In the article that was posted one year ago, “Stopping Testosterone Prior to FTM Top Surgery: Reasons and Recommendations”, I stated that the generally accepted standard of care for FTM top surgery is to have patients stop testosterone treatments beginning from a few weeks prior to surgery and then restarting a few weeks after surgery. Most recommendations are in the range from two to four weeks before surgery until two or more weeks after. The reason for this is to minimize the risk of developing blood clots in the leg, or worse, having them travel to the lungs resulting in a pulmonary embolism, which can be fatal at times.
Intuitively, this seems prudent and reasonable. After all, if one can avoid blood clots, the risk for severe or even life threatening issues is drastically reduced.
Who doesn’t want that?
Well, it is not exactly as simple as that. Most things come with a price and stopping testosterone is no exception.
Just ask a trans-male who has had to stop his testosterone for a significant period of time. There is a reason the vast majority of trans-men are on testosterone.
There is no going back…even briefly, if at all possible.
However, when the upside is the gender affirming, anxiety treating, happiness and exuberance evoking top surgery – a life changing event – then the price will be worth it.
With more time, information and experience with FTM top surgery, there has been an evolution in thought as well as in recommendations regarding stopping testosterone treatments prior to surgery. There are no definitive studies nor anecdotal clinical reports showing a substantial benefit of this approach. Consequently, more and more plastic surgeons performing FTM top surgery have dropped this requirement for many of their patients – at least the “low risk” ones.
Here at the Arizona Center for Aesthetic Plastic Surgery, we have modified our approach on this now for a while now – and our patients are extremely happy about it. Consequently, the vast majority of our FTM top surgery patients will be able to continue taking their testosterone without interruption. For those at higher risk for issues, such as a BMI of 40 or greater, we will still require that they stop their testosterone before surgery.
If you have any questions about this or top surgery in general, please feel free to contact my office at (480) 451-3000 or by email ).
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona
