You will be required to complete a surgical readiness assessment (also known as a surgical recommendation form) by a qualified assessor (MD, Nurse practitioner, psychologist, ..) prior to undergoing surgery. Any MD or nurse practitioner can complete this for you (including your family doctor). This is often competed before consultation with a surgeon, but not necessarily. There are also psychologists in BC that can complete this readiness assessment and form with you for a fee, in-person or from abroad. We are happy to help coordinate this for you. There are many acceptable versions of this readiness assessment document, but we have provided a blank example of one below in case you haven’t completed one yet, and your family doctor needs one.

DOWNLOAD SURGICAL RECOMMENDATION FORM

The consultation with Dr Mckee takes place at a medical office. You will need your health insurance card to register. You will meet in a consultation room with Dr. Mckee where he will ask about your medical background, goals, and expectations of top surgery. You are welcome to have a support person present during the talking portion of the clinical visit ( such as a family member, partner, close friend, parental guardian, primary care giver, foster parent).  You will be asked to change into a surgical gown to make the 30 second physical examination of the chest easier. During the quick examination, we can ask any support people to step out of the room temporarily. Dr Mckee will take a few measurements and may or may not need to stretch the skin (with your permission) to anticipate how things would come together during surgery.  After the examination, you are welcome to stay in the gown or change back into your own shirt.  With everyone together in the room again, Dr Mckee will explain the surgical options, offer explanations on how the procedure works, show you before-and-after photos, and answer your questions.

Dr Mckee will ask you questions in order to make sure that you are making informed decision for yourself regarding top surgery. You must be aware of all your options, and aware of the implications and risks of surgery. It is therefore part of the consent process to discuss a list of possible complications and risks of the procedure so that you can make an informed decision. You can read more about general top surgery risks and complications ahead of time on the Trans Care BC website .  The risks and complications associated with both Double Incision mastectomy and Keyhole mastectomy techniques are rare.   We take many steps in order to reduce complications. This starts at the referral stage by pre-screening patients for surgery. The safety steps that we take also begin during the consultation - learning about each patient’s individual medical background.  We believe in educating each patient (and their support people present) of the possible risks and complications of top surgery - in order to minimize chances of complications happening.  Possible rare complications include infection , bleeding, wounds opening up slightly, persistent numb areas, nipple loss, chest or nipple asymmetry, contour irregularities, scarring issues, temporary fluid under the skin, allergic reactions, regretting having had the surgery, and rare issues relating to the general anesthesia.

There will be time for questions and answers at the end of the consultation.  Dr. Mckee and you will both decide together if moving forward with surgery with Dr Mckee is the best option. Both yourself and Dr Mckee must be comfortable with each-other, the consent process, and the small risks involved. If a second consultation is required for additional questions for Dr. Mckee, that is easy to arrange.

Photographs are sometimes taken before, and after surgery and stored securely. Some patients may choose to have their photos used for educational purposes for other medical learners, and for other patients considering top surgery. With your added consent, photos or videos could be used for medical journal publications, teaching session presentations, and social media education. With this additional consent, we are happy to support the education process around top surgery.  If you do not give additional consent to use the photos for educational purposes, then the photos will not be used, or shared. It is a personal preference.  

To learn more about preparing for the surgical consult, you may find the Trans Care BC Health Navigation Guide for Chest Construction Surgery