Top surgery consultation #1

I 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.

  1.  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!)
  2. 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.
  3. 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.
  4. 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.
  5. Do you resize nipples?  She resizes areolas, and nipples retract on their own.
  6. 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.