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Florida—the third most populous state in the United States—is one of the states where it is hardest to get gender affirming care. This is true for everyone, but it especially affects minors. Even with a documented history of gender dysphoria, minors can receive almost no gender affirming care before the age of eighteen. And, even when they turn eighteen, it can take several years before they can actually get the care they need. Washington state-based plastic surgery practice Allure Esthetic is one of the top destinations in the United States for gender affirming surgery. Dr. Javad Sajan provides the best FTM top surgery for minor Florida patients.
Understanding FTM Top Surgery For Minors
The majority of gender affirming surgeries are performed on adults. However, in severe cases of gender dysphoria or when a young person’s mental health becomes a major concern, many medical professionals will recommend gender affirming surgery. This usually occurs after extensive mental health treatment and hormone therapy. By the time most patients reach this phase of treatment, they will be adults. Top surgery is rarely performed on patients below fifteen and most minor patients fall within the sixteen to seventeen age range.
Medical professionals do not recommend surgical transgender procedures to minors lightly. Most will not transition until they are adults (if they choose to physically transition). Often, minors who get top surgery require these gender affirming procedures to save their lives and improve their quality of life.
In cases where a young adult may benefit from top surgery, Dr. Sajan uses the guidelines set forth by the World Professional Association for Transgender Health. WPATH consists of medical professionals such as surgeons, psychologists, gynecologists, and even medical residents and emergency physicians. These professionals—based on their work with the transgender community and medical studies—come up with guidelines to ensure safe, equitable, and accessible transgender surgery. The association works closely with transgender, nonbinary, and gender non-conforming people around the world.
Minors generally need to meet certain guidelines to be eligible for FTM top surgery Florida:
- Diagnosis and history of gender dysphoria and incongruence
- Understands the procedure, the risks, and is mentally capable and mature enough to consent to surgery
- Has lived in their preferred gender for at least one year
- Parental consent
- Has a letter of recommendation from their mental health provider
- Have been on hormone therapy for at least six months (This guideline is optional and Dr. Sajan does not require this, but some practices and surgeons do).
Beyond WPATH, some insurance companies may have certain guidelines the patient and provider must follow to have the surgery eligible for insurance coverage. This could include obtaining an additional letter of support or providing large amounts of medical records.
Benefits & Risks
Every surgery comes with benefits and risks. Minor top surgery is not an exception. Dr. Sajan will counsel both the patient and their parent or guardian on these benefits and risks during a consultation and before surgery.
Benefits could include:
- Aid in treating gender dysphoria
- Prevent injury from incorrect or frequent binding
- Allows patients to wear clothing without binding
- Reduces instances of misgendering
- Live more visibly and easily in their gender identity
- Improve the patient’s quality of life
- Minor patients may be good candidates for less invasive types of top surgery
- Better mental health and well-being
- Customizable with several surgical techniques available
- Minimal risk
- Permanent results
- Short surgery time
- Well tolerated recovery
- Performed by WPATH standards
Risks associated with FTM top surgery for minors generally follow the risks of top surgery for adults as well:
- Complications of general anesthesia
- Re-opening of incisions
- Skin necrosis
- Fluid collection
- Hematoma (severe bruising)
Major complications of FTM top surgery are rare, especially when performed by a surgeon like Dr. Sajan who has performed hundreds of top surgeries on transgender men and non-binary people from many different backgrounds.
Traveling For Minor FTM Top Surgery
Choosing to travel across the country for gender affirming top surgery is not only a major decision, but a courageous one. Allure Esthetic Plastic Surgery aims to accommodate patients traveling to us in any way we can.
Florida patients can schedule a virtual consultation with Dr. Sajan. From there, he will evaluate candidacy and discuss a surgical plan with the patient and their parent. After their consultation, patients will need to begin gathering the proper documentation necessary for surgery. This could include medical records and letters of support. If patients run into issues with Florida providers being unwilling or unable to provide letters of support, we can help them find Washington-based providers who can help.
Patients and at least one parent or legal guardian need to make travel arrangements and plan to stay in Seattle for around one to two weeks. Dr. Sajan usually prefers that patients come for an in-person pre-operative appointment a few days before surgery, but virtual options are sometimes available depending on the case.
Preparing For Top Surgery
Dr. Sajan may request that patients make minor modifications to the medications or supplements they take before surgery. At the pre-operative appointment, all paperwork and medical clearances (if necessary) are reviewed. Due to the long distance nature of the case, patients can expect to call and email frequently with Allure Esthetic’s team to determine everything necessary.
On the day of surgery, the Allure Esthetic team will run standard tests to ensure the patient is healthy and fit for surgery at that moment. After this, Dr. Sajan will meet with the patient to review their surgical plan and make surgical markings. Patients will then be placed under general anesthesia.
Undergoing FTM Top Surgery For Minors
The most common type of top surgery for minors uses the double incision method. As the name suggests, it uses two incisions on either side of the chest. Via these incisions, Dr. Sajan removes skin, breast tissue, and the nipples. For patients who want to keep their nipples, Dr. Sajan performs what is known as a “free nipple graft” where the nipple is removed from the skin. He then makes the nipple smaller and shapes it to appear more masculine. At the end of the procedure, Dr. Sajan will place the nipples into their proper position on the chest.
Dr. Sajan may also perform liposuction to remove tissue unable to be removed manually. Sometimes—for patients with little natural breast tissue—liposuction alone may suffice. This is fairly rare across all MTF top surgery patients.
In general, Dr. Sajan likes to have his minor top surgery patients stay in the Seattle area for around a week. At the one week post-op, the nipple bolsters can often be removed and patients can see their new chest fully for the first time. Additionally, it is usually more comfortable to travel at that point in the recovery process. This also allows him not to place drains.
Patients will wear compression garments and should refrain from lifting their arms above their head. While walking and some daily activities are fine to perform, patients should refrain from anything too strenuous. FTM top surgery patients tend to tolerate the recovery well.
Frequently Asked Questions
Do You Have To Be On Hormones Before Top Surgery?
No, Dr. Sajan does not require FTM top surgery patients to have taken hormones before surgery. There is no substantial benefit either way. If a patient takes hormones, great. If not, also perfectly fine. However, if you do take hormones, Dr. Sajan may request that you alter your dosage or regimen to prevent complications during surgery.
When Can I Return Home After Minor FTM Top Surgery?
Usually, patients can fly home around a week after surgery. If absolutely necessary, they may be able to return sooner, but this is on a case-by-case basis and will alter Dr. Sajan’s recovery instructions.
What Insurances Do You Accept? Do You Accept Out-of-State Insurance?
Allure Esthetic accepts all private insurance. This includes out-of-state insurance.
Do You Have To Have Gender Dysphoria To Get FTM Top Surgery?
As a minor, yes. WPATH guidelines require that patients have a documented history with and diagnosis of gender dysphoria. Additionally, many insurance companies will not cover gender affirming surgeries without this documentation as well. Finally, most surgeons will not perform surgery on a minor without a gender dysphoria diagnosis, even if money is not a problem.
Adults may be able to access FTM top surgery without a history of gender dysphoria. However, insurance will still usually not cover patients in these cases. Therefore, it is best to begin the process of working with a mental health professional and physician to determine the right treatment plan moving forward.
How Much Is FTM Top Surgery Out-Of-Pocket?
If necessary, yes, patients are welcome to pay out of pocket. Allure Esthetic accepts all major debit and credit cards, certified checks, and cash. Our insurance coordinators try their best to work with insurance companies to seek full coverage. However, we recommend reaching out to your insurance company before seeking surgery to ensure it is coverable based on your plan.
One Of The Nation’s Leaders In Gender Affirming Top Surgery
Dr. Javad Sajan is a Seattle plastic surgeon who has specialized in gender affirming surgery from the beginning of his private practice career. Along with FTM top surgery, he also frequently performs facial feminization, body contouring, and several other masculinization and feminization procedures. Dr. Sajan is a member of WPATH. Allure Esthetic Plastic Surgery provides the best minor FTM top surgery Florida patients can get.
Dr. Sajan and the Allure Esthetic team aim to create a safe space for people of all gender identities. We strive to always be mindful and thoughtful to be affirming, even in small interactions. To learn more and schedule a consultation, call us at 206-209-0988. Patients can also reach out online via chat, contact form, or Price Simulator.