28 Years Old, FTM Double Incision Top Surgery with Dr. Richard Tholen, 16 Months on Testosterone - Minneapolis, MN

I had wanted top surgery for years. My clothes didn't fit the way I wanted them to, and like many transguys, I dreamed of going to the beach and being outside topless like cisgender guys. I researched the surgeons in Minnesota and surrounding states, and I found the most information about Dr. Tholen--lots of pictures and testimonials, and specifics about how the procedure is done. I wasn't willing to go to any surgeon whose past work I couldn't extensively review.

I set up a consult with Dr. Tholen in mid December 2014. He examined my chest and answered my many, many questions about the procedure and after care. After the consult I met with the woman who handles the billing to get specifics about the cost of the procedure. Dr. Tholen's practice does not accept payment from insurance companies, so everything has to be paid out of pocket. They give a small discount for paying in cash or check, and 100% of the payment is due two weeks prior to the scheduled surgery. There is a $1,000 fee if you voluntarily cancel or postpone your surgery within two weeks of the originally scheduled date. My surgery cost about $9,700 with the cash/check discount. All follow-up appointments are included in the cost of the surgery. I needed a few extra months to save money, so I scheduled the surgery for 3/11/2015.

I had been on testosterone for 16 months at the time of my surgery. Before testosterone my chest was a full B cup, and at the time of surgery was a significantly less full B cup. The morning of the procedure I arrived 1 hour before the surgery. Dr. Tholen again examined my chest and drew the incision lines onto my skin in blue marker. He answered some last minute questions and I headed to the OR. The procedure took about 4 hours from start to finish. I did have a urinary catheter in place, though it was inserted after I was already asleep, thankfully. My first memory afterwards is of sipping a Sprite and eating saltines in the recovery room. I had absolutely no post-operative nausea, and walked out of the office on my own two feet about 90 minutes after the surgery.

I stayed with friends for almost two weeks after the surgery to be looked after. I was taking Vicodin, methocarbamol (muscle relaxer), and Celebrex (for nerve pain) for almost 2 weeks after the procedure--be sure to factor in the cost of medications in your planning. For the first 2 weeks, I didn't do much, lots of sleeping and lots of TV, and I was pretty sore despite the medications. I wore a compression garment for almost 4 weeks to help minimize swelling. The garment cannot be removed until the first post-op appointment, and you cannot use deodorant before the appointment due to risk of infection, so be prepared to be pretty smelly for a couple weeks.

My first follow up appointment was at 9 days post-op, at which time the drains were removed. The majority of my pain was caused by the drains, so I felt a lot better after they were gone. Everything looked great, and I was relieved to be able to finally wash my armpits and put on deodorant at the office. I chose to purchase a second (clean!) compression garment for $100 at my 9 day post-op appointment so that I could wash and switch the garment every few days to minimize the smelliness. You will only sponge bathe for about 3 weeks, and someone may have to wash your hair for you. My next follow up appointment was at 3 weeks post-op, and I was able to drive myself to the appointment. Again, everything looked great and I was told I could shower delicately, and slowly begin to raise my arms above my head. I was instructed to rub Vitamin E oil daily into my nipples and the incisions to aid healing and help break up scar tissue. My third appointment was at 6 weeks post op. At that time I was told I could return to all my normal activities as tolerated (lifting weights!), and was given a tube of gel to rub into my scars twice daily to minimize the appearance of the scar and lessen the redness.

Currently I am 7.5 weeks post-op and I'm feeling great. I'm able to do yoga, pull-ups and push ups without any pain. I am beyond thrilled with the results of my surgery, it looks way, way better than I ever expected it would. The scars from the incisions are very, very thin and smooth--no rippling or dimpling, and I have no "dog ears" at the edges of the incisions. The nipples are round, appropriately sized, symmetrically placed, and in the correct position for a male chest. The placement of the incisions is perfect at the lower edge of the pectoral muscle--the scars could definitely be hidden if I developed my chest enough at the gym. The combination of Dr. Tholen's expertise and experience, along with my closely following his post operative instructions and REALLY taking it easy for 3 weeks produced an excellent result. I would highly recommend Dr. Tholen to anyone looking for a surgeon in the mid-west.

Overall, the staff was excellent. Everyone was super friendly and respectful, everyone got my pronouns and name correct every single time, and the women at the front desk remembered my name the second I walked into the office. I felt very taken care of every time I was there, and they made the complicated process of having surgery seem easy. When I needed to move one of my post-operative follow up appointments they were very flexible and were able to get me in at time that worked for me. The staff make themselves very available for questions--I had a question about my chest on a Sunday and was able to speak directly with Dr. Tholen. Dr. Tholen and the nurses are very knowledgeable and have been involved with transgender surgeries many, many times, so there was no weirdness about my transgender identity.