10. I Left My Tits in Michigan: Part 1
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In the first part of our titty chop series, Alex and Mattie discuss the process of pre-paring for top surgery.
No virus talk in this one! We only discuss getting rid of boobs.
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Tap a timestamp or any sentence to play from there · machine transcribed (mlx:mlx-community/whisper-large-v3-turbo), expect mistakesAlexHi, I'm Alex Cox. And I'm Mattie Cox. This is a queer podcast about gender, our minds, and all sorts of transitions. Welcome to Two Headed Girl.
You scheduled top surgery. I did. Quick refresher. What is top surgery?
MattieTop surgery is the removing of the breasts in various ways.
AlexIt's surgery. What does various ways mean?
MattieIt means there's different ways to get rid of them titties.
AlexI mean, yes, but it is a surgical procedure.
MattieIt's a surgery to remove the excess breast tissue on your chest to give your chest a masculine look.
AlexHow long have you wanted to do this now?
MattieTwo years. Man. Well, actually, funny enough, it'll be two years in March since I started looking into top surgeons, and that is when my top surgery is scheduled.
AlexFirst of all, I don't want people to think that we are advocating for top surgery or any type of particular surgery of any kind, really.
MattieYou don't have to have surgery to be trans and you don't have to be on testosterone to be trans or estrogen.
AlexIt's just a fairly common thing for a lot of transmasculine folks to do, including yourself. So I think it's really important that we talk about it and kind of document the whole process, just how we documented you coming out and how we dealt with that as a couple and how we explored our own genders together.
MattieExactly. And now it's going to be an exploration of my chest together.
AlexI'm familiar with it already. Anyway. There are so many things that we could start with. How do you find this type of surgeon? Because essentially, it's a plastic surgeon. And I feel like a lot of people like to shy away from that term because we, for some reason as a society, see plastic surgery as vain or unnecessary when like the majority of plastic, quote, plastic surgeons, even that's like a misnomer, heal skin conditions and stuff like that.
And what used to be called a sex change is now called gender affirmation surgery because you getting most of your chest fat removed has nothing to do with your genitals.
MattieThat is very true. But it has to do with making me more masculine in appearance.
AlexSo how did you go about finding your doctor?
Mattieso I can only speak for the U.S. because I know it's a really different process in the UK and I only know that because I did I did research and I've watched videos on YouTube so there is actually like a database of top surgeons in the U.S. there's a website where you go and it'll list all the top surgeons in your state or if there are any in your state and then you can break it down even farther to see if they accept your insurance or they never will
very very few that's not true or if they accept like care credit and stuff like that what's care credit alone you take out a line of credit specifically for top surgery so is this just for queer and trans folks no it's for any medical uh procedures but but it can be used for uh a lot of people use it to help pay for gender affirming surgeries. Who puts together this database? It looks like it's just like a trans community. I'm assuming it's a bunch of trans people that
have been through the surgeries or it's a bunch of, not a bunch of medical professionals, but it's medical professionals working with trans clients or that are well-versed in trans surgeries.
AlexAre there any trans doctors who do gender affirmation surgeries?
MattieNot that I'm aware of.
AlexThat sucks.
MattieI mean.
AlexThere has to be. Right? Come on.
MattieOut of all the ones I've looked at in the U.S. that are on that specific source, and we can link it in the show notes, I have not seen any.
AlexBut from that specific source. And that doesn't include anyone who does surgeries for trans women, though, right?
MattieNo, I mean, it should because some are some, yes, because some are just listed as gender affirmation surgeries, not FTM top surgeries like some surgeons do all or both or multiple.
AlexCan you just take me through the process of what it was like scheduling your surgery? Because there's a number of things you have to do to just prepare for, you know, booking it.
MattieWhen I first considered top surgery or thought about getting it, I researched a bunch of surgeons. One that I had heard of because he's pretty popular, Dr. Garamoni in Florida. He is, as far as I'm aware, the most popular and well-known top surgeon in the United States. And then I started researching surgeons closer to home, specifically just because I was curious. Like, I know you have family in Florida and we could fly there. But like, I was curious to find surgeons closer to home.
And then I started researching like their results.
AlexI don't know if folks will know what you mean by results, like how people's chests look afterwards.
MattieYeah. So like how many satisfied...
AlexSatisfied customers.
MattieSatisfied customers.
AlexExactly.
MattieYeah.
AlexThat's what they are. I was a satisfied customer when I got my hand tumor removed.
MattieThat's true. Yeah.
AlexBecause we live, again, in a country where health care is very much a part of our capitalist process.
MattieUnfortunately. After I did that, I narrowed down surgeons. So I was looking at like four of them. One in Ohio, one in Wisconsin, one in Michigan, and then one in Florida. And I honestly looked at results, prices, and then like the feedback and like community surrounding the surgeons, which I know you sort of find problematic. But I think there's like a community around top surgeons, like people that have gone there and share results and like recommend the surgeon.
There's like Facebook groups and web pages and stuff. And I find the resources helpful. I find like the sense of the sense of like helping one another out is really great. I know a lot of people in the Facebook group where I am a part of for the top surgeon I'm going to are helpful to each other about surgery tips, aftercare tips and like recovery, even for people who haven't seen that surgeon. So it's a community of resources, which is why I like it.
AlexThe only reason that I was kind of turned off by these types of groups is it felt almost like fan clubs for a lot of them. And I saw them, you know, some folks trashing other surgeons. And it just, I don't know, it gave me an icky feeling.
MattieThat's definitely not how it is, though.
AlexYou're right. The majority of it is not like that at all. But on the side, I was doing my own research of top surgeons. And because, you know, I mean, if you think about how much time I spend on WebMD for things that have nothing to do with any sort of physical affliction I have, like, of course, I'm going to spend hours and hours researching, like, just every aspect of what this is going to be like for you.
all right so you eventually found your top surgeon who's in Michigan what made you go with him other than distance and I know you say that you liked the results but were there any other factors like I mean price yeah yeah I know and that was something I worried about too was that uh you might be rushing into things to like get the cheapest surgery which unfortunately a lot of
people have to do and it sucks but there are some surgeons out there who are cheaper just because of location and there's so many so many factors we are just talking about you right now so for you other than okay price location the the results what for you constitutes good results I guess
Mattiewell one of the things they recommend on like top surgeons websites is looking at people's results like not right after they're healing from surgery but like a year out you know or like a couple years out to see how your chest will settle after you've had surgery and also like bedside manner and community the doctor i've chosen people like rave about his bedside manner and how helpful he is and like how his nurses don't misgender like sometimes the surgeon is really great but
the person's hospital experience is really bad especially if they still have their old name and gender on their documentation and that just being in the hospital is stressful let alone like constantly getting misgendered and being there for gender affirmation surgery and still getting misgendered that is fucking wild and that is something that literally no one has complained
Alexabout like i just i don't understand i mean i i understand slip-ups they suck they don't like that's not to say it's not completely reasonable to be upset when you're being misgendered in the hospital but if you look at the patient's chart see why they're here and most hospitals even fairly conservative even the ones that i've been to ask what my preferred name is because my name
is alexandra bright and they're like do you alex ally and i just think yeah they'll put alex on
Mattieyour medical bracelet it's so strange to me there's that part in the Skylar episode of Queer Eye where he says I was in bed had my scars and my chest clearly flat and bandaged and like my full beard and I was still constantly getting misnamed and misgendered and like for him to be going through that in the hospital like that's something I can't even imagine and like you're already vulnerable and healing and miserable and like oof so i mean yes the bedside manner big contributing
Alexfactor i think it's funny that you and i have very different approaches to how we choose doctors because i want some not that i do you want the doctor that's an asshole i i don't want the doctor who's an asshole but but i don't care if my doctor is an asshole as long as they're getting good results i had at one time a very nice dentist lovely guy was horrible like i would go and i don't
even remember what it was like uh oh he missed a cavity i've only ever had one cavity in my life brag it up brag it up yeah humble brag only one cavity i'm sorry that i keep talking about my my
Mattiehand surgery it was just such a no that's a good it's a big surgery and it's also a good comparative
Alexthing hospital wise and like surgeon wise yeah for sure yeah i and i went to a lot of different surgeons, visited a lot of facilities that had different physical therapy stuff. I say a lot, but it was like three or four because I was really lucky to find a guy who was an asshole, but he knew, yes, he was an asshole, did not have a good bedside manner. However, I know that I need to be an advocate for myself in that situation because doctors
are not taught bedside manner typically in med school as we know from our friends who are now doctors oh that's so weird oh i was gonna say from house and gray's anatomy but also i mean also from real life also from real life uh and but because i just knew all of the questions that i wanted to ask it sure he gave short answers but i'd be like i don't understand that please explain it like I'm a five-year-old.
And it's like, I don't know. It is frustrating, sure, that you need to keep advocating for yourself. But everything I'd heard was like, yes, this guy gets results. He doesn't miss anything.
MattieWhich had happened with your previous doctor.
AlexYep, which is why I got so into this.
MattieYeah. Well, I mean, it's important to get consults from different doctors. I had a consult from one surgeon who basically I did not like his response and ultimately decided not to go with that doctor not because of his response but like that was definitely a negative contributing factor is he told me what kind of top surgery I would get like straight up he was like this is a surgery you're getting this is how much money it is this is how it would be he didn't ask my opinion or what I felt or what I thought whereas I feel like this this is a surgery where like a doctor should ask
you how you feel and what you think and like obviously give their professional opinion. But this is not like you're doing this because you need to. I say so kind of thing.
AlexYeah, let's get into that because there are a variety of surgeries. It's I mean, even again, with my tiny tumor, there were not a ton of options, but he was like, this is how I typically do it. This is you know, you're going to have an incision. this far in. Sometimes people go around the back. I find that it's ineffective because blah, blah, blah. I've tried to like block everything out now that because I don't need to. Because you don't
Mattieneed to know the information about how they sliced open your hand. Yeah, I don't. I don't need to
Alexknow. I just know that the tumor is gone and I'm happy about it. They were so worried about your
Mattiescar. It's going to be a whole inch. It's going to be terrible. And it's like the most unnoticeable
Alexcoolest car ever. I know. I love it. It's a little baby. It's a little baby with a...
MattieLittle Frankenfinger. Little Frankenfinger.
AlexAll other plastic surgeries, some people would call them elective. And, you know, it's so it's your choice. It is your body. You are the expert on your body. And I completely understand why you wouldn't want to go with somebody because that's not even bedside manner. That is how he's going to go about the procedure.
MattieRight. I feel like that is super ego like that. I just felt like it was a ego boost, like I push you out of the way, ego in the room. This is what I do. Done.
AlexYeah, that that to me didn't feel like bedside manner. or rather I totally understood where you were coming from because this is your body. This is your chest. This is something you are going to live with for the rest of your life.
MattieHappily. Hopefully. Well, you would want it to be happily.
AlexWell, that's what I mean. You want as much agency. That's what this is all about, right? Yes. Having agency over your body.
MattieYeah.
AlexAnd to have especially a man coming in and saying, we are going to chop up your boobs this way without explaining why or, you know, not explaining the reason that your body type should have this kind of surgery. I find that gross. And looking into doctors on my own, I saw that as well. And we haven't talked about this yet. what are the different types of surgeries i i did not know that there was more than one
type of top surgery there's a lot years ago yeah yeah um i actually don't know how
Mattiethree type i i don't know i know double incision keyhole periareolar t anchor and i believe there's one more it's like minimal scarring or something it's like a form of double incision but smaller So most people get double incision, which is where the surgeon cuts underneath the breast line, like along the pectoral, where your pectoral muscles would be, removes the breast tissue.
And you end up with two horizontal scars where your pec muscles would be. And they put nipple grafts in a place that would be where naturally masculine nipples would lie. And that's the most common because it is for all body types. Like it doesn't matter what size your chest is. It could be double D. It could be A. And that is like you could get that surgery. So periareolar top surgery is also a lot like keyhole where around your nipple they cut a little incision just like around the outside of the areola.
Hence areolar. and just liposuck the boob out. Liposuck that tissue out. And it's for chests. Keyhole and periareolar are for chests that are A or B. Usually can't be for chests that are any bigger just because the elasticity of the breast tissue and the skin would make it so that the chest would have extra skin. So you would have to either get a revision or it just wouldn't yield good results, which can also happen even if you have a small chest but you've been binding for let's say like
years and years and years and the skin elasticity of your boobs is not bouncy um is is not good skin elasticity then you have to don't have to but then they recommend you get di because otherwise there
Alexwill be extra tissue and that's why di is the most common in general right because it yields the best results yeah and my understanding I think was that so many people start binding so early and then they basic the best results are from double incision yeah yeah you're right okay cool what did it feel like after getting that call and making your appointment
MattieReally good. Like I have been waiting a really long time to schedule it. And so good. I was taken off guard because I made the call to schedule top surgery. Well, we did together.
AlexWe were going to record it.
MattieYeah, we did together. We were in bed on a Saturday morning, ready to call and record and
Alexhold up. That made it sound weird. We were in bed because there's a lot of blankets and it is one of the best places to record because like there's pillows everywhere oh i'm i didn't mean the dirty
Mattiei meant like we were in bed and i didn't say it like that yeah we were we were fucking no no okay
Alexokay all right i am sorry i'm sorry continue i brought this upon myself we were all settled
Mattiein the bedroom ready to record about my top surgery call and scheduling it and the office was closed and didn't call us back. So then Monday last week, I was walking in between dog walks and I'm climbing up this, this walk up these like four flights of stairs and I got a call and I recognized the number. I answered the phone like right there on the spot as I'm trying to like leash up a dog. I was scheduling my top surgery and it was stressful and very exciting. And I was
Alexsuper happy afterwards and texted you right away. What was, you know, the receptionist like, or I really have no concept of what this initial call is, because even online,
Mattiefolks don't really talk about it. The first thing you have to do is email pictures of your chest. If you don't get an in-person consult, what you do then is email pictures of your chest, and then the nurse or receptionist or nurse practitioner gives the pictures to the doctor and then you and the doctor have an email dialogue about your chest and what surgery you think is best and what you agree on. Once you decide you're ready or you have the funds or you have know what time
and when or you have no more family tragedies or hand tumors, you can call and schedule top surgery. So I had already done an email consult with the doctor. So I knew all of the like big questions like what surgery and where and when and all of like the pre-op and all that was already discussed and out of the way. So for me, the questions were, when are you looking to schedule it? Do you have someone that can come with you? What are the medications you're on? How much do you weigh? Then I paid. And I, oh, and I gave my name and my email address so that the receptionist could look at our other consult emails.
Because I had, back in May, I had gotten a consultation from this doctor that I wanted and everything went well. So my call was very, like, simplistic. There were no, like, questions about what type of surgery and where do you want your nipples resized and, like, all this different stuff. Like, none of that was on the phone call.
AlexWhy didn't you have me take the pictures of your chest? You took them yourself, yeah?
MattieI guess I was self-conscious and I kind of did it impulsively. oh because a consult isn't a yes I'm scheduling surgery so I was still surgeon shopping when I got my consult
Alexno no I'm giggling because that's a good thing and I almost wish that other people sort of did the same thing maybe I'm getting the wrong impression from people online but doesn't it seem like and maybe this is because some consultations um cost money oh yeah that's true uh all the email consults i've done have been free yeah that's awesome um and i'm that's
surprising i don't like that it's surprising but it is uh it seems like people go with not even necessarily who's closest or who's cheapest it's just like yeah i like these results all right good to go. The first surgeon they see sometimes I feel like. Yeah which I I mean I understand.
MattieIf your dysphoria is sorry I didn't if your dysphoria is crippling and like you make that effort to like reach out and have a consult then you want to get it done as quickly as possible. I feel like I had the resources and not the leisure at the time to like think it over.
AlexAnd you were in therapy and dealing with your dysphoria in different ways as well.
MattieYeah. I didn't want to make a rash decision. I also wanted to make sure I was in a good place mentally, bipolar-wise, like stable before I remove a part of my body.
AlexYeah. You're smart and responsible.
MattieWell, it was only at the urging of you that I get a gender therapist. So I was like, I'm already in regular therapy. This is fine. And then I went in gender therapy and I was like, oh, this is yes.
AlexThis is something I needed.
MattieThank you for listening to this episode of Two Headed Girl. We know this is a difficult time for everyone, especially trans people who have had to postpone surgeries and have little or no access to hormones. If you're in need of emotional or financial support, please check out the resources listed in the show notes. If you're interested in hearing more, head on over to twoheadedgirl.fm or anywhere you find your podcasts, including our favorite app, Overcast, created by Marco Arment. Thank you again. Take care of yourselves and wash your damn hands.
AlexI you know what honestly I could be wrong because I was just like oh god there's so many boobs on this screen right now