Hospital:

What’s It Like to Have Top Surgery? Ash Shares His Story

June 1, 2021

pictured above, from left: Dr. Susanna Nazarian and Ash 

Ash sought top surgery for nearly a decade. Finding the right opportunity with the right healthcare provider proved frustrating – an experience not atypical for those in the trans community.

For Ash, 28, of Paulsboro, NJ, getting top surgery – or masculinizing chest surgery, an integral surgical procedure to remove breast tissue for transgender men – would award him two things:

  • A decreased risk of breast cancer, which ran high in his family.
  • The ability to finally feel like himself.

When Ash heard of Jefferson Health – New Jersey’s Haddonfield Primary & Specialty Care, he made an appointment right away. From the moment he walked into the LGBTQ+ affirming practice and met with his provider Marina Khazan, APN, he was pleasantly surprised.

“Everyone treated me with the utmost respect, from using the proper pronouns to genuinely asking me how I’m doing,” he said. “Ms. Khazan didn’t rush me at all. We covered literally everything – including a new opportunity to get top surgery.”

Within a few weeks, Ash met with breast surgeon Dr. Susanna Nazarian. Before he knew it, he was set for surgery in mid-May.

“I couldn’t believe it was finally happening. I was just so excited,” Ash said.

Dr. Nazarian was also admittedly eager, as Ash was her first top surgery patient. Since joining Jefferson earlier this year, she says she’s been drawn to the health system’s LGBTQ+ care efforts.

“I have many friends in the LGBTQ+ community. Learning more about how I can help fulfill LGBTQ+ needs in my own practice has been incredibly eye-opening and humbling,” said Dr. Nazarian. “Helping change peoples’ lives in a meaningful way and allowing them to shine feels magical. I feel so fortunate to be able to help Ash on his journey.”

What was it like getting set up?

Preparing for surgery was seamless, Ash recalls. First, he provided documentation from his therapist that this was something he’s considered for a long time. Then, he had to have breast imaging done to check on a previous breast cancer scare – a benign tumor found in the right breast that had been removed a few years ago.

It was essential to see that nothing else suspicious had developed since, explained Dr. Nazarian. “We always want to be thoughtful and proactive in our approach; we know if we remove a breast with cancer without treating it appropriately beforehand, unnecessary complications can occur and lengthen the patient’s healing.”

Other than that, Dr. Nazarian’s office ensured everything is covered appropriately by my insurance, Ash says, and then I was ready to go.

How did you feel the day of?

“I was equally anxious and excited,” said Ash. “Of course, there was this fear of ‘what if I don’t look like what I’ve imagined for so long?’ This image has been building up in my head for 10 years. It was nerve-wracking, but I had to have faith.”

Both Dr. Nazarian and Dr. Eric Chang, the plastic surgeon on my team, quelled my fears and held my hand the entire way leading up to surgery, says Ash.

“The moment I woke up, I started patting myself. All I could think was, ‘they’re really gone.’ It was surreal,” continued Ash.

What has recovery been like?

“I didn’t experience that much pain, but I do have a high pain tolerance,” explained Ash. “For me, I’ve been more tired and sore than anything.”

Ash received nerve blocks, or regional anesthesia (injections of anesthetics directly to the affected area, either pre-operatively or after general anesthesia is given), to help control his pain, which is common following top surgery, says Dr. Nazarian. Nerve blocks are incredibly beneficial as they can ease recovery and reduce the need for pain medication. However, they aren’t recommended for everyone; your surgeon and anesthesiologist will decide if they are right for you.

Naturally, it’s been challenging to move (as it is after most surgeries), so Ash’s mom is letting him stay with her until he’s “back on his feet.” He also has a home health nurse visit a couple of times a week.

On top of his scheduled follow-up appointments with Dr. Nazarian, she’s called him several times to check in, Ash adds. “She’s one of the greatest doctors I’ve ever had.”

Do you have any advice for others?

“Go at your own pace. Do what makes you feel comfortable,” said Ash. “Ten years ago, I was just figuring myself out. I changed my wardrobe, which wasn’t that different because I always relied on jeans and a tee-shirt anyhow. But my chest was always my biggest obstacle.”

Every trans person’s journey is going to look different; it may involve dressing differently, receiving hormone therapy, or undergoing surgery. It’s okay to do what you want and don’t let anyone else tell you otherwise, Ash urges. 

For Ash, and many others like him, top surgery wasn’t just about changing his appearance.

“It meant so much to me. Not only am I much less stressed about my health and cancer risk, but I’m so excited,” he continued. “It’s hard to put into words how great it is to finally look the way you feel.”

Every time Ash looks in the mirror, he feels that initial excitement all over again. “My chest looks wonderful, and I couldn’t be happier.”

For more information on Haddonfield Primary & Specialty Care, an LGBTQ+ Affirming Practice, click HERE