What is Top Surgery?

How do I get referred for Top Surgery?

How experienced is Dr. Mckee with Top surgery?

What are the differences between Double Incision and Keyhole techniques?

What happens during during the consultation with Dr. Mckee?

What should I do to prepare for surgery?

What should I do on surgery day?

What should I do after surgery for the best results?

Can I smoke cigarettes? vape? or use nicotine products?

Nicotine products (such a cigarettes, cigars, vaping, nicotine patch) can increase risks of wound issues during surgery. It is recommended not be use any nicotine products for 3 weeks before surgery, and 3 weeks after surgery. We accept patient referrals for patients who use tobacco, and we discuss the risks prior to surgery.

Can I smoke marijuana?

Marijuana does not have the same devastating effects as nicotine when it comes to healing. The only reason to avoid smoking marijuana for a week prior to surgery, is because your throat may be a little irritated during surgery from the breathing apparatus used during the procedure while you are under general anesthesia.  Avoid breathing any fumes in general for a week before surgery.

Are drains used in top surgery?

No. Dr. Mckee does not routinely use drains with top surgery.

Is the surgery covered by B.C. and Yukon health insurance?

Yes.

Should I stop taking my testosterone medication around the time of surgery?

No. If you take testosterone regularly, there is no need to stop taking around the time of surgery.

Should I lose extra weight before surgery?

For patients with excessive body weight (Body Mass Index  greater than 30), it is recommended to lose weight prior to surgery in order to decrease the chances of complications ( including seroma, bleeding, infection, wounds opening, and contour/shape irregularities).

When is it safe to fly in an airplane after surgery?

It is generally safe to fly in an airplane a couple days after surgery if there has not been any healing concerns or complications after surgery.

I live out of town. Is it safe to drive away from the Lower Mainland after surgery?

It is generally safe to travel out of the Lower Mainland right after surgery. You will need someone to drive you. Please take note of the the location of your local hospital and emergency room in case of rare emergencies after surgery. For information on arranging transportation and accommodations and what funding might be available to you, see Trans Care BC’s Health Navigation Guide to Chest Construction Surgery.

Can other procedures be combined at the same time as my top surgery? Liposuction?

Top surgery and contouring is confined to the chest.  Patients that want additional cosmetic procedures at the same time are welcome to inquire about these during their surgical consult. Common additional procedures include the use of liposuction to shape the rest of the body creating a more masculine appearance (reducing fat/curves from the side/ under the armpit, or reducing fat/curves from the hips). 

When can I work after surgery?

Patients that have a desk job often return to work after 1 week from surgery if they are motivated to do so.  Other patients that have manual lifting/construction type jobs may take 6 weeks to return to work. Every patient is different. Some people need less time off, and others need more time off. We are happy to write you a note for work during the first follow-up visit after surgery, or on the day of surgery. The note can be as detailed or as vague as you wish, and we are flexible regarding the duration required off work.

What should I do if my chest is itchy right after surgery?

Sometimes the strong pain medication (narcotic) prescribed, or the surgical tape, can cause itchiness. The first step is to take Benadryl or Gravol, and avoid the narcotic pain medication. Do not scratch the chest because this could irritate the incisions.

A severe allergic reaction to medication can include  difficulty breathing, swollen throat, and large body rashes. These reactions are very rare, but if they occur you should go to the Emergency Room immediately.

When can I shower after surgery?

The day after surgery it is safe to shower from the waist down, and sponge bath the armpits and face. Do not get the original dressing wet. After 10 days after surgery, it is safe to remove the minor dressing at that point and shower the entire body. Please see the ‘After Surgery’ section for more information about showering.

Is there a preferred sleeping position after surgery?

Above all, we believe that you should find the most comfortable position to sleep in order to be well rested and heal after top surgery ( be it on your back, side, or front). Some surgeons believe that sleeping on your back for 1 week after surgery is best. We are unsure if this makes a difference at all. Definitely with keyhole surgery or DIM without nipple grafts, there is no advantage to sleeping on your back. With nipple grafts however, it is conceivable that sleeping on your back for the first week may be beneficial to prevent friction to the fragile nipple grafts. There is no evidence in the surgery literature proving this.

On the night before surgery, do I have to wash my body with any special cleaning solution?

No. Just use regular soap and water.

Do I have to shave my chest or armpits prior to surgery?

The advantage of shaving your chest and/or armpits before top surgery is so that the large adhesive dressing applied on the day of surgery does not hurt as much when it moves and rubs after surgery, or when it is removed by the doctor 1 week after surgery. Shaving the hair in these area will likely help to minimize discomfort after surgery. It is a personal preference to shave your chest or armpit, but not a requirement.

I have seen some post-operative photos of scars in a straight line, versus others with a curved swoop up the side. Which will I receive?

At the consultation, discuss your cosmetic goals with Dr. Mckee, and your desired preference. Different patient’s prefer different scar shapes. There a range of scar shapes that can be accomplished for each individual patient, while also limited by each individuals body type.

How old do I have to be to consent for and receive Top Surgery by Dr Mckee?

Regarding the age of top surgery patients, the overwhelming majority of patients who undergoing top surgery with Dr Mckee are 19 years or older. In British Columbia, the age of majority is defined as 19 years old, whereas in most other provinces the age of majority is 18 years old. In BC however, 18 year olds are considered minors. On rare occasion, with special consideration, we perform top surgery for 18 year-olds , for those patients who meet the strict criteria of a ‘mature minor’, and who are fully and legally able to consent for themselves by Canadian law.   In such rare cases, we obtain guidance from a variety of healthcare professionals and supportive parties who may support the patient in their decision making:  including the referring family doctor, psychologists, gender therapists, social workers, patient counsellors, pediatricians, and Trans Care BC. We also may obtain support from the hospital ethics board when needed. For a mature minor (age 18 in BC), we require a parent (or primary legal guardian) to be present for the consultation process, and to be supportive of the procedure. The ‘BC Infants Act’ gives a mature minor the ability to consent for themselves if the medical treatment is found to be in the patient’s best interest, and we gauge this with input from the patient, medical professionals involved , and parental guardian all being in unison. We believe that a human being of consenting ability has the right to choose for themselves what to do with their own body – specifically if they have the mental capacity to do so, and are aware and properly informed of the options, implications, and possible risks. We do not operate on patients younger than 18 years old.