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Dr. Hugh McLean
A Top Surgeon Specializing in

Top Surgery

FAQ

Why should I go to you (Dr. McLean) for this procedure? How long have you been performing this procedure?

Dr. Mclean has over 20 years of experience when it comes to performing the FTM top surgery procedure and a total of 40+ years of experience in plastic surgery overall. He is certified as a specialist in plastic surgery by the Royal College of Physicians & Surgeons of Canada and the American Board of Plastic Surgeons, Inc. He is a member of various organizations including the Canadian Society of Plastic Surgeons, Ontario Society of Plastic Surgeons, American Society for Aesthetic Plastic Surgery and so on. 

Dr. Mclean is known as one of the best surgeons to perform Top Surgery because of his special interest in updated techniques for FTM (as well as MTF) surgical transformation. He also has the empathy and understanding to know that these transformations go well beyond skin deep and will truly have a positive impact on the person’s well-being and sense of self.

For anyone who has ever met Dr. Mclean, it’s clear that the reason why he does superior work each time is because he is able to synergize his state-of-the-art tools, knowledge, and experience with undying zeal and genuine care for his patients.

Why did you start performing these procedures?

Not so long ago, countries like Canada and the United States started to open its eyes to LGBTQ+ rights. As a thought leader, I kept a close watch on gender inclusivity and transgender health and thought of how I can contribute to it. I then realized that there is an important contribution I can make to help end gender dysphoria in individuals that suffer from it - by dedicating myself to gaining knowledge and experience regarding safe and transformative cosmetic procedures. At the end of the day, it’s all about helping everyone to feel confident and happy in their own skin.

How has the field changed since you began?

I would say that even now, transgender surgery remains to be a growing field in the realm of plastic surgery. With regards to FTM body contouring and top surgery, plenty of tried and true techniques such as liposuction, tummy tuck surgery, brachioplasty, double incision mastectomy, and periareolar surgery remain to be effective go-to solutions in achieving a more masculine bodily appearance. Though some of these methods have been around for decades, studies continue to give opportunities for finetuning - and this is why it’s so inspiring for me to learn about the latest information from international conferences.

What is your best piece of advice for someone who wants to undergo this procedure?

Nothing brings more joy to my heart than to positively impact a patient’s sense of well-being. I consider this the end goal of my profession. So my best piece of advice for my transgender patients is that they should have a healthy sense of self-love no matter what. Plastic surgery shouldn’t be the linchpin for one’s sense of self love - rather, it’s a personal journey that you can choose for yourself as a reflection of that self-love. If certain procedures will help to give you more confidence and comfort in your daily life… and you’ve weighed the risks... and you’re decided that this will be helpful to you, then by all means, go for it.

Will my surgery be reimbursed by my province’s health insurance?

The cost of gender reassignment surgery is covered in most Canadian provinces. However, feminizing surgeries that are considered cosmetic - such as facial feminization, breast augmentation, voice surgery and Adam’s Apple reduction are currently not covered by all health programs.

From what age can I have gender reassignment surgery?

The World Professional Association for Transgender Health states in the Standards of Care that the minimum age to undergo a surgery for the masculinization of the torso is 16 years old.

What documents do I need to provide if I want to have surgery?

The basic documents that you would need to present include those that allow surgeons to confirm that you have met the World Professional Association for Transgender Health’s Standards of Care. Additionally, you will need to secure documents like proof of good health from your physician to make sure that you are in the health state of a good plastic surgery candidate.

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 are those that have attained a healthy and stable weight, specifically with a BMI range of 18.5 to 25. If your BMI is below or above the normal range, you will need further assessment to determine if you are eligible for this surgery.

Should I stop taking my hormones before surgery?

Yes. Testosterone needs to be stopped 2 weeks before the procedure. The reason why surgeons recommend stopping testosterone before and/or after surgery is because situdies have shown that high testosterone levels correlate to delayed wound healing and an increased risk of forming blood clots in the veins - also known as deep vein thrombosis.

Will the dosage of my hormones need to be adjusted after surgery?

For masculinizing hormones such as testosterone, you won’t need to have a follow-up appointment regarding dosage. However, your surgeon may ask you to stop testosterone for a few weeks after surgery to allow for proper and speedy healing.

How do I prepare for surgery?

For any type of plastic surgery, it is important to make sure that you are in optimal health. This ensures that the body has the healing capacity needed to recover well and get satisfactory results. If you are overweight, you might need to first achieve a stable and healthy weight before undergoing the surgery.

Once I am back home after surgery, what should I do if I need help?

Should you encounter a medical emergency after getting home, you can go to the emergency room of the nearest hospital or call the after-hours phone number provided by the McLean Clinic for emergencies.  They will instruct you on how to proceed.

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 rate. 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 two weeks.

When can I start to swim again after my surgical procedure?

To ensure proper healing and to minimize the chances of an infection, refrain from swimming after your surgical procedure. Both contact with the water and the physical activity of swimming is not conducive to proper healing. You can resume swimming after approximately 6 weeks.

With Periareolar/Keyhole, can you do a nipple reduction during the initial surgery?

Throughout this procedure, the nipple stalk is left intact but depending on the patient’s needs or goals, the nipple can be resized and the areola can be downsized to achieve a more masculine aesthetic.

What will be expected of a patient to get the best results?

The patient is expected to follow instructions mainly regarding suture care and what physical activities to avoid. For instance, activities that involve lifting the hands and reaching can increase scarring. A healthy and balanced diet will of course help the body to heal along with the avoidance of habits that compromise the body’s healing process - such as drinking and smoking.

Where and how will you perform my procedure?

We have two main techniques for FTM top surgery: the double incision mastectomy and the keyhole (aka periareolar) top surgery.  The double incision mastectomy involves two incisions that allow for the removal of all breast tissue. The nipple is also removed, resized, and re-positioned to have a more masculine appearance. This is best for large, overhanging breasts. 

Meanwhile, with the periareolar top surgery, an incision is made 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. 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.

What surgical technique do you recommend?

The two main techniques used in FTM top surgery are the double incision mastectomy and the keyhole (aka periareolar) top surgery. The double incision mastectomy is best suited for individuals with large, overhanging breasts. Meanwhile, the keyhole or periareolar top surgery is best for individuals with smaller chests and tighter chest skin. Have a consultation with us and we will be able to discuss your expectations and which of these techniques will be best suited for you.

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

The recovery period for FTM top surgery is at around 6 - 8 weeks after the surgery. After this time frame, you will be able to resume physical activities such as running, lifting, and various other sports.

What is the rate of people that transition back after?

According to a survey conducted by the World Professional Association for Transgender Health, approximately 0.3% of patients who underwent transition-related surgery later request for detransition-related surgical care.

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