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Dr. Hugh McLean
A Top Surgeon Specializing in

Top Surgery

FTM Surgery - FAQ Page

Meet the Doctors

We take pride in our team of well-trained doctors and medical staff. FTM top surgeries are performed by Dr. Hugh McLean, Dr. Kathleen Armstrong, and Dr. David Boudana. They are all extremely qualified plastic surgeons who have been performing this type of gender-confirming procedure for over 30 years combined. To learn more about our doctors or FTM top surgery, please visit the Contact Us page to book a consultation.

Preoperative Preparation

1. How do I prepare for FTM surgery?

For any type of plastic surgery, it is important to make sure that you are in optimal health. Here are some proactive steps that you can take to help strengthen your body’s immune system prior to your surgery to ensure successful results and speed up your healing.

Stop drinking alcohol at least a week leading up to your surgery. Doctors warn against drinking even a small amount of alcohol before your top surgery, as it can weaken the immune system and impede recovery.

Quit smoking three to six weeks before your operation. According to the World Health Organization (WHO), smokers have a higher risk of suffering from post-surgical complications.

If you are overweight, you might need to first achieve a stable and healthy weight before undergoing the surgery. Follow a nutritious top surgery diet rich in protein, vitamin C, and zinc.

2. Do I have to stop testosterone/medications before surgery?

No. However, our doctors may recommend that you discontinue taking testosterone on the day of your surgery.

3. How long is the phone pre-op call?

Typically, a phone pre-op call can take anywhere from 15 to 30 minutes, depending on how many questions you may have.

4. Is the prescription covered through my benefits?

It depends. Since every insurance company is different, you should check with your provider to see if this is covered under your health card plan.

5. Do I have to take off any of my body piercings?

Good news! You can leave most of your piercings in, except for the ones that may affect the surgery (i.e. piercings in the nose, mouth, and of course, chest area). Don’t worry. Our anesthetist will advise and assist you should there be piercings and other matters that need to be taken care of before the actual procedure.

Out of Town

1. How soon can I fly after surgery?

It is not safe to fly immediately after your surgery due to the risk of increased air pressure on your incisions. If possible, book your return flight and hotel accommodation for at least a few days after your surgery date.

Self Pay/Out-of-Pocket

1. How much does the FTM top surgery cost?

The total cost of the surgery is $8,900.00 plus HST.

2. Does the cost vary depending on my breast size?

The cost generally is the same for all top surgery.

3. How much is contouring and what does it include?

Contouring is included in the cost of the self-pay surgery.

4. What is included in my fees?

The quoted surgery cost covers everything you need from start to finish, including:

  • Pre-operative visits
  • Cost of actual surgery
  • General anesthesia
  • Use of medical facility fees
  • Pathology fees
  • 24/7 after-hours supports
  • Post-operative visits
  • Surgical binder and dressing supplies

5. What payment options do you offer?

We take all major credit cards, e-Transfer, bank drafts, and/or money orders.

6. If I have OHIP coverage but decide to self-pay instead, can I?

No, you cannot. Once you get approved by the Ministry of Health, you must stay with the coverage.

Documentation

1. What documents do I need to provide if I want to have an FTM surgery?

If you are under the age of 18, you need to present a document that allows surgeons to confirm that you have met the World Professional Association for Transgender Health’s Standards of Care and proof of good health from your physician to make sure that you are a good plastic surgery candidate.

2. How long will I be off of work or school?

Depending on what you do for work and what your school schedule involves, you can be off from 2 weeks to sometimes 8 if you work in a more physical type of job.

3. Can the doctor give me an off work/school note?

Yes. We can provide a school or work note at a minimal fee of $25.00.

4. Will the doctor complete the off-work insurance forms?

Yes. We can complete insurance forms. There will be a fee of $45.00

OHIP Coverage

1. top surgery procedure covered by OHIP?

FTM surgery can be costly, but thankfully your gender confirmation surgery may be covered by the Ontario Health Insurance Plan (OHIP). To have your procedure covered, you must meet the following criteria:

  • Receive a proper diagnosis and recommendation from a mental health specialist, such as a psychologist, psychiatrist, or a behavioural therapist
  • Have your doctor or nurse complete and submit the Request for Prior Approval for Funding of Sex Reassignment Surgery to the Ministry of Health and Long-Term Care. Your healthcare provider will notify you of the status of your application.
  • Only once approved, you can get in touch with us to schedule your top surgery. If you have surgery before getting approval from the ministry, the cost of the surgery will not be covered.

To learn more about OHIP Covered FTM criteria, be sure to check out this blog post.

2. If I am non-binary, do I qualify for OHIP coverage?

Since we are not involved in the OHIP approval process, we recommend that you discuss this concern in detail with your family physician or healthcare provider. Usually, this is determined by the Ministry of Health and Long-Term Care.

COVID-19

1. Do I have to be vaccinated before I can have surgery?

No. We do not require you to be vaccinated before surgery. If you are already vaccinated, it will not affect the surgery in any way.

2. Do patients have to be COVID-19 Tested before surgery?

Yes. Patients are required to undergo COVID-19 testing 7 to 10 days before surgery.

3. How are consultations taking place during COVID-19?

Most of our consultations are being done over the phone. You only need to come into the clinic in person if the doctor requires you to come in for a secondary consultation.

4. Do I have to self-isolate before or after surgery?

Once you have been tested for COVID-19 and your results come back negative, we recommend that you still limit how many people you see and the places where you go. This is to ensure your safety and the safety of the staff at our clinic.

Consultation

1. What does the consultation process look like?

To minimize the risk of COVID-19 infection, we are currently offering virtual consultations. To book an appointment, you can call us at 1-855-311-7722 or complete our online contact form on the website. Our patient coordinator will get in touch with you within two days to schedule you for online consultation.

During the consultation, our nurses will ask you some questions regarding your medical history and provide a brief overview of FTM top surgery. After this, you will be connected with one of our surgeons for the initial consultation. As the majority of our top surgery patients can attest to, our doctors here at McLean Clinic conduct consultation in a gentle, respectful, and professional manner. They are committed to providing each patient with the best treatment options available. Do not hesitate to ask questions or bring up any pressing concerns you may have related to the surgery (i.e. pain, recovery, or scarring). Our doctors will be more than happy to answer your inquiries.

Lastly, Elizabeth, our Director of Client Relations, will discuss everything you need to know regarding the schedule, cost, and flexible payment options for your FTM/N top surgery.

Check out What Is The McLean Experience For FTM Surgery Like? for helpful tips on how to take your pre-consultation photos effectively and a more in-depth guide about our process.

2. How soon after my consultation can I receive the surgery?

Typically, we can set your surgery date within 3 to 6 months after your initial consultation—sometimes, even sooner. However, waiting times may vary depending on several factors, including funding approval from your health insurance and the volume of patients we have on the waiting list at a given time.

3. Where is the surgery performed?

FTM top surgery is performed at McLean Clinic in Mississauga. We are a private, independent health facility that follows the same guidelines as a regular hospital. We have a fully equipped operating room, recovery room, and other necessary facilities to ensure a safe and comfortable top surgery experience for our patients.

Post-Operative Tips

1. How long of a recovery period can I expect and what kind of help will I need during my recovery?

Generally, the recovery period for FTM top surgery takes around 6 to 8 weeks after the procedure. After this time frame, you will be able to resume physical activities, such as running, lifting, and various other sports. We recommend that you arrange for a family member, friend, or caregiver to assist you within the first 24 to 48 hours post-op when you’ll experience some discomfort and limited movement.

2. Can I drive myself home after surgery?

No. We suggest that you have someone pick you up from the clinic. The amount of time it takes for you to be able to drive again will depend on the specifics of your surgery and your body’s healing process. Before driving again, you would need to be able to make unrestrained arm movements that won’t cause discomfort or scarring. This will usually take around 1 or 2 weeks.

3. What supplies will I need after the surgery?

After your surgery, we will provide you with a bag of dressings with post-op care instructions to help your healing. We recommend having a tube of polysporin (the gel one, not the ointment) to prevent wound infection. For an exhaustive list of things to pack for your FTM surgery recovery, read this article.

4. What do the follow-up appointments look like?

Your first post-operative appointment is set a day after your surgery either in person or over the phone. The next follow-up checkup will be 5 to 10 days later where you have to come into the clinic to remove your dressings or drains, depending on what type of surgery you had.

5. What type of pain medication is given after surgery?

We prescribe tramadol for post-surgery pain relief.

6. Is there a local hotel I can stay at?

Delta Hotels by Marriott Toronto Mississauga is located in our building. Our clinic is across Square One. There are also many Airbnb listings within the Greater Toronto Area that may suit your needs.

7. How long does someone have to stay with me after my surgery?

The first 24 to 48 hours after the surgery is most crucial. You may experience a bit of pain and discomfort and will be unable to move your arms. We recommend that you request a friend or family member to stay with you or arrange for a caregiver during this time.

8. When can I swim, exercise, or be topless in the sun?

We strongly advise against prolonged sun exposure, which can pose risks of darkening your incision scars, making them more visible. Avoid swimming and other forms of exercises that require strenuous arm movements that may put a strain on the incision site. We suggest waiting at least 6 months or until your doctor approves.

9. When can I get a tattoo?

Getting a tattoo post-surgery can increase your risk of infection. If you are planning on getting a tattoo to conceal your surgical scars, you should wait at least 12 to 18 months post operation. It’s also best to consult your doctor before getting inked.

10. What can I use on my scars?

We highly recommend using our Scar Recovery Gel from Skin Medica. It is plant-based, delivers great results, dries very quickly with, and without the mess or staining of your clothes.

General Q&A

1. Where and how will you perform the procedure?

We have two main techniques for FTM top surgery: the double incision mastectomy and the keyhole (aka periareolar) top surgery.

As its name suggests, the double incision mastectomy, also known as a bilateral mastectomy, involves two incisions that allow for the removal of all breast tissue. The nipple is also removed, resized, and repositioned to have a more masculine appearance. This is best for large, overhanging breasts.

On the other hand, the periareolar top surgery creates an incision all around the edges of the areola. The nipple and areola can sometimes but not always be adjusted within this procedure to have a more masculine appearance, although it has higher chances of preserved nipple sensitivity. This procedure is ideal for individuals with small chests and tight skin in their chest area.

Both procedures involve the use of anesthesia and are performed in a sterile surgical environment in our clinic.

2. How do I know if I am a candidate for a Keyhole or DIM?

After an initial consultation, our doctors will discuss which treatment options are recommended for your body type.

3. What’s the minimum age for top-surgery eligibility?

According to The World Professional Association for Transgender Health’s Standards of Care, the minimum age to undergo surgery for the masculinization of the torso is 16 years old. Patients must have parental consent and documentation from a physician to determine eligibility.

4. Can I be operated on if I am overweight?

Weight can significantly influence the results of your surgery. Therefore, good candidates for the FTM top surgery should have a healthy and stable weight, specifically with a BMI range of under 33.

5. Will I need bloodwork done before surgery?

As with any type of medical procedure, your doctor may request lab tests done to ensure the success and safety of your operation. This will be discussed during the initial consultation.

6. Does my private insurance cover top surgery or the contouring fees?

We don’t deal with third-party insurance companies. We suggest discussing the details of your coverage with your provider.

7.Do you perform bottom surgery as well?

No. We do not perform bottom surgery at our clinic.

8. Do I need a referral to receive the surgery?

No. Although a referral is always helpful, we do not require one for surgery.

9. If I need a revision, when can I have it done?

We recommend that you wait at least 9 months to a year until the body is fully healed before you do a revision surgery.

10. What are the different types of top surgeries you offer?

We offer the double incision mastectomy and the keyhole mastectomy procedure.

11. Where does the surgery take place?

The top surgery is performed at McLean Clinic in Mississauga.

12. Will I have drains?

It depends. Only the periareolar or keyhole mastectomy procedure requires the drains.

13. What is a dog ear?

Dog ears refer to the excess skin and fat that protrude out of the primary incision lines on the sides or near the center of the chest after a double-incision top surgery.

14. Can I still get pregnant after having top surgery?

Yes. The breasts are not involved in the gestational process. Having them removed through top surgery will not affect your ability to conceive unless you’ve had other procedures done like a bottom surgery.

15. Do I have to have nipples?

It’s up to you. Patients have the option to get a top surgery done without nipples.

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