. Sorry to hear your sensation is painful so far – hope it improves!
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Congrats on the consult. I’m in the process of getting a couple done as well. I had considered Dr. Rumer and really liked her a lot at the convention but she doesn’t do the procedure I’m looking at having. I want to get the Inverted T or T anchor and only a few doctors do that it seems. Good luck with everything.
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That’s awesome you’re in the process of getting some consultations lined up! It’s kind of convenient you get your choices narrowed down because of the type of surgery you want – not so overwhelming to figure out who to go with! Good luck to you too!
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I hadn’t thought about it that way but you’re right. I only have a few choices and it’s just a matter of picking the one that suits me best.
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Hi. I recently had a consult, too. I liked the surgeon very much. I’m too big for the keyhole, so I’ll have to have the double incision with nipple grafts. However, she has a technique where hopefully I won’t have drains! My thoughts on sensation–I had a breast reduction about 8 years ago. The nipples were left attached. While I do have some sensation, it is not erotic and mostly just annoying. They either hurt or are erect all the time, which is very irritating. I am very self conscious about them for that reason–I feel like they are always showing. Regarding getting off T for surgery–I am doing the pellet HRT and my surgeon didn’t think I needed to stop doing it prior to surgery. So we shall see. I don’t know why some docs say yes, you need to get off, and some don’t. Anyway, good luck in your decision. I enjoy your blog! Thanks.
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Do you mind mentioning what surgeon you consulted with? Doing it without drains is super appealing! Good luck to you!
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Sure! It’s Dr. Sidhbh Gallagher, Indianapolis, IN. She’s from Ireland and she’s great. Really easy to talk to. She’s been all over the world studying trans surgeries. http://indianatransgendernetwork.com/resources/medical-info/sex-reassignment-surgeries/dr-sidhbh-gallagher-gender-confirming-surgeries-indianapolis/
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It’s fun to say “peri-areolar.”
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haha! say it 10X fast.
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