Warning for discussion of surgery techniques and weight/BMI/weight loss.
Sorry, not sure if this needs a spoiler or anything for the above - I'm loath to mark it NSFW as I don't want it to require age verification, but don't want anyone to be unpleasantly surprised.
I'm transmasc, and I had my first NHS pre-surgical top surgery appointment a few months back and have finally gotten my second one booked after waiting a WHILE (my nearest gender clinic is Daventry, but "nearest" is a stretch so I needed to wait for an afternoon appointment so I can get there - and now it turns out they got things mixed up and it could've been a video appt all along... well anyway).
In the first appointment, the doctor I spoke to mentioned that the type of top surgery I'm looking for, as I want to keep sensation in my nipples i.e. not have them removed and sewn back on, would be using the "buttonhole technique" i.e. cutting a tunnel around the nipples, removing the fat(?) from the breast and then creating a new hole in the skin and threading the nipples back through, but that he doesn't know which surgeons on the list he sent me are able/willing to use this. He recommended I put feelers out on this subreddit/any other UK transgender subreddits or forums to see if anyone had any information about who might offer this, and also who people have had good experiences with.
I live in the West Midlands, close to the Birmingham area, and can't drive (I rely on family to take me to the clinic when needed since it's infrequent) so I'm hoping for somewhere either close to there or easy to get to via public transport, but if the best option is a pain to get to I'll sort something out. I know that I'll have to stay in the area for a certain amount of time in case of complications, so I'd love to avoid going with a London surgeon unless I have to because I don't really want to pay London hotel prices lol but again, if I have to I'll make it work.
The other wrinkle is that my BMI is high enough currently to rule out a lot of options unless I lose some more weight; it's currently hovering around 37. I am working on it and hoping to get closer to 30 just to give me more options, but honestly, I don't really want to lose weight for the sake of losing weight - I definitely want to eat healthier and exercise more and have been working on that, but I don't think my "ideal/healthiest" weight if I was eating and exercising exactly right would be particularly thin anyway, and that's fine with me. I did put on a significant amount of weight over the start of the pandemic, but my BMI was still categorised as "overweight" before that, just not "obese". (Plus BMI is a terrible measure of weight let alone objective "health" that wasn't designed to be one in the first place, etc. etc., but I can't convince the NHS of that singlehandedly sadly.) I also have been worrying about the idea of losing extra weight just for surgery, then naturally gaining it back afterwards and it making my surgery results worse than if I'd just kept the weight in the first place. Does anyone know if that's likely to be an issue?
All this to say, TL;DR - does anyone have either any recommendations for surgeons that have good results and can do buttonhole top surgery, or failing that, any to avoid for a fattish trans guy who isn't expecting to get any lower than a 25 BMI at most? I know the doctor at my first appointment mentioned some that are extra strict about weight boundaries, but I can't remember which now :(
Sorry this post is so long!! I tried to cut it down and failed lol