r/no_T_top_surgery

Got top surgery April 28, previously was 30J (humongous). I don't have to tell you how frustrating it was to have J cups (J for Jugs of Giants), and I couldn't even dream of fairy dresses. Today, I fit in this strapless (!!!!) size M gown I found at Goodwill.... I couldn't believe it. My body in a gown???

Now, get this: I found it the day before my 5th wedding anniversary. On my wedding day, I was braless with saggy breasts in a shapeless dress because it was Covid and I could only buy bras at a bra fitting studio. And for our anniversary, 5 years after, I get to show up like a blooming iris. My spouse also was amazing during my recovery, stripped my drains, fed me, and kept track of my meds, so this is a reward for both of us.

The top portion of the gown fits surprisingly well despite my lack of any boobage. The frills kinda make me look like I have A/B cups, which is fine with me! Honestly, how normal my body looks boobless was a huge surprise. Several people I knew didn't even notice I don't have them anymore. Anyway.... Got a big scoop of body euphoria today and wanted to share with people who understand it best.

Officially 2 years post-op today! Still very happy with my results and I can believe time is flying so fast! I love my chest so much!🥹🏳️‍⚧️💗💗✨✨

The first 3 pictures are of me and my chest today! 💗

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The 4th and the 5th ones are of you last year! ( So 1 year post op ) 🏳️‍⚧️✨

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The last one is of me just after surgery!💗✨🏳️‍⚧️

Micropore tape is starting to irritate my skin and creating “grooves”. Nurse said I have to wear tape for the rest of this week, but then I can probably go without. I’m so ready to get rid of it!

I have been getting manual lymphatic drainage massages 1-2 times a week and they’ve really helped with reducing swelling.

Overall still very pleased - some stitches have been forced out on the left incision and will probably create more visible scarring but I don’t really care.

This post is a follow-up from my original post found here: Nordesthetics Clinic / Dr. Aurimas Dobilinskas

I’m trans/non-binary and I am incredibly happy with my results and the care provided at the clinic.

Here is a list of things I think are good to know regarding the whole process:

- Most, if not all of the communication pre-surgery is done via email. Once you get in touch with them (I did so through their website) you are assigned a clinic rep who will deal with all your queries and bookings. I found communication with them to be overall quick and easy (although a bunch of automated emails were sent that contradict or confused the personalised correspondence but I just followed the latter and/or send them info I’d already sent again just in case…and it all worked out)

- If you choose not to send them pics through the form on the website they will ask for it via email - they basically want to get pics ASAP so their surgical team can determine what they can offer you. I was approved for a gender-affirming mastectomy (subject to blood tests and in-person clinical assessment in the actual clinic right before surgery, more on this below).

- They will also ask for a surgery referral letter - my advice is to get this before you contact them as it will make the whole process a lot smoother and quicker. I went through Anne Health and paid £250, but they will basically accept any letter from a qualified professional so this could also be your GP (which is probably cheaper).

- After you’ve submitted pics, surgery referral letter and completed their health questionnaire they can let you know which surgeon(s) are available for which dates. As far as I’ve been able to gather through research online they have at least 10 surgeons who perform top surgery at the clinic. Some have results online (I suggest you join the Facebook Group specifically set up for transgender patients of Nordesthetics), some don’t. I’m under the impression, however, that they’re all well experienced. You can opt for an online consultation with a surgeon anytime before and after booking surgery for €60. I did and found it helpful - NB the surgeon I had my online consultation with was not the surgeon who performed the surgery, more on this below.

- As there wasn’t any surgeon available until June earliest when I contacted them in February I opted for their Fast Track route, which basically means you can choose which week (still subject to availability) you’d like to have surgery and then you arrive the weekend before to be ready to go in case of cancellations. They’ll do the pre-op tests between Sunday-Tuesday (for me it was Tuesday but only bc it was Easter weekend) and then they’ll let you know by Wednesday when your surgery will be that week (provided you’ve been cleared after pre-op tests). The clinic will ask that you fast each day until 12pm just in case the notification will be for the same day. I got notified on Wednesday that my surgery would be the next day and that my surgeon would be Dr. Aurimas Dobilinskas. According to their website and the surgeon I spoke to during my online consult they have been doing the Fast Track for over 2 years and have never not been able to book patients in. In the event of this happening they will compensate for flights and accommodation costs up to €1000. 

- On the day of my surgery I met my surgeon for an assessment and he was very kind and open to any questions and scar shape preferences. My advice is to have a clear idea (with example pics if possible) about what you want bc otherwise they will just go with what they think everyone wanting top surgery wants. Please note they do respond well to what you want, just be clear! When they mark your chest don’t be afraid to say exactly how you’d like it. I got exactly what I wanted.

- I was asked to be at the clinic about 2 hrs before my surgery - having fasted for 6 hrs on food and drinks (excl. water) and 4 hrs on water - and was taken to the ward where I’d spend the night. Everyone was very nice and helpful and the ward was modern, clean and comfortable. 

- About an hour before surgery the anaesthetist came by and did his assessment and chat - he was very outgoing and kind and made me feel at ease.
Once in the operating room I remember lying on the table with my arms spread (they put a very comfy weighted blanket on you), the nurse inserting the cannula (the only part that was slightly painful, but nothing bad!) and then I woke up in the ward with my chest wrapped and high af on drugs!

- Even though it was outside visiting hrs they still allowed my partner in to see me which I really appreciated. Nurses were great, painkillers were great and the food/drink provided was great. 

- Before I was discharged the next morning the surgeon came by to check in and I got to see my chest out of the binder for the first time - it was fantastic. All was good and after a lymphatic drainage massage (helps with swelling) they sent me home with a bag full of painkillers and the instruction to shower the next day and each day after.

- We stayed in apartments opposite the clinic which was handy. They also have their own self catered apartments but they were fully booked (I would strongly advise to stay somewhere with a kitchen).

- Recovery was fine - most annoying thing is that the meds make you constipated, but the clinic will give you something for that if you ask.

- Before they fully discharge you (between 5-7 days post-op) they’ll change your tape and you have a last check-up with surgeon. He told me to keep him posted by sending pics and said he’d answer any questions that may arise in forthcoming weeks.

- Flying home post-op sucks. If you can avoid flying budget I would. But now that I’m home it’s all fine :)

Important to note: when the clinic gives you all the paperwork to sign, one of the forms will state you’ll be getting a “breast reduction” - don’t panic! This is NOT what you’re getting, you’re still getting a full gender affirming mastectomy. They just (for some reason) do not have that specific category for their admin.

CON: BMI limit is 35 and if it is over 30 you’re not entitled to revision. So not inclusive of all body types which is very disappointing.

Overview of costs:
Total fee for surgery with 5% Fast Track discount was: €4085.00 / £3571.11. Please note that their fees go up every year come August. This included:
*Surgery
*Pre-op tests
*Pre-op consult with surgeon and anaesthetist
*Overnight stay in clinic with meals provided (2 bed ward, 1 bed ward upon request and if available - I was in a 2 bed ward but there was no other patient during my stay. Food was good)
*Post-op check-up with resident doctor in ward after surgery
*Painkillers, stool meds + tape
*Compression binder
*2 lymphatic drainage massages (1 right after surgery and 1 before you are discharged)
*Tape change before discharge
*Transport from and to Kaunas Airport upon arrival and departure (Vilnius also possible but only within office hours)
*Transport from and to clinic (from/to wherever you’re staying)

Remaining costs of flights, accommodation, food, surgery referral, mastectomy pillow etc. came to about:
£1800 (mind you we could’ve budgeted more so this figure could defs be lower)

So all-in this cost me: £5371.11 (I am not including full recovery time after getting home in this!)

I also opted for some add-ons the clinic had on offer (but these are optional and not necessary if budget doesn’t allow):
*Online consult with a surgeon couple months before: €60.00 / £53.22
*UK Pre-op test package with Sirkka Health: £198.00 - I basically opted for this so I would know a month beforehand whether there would be any issues after the clinic reviewed my blood test results (and thus would be more likely to be able to action them if necessary). Sirkka Health is one of their partners so they automatically send the results through to the clinic. 
*After care package: €450.00 / £393.39 - https://www.nordesthetics.com/en/aftercare-package-in-uk-ireland/
*2 extra lymphatic drainage massages: €35.00 / £30.60 each

I'm now three weeks post-op from top surgery and wanted to share my experience!

Procedure: Double Incision, No nipple grafts, Underarm/Flank Liposuction

Context: Nonbinary, no HRT/Testosterone, no gender dysphoria diagnosis, international travel to Stockholm.

The Consultation

My consultation was back in December. I booked a free consult online via the ACPK website and was able to book the appointment for a couple of days later. Before the consult, I wrote up a list of questions that I needed answering in case I forgot in the stress of the appointment.

Dr Amoroso was incredibly thorough, and answered almost all of my questions just through his comprehensive explanation of what I could expect. I had sent over some photos of my chest beforehand, and he used a surgical software programme to 3D model me and discuss what my results might look like. This was really reassuring as the 'not knowing' is definitely the most anxiety-inducing part. I was then given plenty of opportunities to ask all of the questions I had remaining.

I was also at this stage recommended lipo - That's because I had a very large cup size pre-op and a lot of the tissue was in my underarm area. Having now had the surgery, this was absolutely necessary and has made my results even better than I could imagine.

Booking for Surgery

I was able to choose my surgical date after the consult. I could have had surgery in January within 4 weeks of my consult, but I chose to wait until the end of April just for practicalities and the sake of being able to plan my recovery for a quieter period of my calendar.

I was sent over a few pieces of paperwork. I was also informed that I would need to provide evidence of the necessity of the surgery - This sounds intimidating, but they accept letters from therapists. So I just contacted my therapist and paid approx. £60 for the referral letter that just explained that I had been out as nonbinary for a long time and had discussed my want for surgery in the past, and that I had no psychatric contraindications to getting surgery.

Pre-Op Travel + Preparation

I flew into Stockholm a couple of days in advance of the surgery. I was given a large prescription for various medications (Euprasim, Celecoxib, Paracetamol and Odensatron alongside the stronger painkillers), which I picked up from the pharmacy the day before surgery. Technically you could pick them up after surgery, but who wants to add more stress to recovery?

Something important to note is that ACPK do not allow you to have piercing jewellery in during the procedure. Not retainers, nothing. So if you have a lot of piercings (like me) then you may need to prepare a piercing rescue kit haha. If you need jewellery reinserting, I recommend Chai at CALM Body Modifications. He's only a short trip from the clinic.

The Night Before

I was asked to use a chlorhexidine based pre-surgical scrub wash to prepare my entire body for surgery. There was a shampoo, and then a big sponge soaked in chlorhexidine soap. You have to wash your entire body and hair twice, and then use a clean towel and get into clean pajamas/clean sheets. If you're staying in a hotel or airbnb, keep this in mind as you may need to ask the front desk for clean sheets and towels.

Aside from that, I was asked to not eat for 12 hours in advance of surgery, and no fluids 8 hours in advance of surgery. That was fine - I just swished my mouth out with water in the morning when I felt a bit thirsty,

Pre-Surgery

I got to the clinic at 8.30am. One of the nurses took me to take some 'before' photos, which took 5 minutes. Then I was taken through to the pre-op area, got changed into a surgical gown and a luxurious robe (which you get to keep!), and met the anaesthesia nurse. She was awesome! She asked me some medical questions, measured my BP, and put a cannula in the back of my hand. I then took a shot glass full of pills.

I waited in the pre-op room until around 9.30am before the anaethesiologist picked me up and took me into the operating theatre. I wasn't nervous, and made some light conversation with the team. Then the anaesthesiologist put some propofol through my cannula and I was out like a light.

Post-Surgery

I 'woke up' in the recovery suite at 12.30pm after what felt like a quick 30 second dream! I think I'd been out of surgery for a while before I properly gained sentience again. I was almost immedietely checked on by the anaesthesia nurse who made sure I was feeling ok, and then brought me the most delicious post-op meal. I was already wearing a compression binder so I assume it was put on me after surgery.

Once I was feeling better, I was taken to the changing rooms and put my outside clothes back on over my compression binder. Then I was able to chill out in the waiting area for a while until I was fully compus mentus and my parents picked me up.

I was expecting to feel really groggy and weird after the anaesthesia, but I was feeling energetic and happy only 10-15 minutes after waking up. I literally felt amazing. No pain, no grogginess, nothing. I walked back to my hotel from the clinic (with family supervising) at around 2pm. They didn't intubate or catheterise me, which was also great so I didn't have a sore throat or anything.

Back at the hotel, I just got into bed and relaxed for the rest of the day. I also set reminders on my phone for medication, as taking them on time is the most important thing. This was stressed to me by the nurses!

Post-Op Travel

I flew home 4 days after top surgery. It was actually pretty fine! I booked wheelchair assistance at the airport both in Stockholm and the UK and I cannot recommend doing this enough! It was so incredibly helpful, as by this time I was feeling a bit worse for wear and could not imagine trying to handle security and walking through the airport by myself. I wore compression socks for the first week anyway, but I do recommend compression socks and wearing your post-op binder as snug as you can.

Week 1

Week 1 started really well. I felt fine, energetic and had little to no pain. I didn't really need any strong painkillers, from around day 3 I was just taking paracetamol and that worked perfectly. I was told I could shower after 48 hours, but I didn't want to mess anything up so I used body wipes and had my mum wash my hair for me.

Week 2

Week 1-2 are a little bit fuzzy in my memory because I had a bad reaction to the Eusaprim (antibiotics) and was severely unwell for about 10 days. I contacted ACPK and they gave me great advice on how to proceed. I should note that if you are travelling into Sweden from abroad, the best way to get in contact and have a speedy response from ACPK is by calling them on the phone. Depending on your phone contract, that might be a lil expensive but IMO totally worth it for direct questions and emergencies. They also respond pretty quickly to emails (once you get the correct address for the nurses), so if you have any issues then do get in touch with them.

I spent most of weeks 1+2 sleeping. I'm talking like, 12+ hours a day. I think allowing myself to just rest as much as possible made the healing process go a lot faster and feel a lot smoother.

Week 3

I've had a very small complication with one of my incisions (see previous posts), however the nurses have been so responsive in answering my questions and putting my mind at ease. They encourage you to email them update photos whenever you need help, so I have been in pretty close contact with them since my operation. The nurses are so kind and knowledgeable, and know exactly how to explain what is going on. If you're a chronic overthinker or, like me, suffer from OCD, then they are a godsend.

By week 3 I am feeling pretty much back to normal in terms of general health. I can walk long distances, and feel active without getting fatigued. I'm now sleeping more 'normal' amounts (8-10hrs) and don't feel the need for naps.

Pain-wise, it's a little more painful this week as my nerves begin to wake up. I'm also a bit sore from the liposuction, which apparently is pretty normal!

Results (So Far)

Overall, my incisions are incredibly neat. They look amazing, and are pretty symmetrical. The slight dehiscense I have experienced is totally my fault as I am stubborn and overly independent! The results were originally quite 'lifted,' but it's my understanding that this allows for tension-free wound healing. They are already flattening down, and I don't expect to be left with ridges haha.

I do not have dog ears or any general weirdness, it's all looking great!

Overall Experience

Overall, my experience with ACPK and Dr Amoroso have been really good. ACPK were comprehensive, helpful, and gave a really high-quality service. Dr Amoroso was intelligent and communicated everything I needed to know in an understandable manner. If you're expecting long conversations, probably not the guy for you. But I appreciated his directness and slightly distant professionalism, that wasn't an issue for me. The results have been awesome, and that is what we're all after right?

I think if you are planning top surgery outside of the UK, ACPK is a great option. I have no regrets about travelling for surgery.

Please do ask any questions you might have! I'm happy to respond.