Breast Augmentation Consult

I have been at four consults with different surgeons trying to get a feeling for who I wanted to go with. Last night I saw Dr. Antonio Mangubat and I decided he is the guy. Funny enough, he is the guy who did the FTM top surgery for my husband back in 2016.

The surprise I have had overall is the wide variance between surgeons and how they handle things. They are all good surgeons, but I hesitated at each of the three previous surgeons because it just didn’t feel right for whatever the reason. Now however, I will be getting 800cc implants in April and I am excited. Another great part is the fact that my insurance is going to pay for it.

Wearing an 800cc sizer to see how my new breasts will sit.

I did want to talk about my consultations a little though. The four doctors all very qualified, but very different.

Dr. Javad Sajan – a great surgeon in Seattle did my original consult back in November of 2018. He is a very personable guy, but I wasn’t happy with what his before/after pictures are for trans ladies, and he seemed to want to go with a smaller size on me, which thinking about is probably what I was seeing in those trans ladies photos… implants that for me looked too small for their frames.

Also he was a little too much into self-promoting/instagram/etc. Made me uncomfortable. Also they didn’t like taking insurance (they refuse to contract with my insurance but agree to do it as out of network, meaning it can be turned down by my insurance if he tries and charge too high a price. This does not mean he is a bad surgeon, but that combined with a lot higher prices meant he wasn’t my number one pick (but still in the running until I sat with Dr. Mangubat)

This was from my testing at Dr. Sajan in November 2018, it isn’t bad, but the 800cc at Mangubat seems better feeling to me.

Dr. Ellie Zara Ley – a fantastic surgeon who did my FFS bone work, although the office interaction/after care could use a little touch up. The reason in the end I didn’t go with her was because first, it is in Scottsdale and I don’t really care to stay another two weeks in a hotel in Arizona if I don’t have to. The extra cost of the flight down, the hotel stay, food, etc makes this not my favorite.

On top of that she explained she would decide what looked right for my body frame once I was under and do it with an expander. She is a wonderfully artistic person, but I wasn’t to keen on waking up not knowing what to expect.

I wouldn’t ever change Dr. Ley having done my FFS although it hurt a lot (April 2019).

Dr. Christiane Ueno – a fantastic Kaiser surgeon. She actually walked me through all the questions I should ask, and she was very knowledgeable. The biggest reasons I didn’t go with her was the upper limit on size, she didn’t think she could go above 600cc (which was in the lower range of what I wanted) but especially her equipment only let her go through the bottom of the breast, not through the armpit. This means very visible scars, not the highest on my list, but she is still a great surgeon.

Dr. Antonio Mangubat – The surgeon I am going with and an overall great choice. First and foremost I was experienced with his office (only Dr. Ley scored for similar reasons) and I knew his office was responsive to concerns and were there 24/7 during recovery.

Also Dr. Mangubat is the one that liked the 800cc and explained how it would help camoflauge the center of my chest and give me a proportional shape. He didn’t have any prejudgments on what I was interested in. Also, his before/after photos blew everyone else’s out of the water, and when I look at my husband’s top surgery results I see that he is a good surgeon.

The hubby went through hell, but his results were really good (this is him post FTM top surgery)

Also it helps that he is the second closest surgeon to our home, meaning I will get the surgery done and come home to my apartment to heal. He also didn’t hesitate about FMLA paperwork or taking my insurance.

Dr. Mangubat’s office is going to contact our transgender case manager Raelean today and will arrange the insurance coverage. We talked about possible dates and when I asked about April they said that shouldn’t be a problem at all. This gives my hubby a chance to work a few audits, and me a chance to get ready physically and mentally. Also it is kind of funny that it will be approximately a year after my FFS that I get my breast augmentation (same month, one year later).

I am super excited about this!

Transition Consult Stuff

Lately I have had a deluge of things happening, the biggest thing was my first Facial Feminization Surgery consult. It was with a well known/renowned Seattle surgeon and it went fairly well.

This is me in the consult room, I am trying to train myself that I don’t look bad so you are all stuck with lots of pictures for me.

The first pro is I think he knows what he is doing. He has the typical smarmy “I know it all” that almost all surgeons have, but he comes across trying to be friendly. His office is gorgeous when you walk in, very high class, and he is very well known for soft work (muscles, fat, hair, etc). He talked about some of the facial bone stuff I need, and agreed to do stuff for me. He would do it in 2 surgeries to minimize how much it hurts.

Unlike the quick review I got by Ley, the local doctor focused more on my fat placement and face lift use as opposed to bone work (Ley wants to do a jaw shave, and more in depth brow work). I know it can be done multiple ways so that didn’t bother me.

The first con is his price. I got a partial consult back in May from Dr. Ley/Meltzer and it was super quick. The “quick” assessment was about $20k in a single surgery (plus 9 days recovering down there). This Dr’s price was almost three times that, close to $60k. That is about what I owe on my student loans. I think this doc is a little more money orientated, no shame in that, but the first thing he did was try and sell me on a nose job, whereas Ley/Meltzer both dismissed the idea of a nose job as a waste and mine was great.

I figured it was going to be more expensive because of locality costs and the fact that this local doctor likes to show off the famous people he works on. I assumed closer to 30k… but the almost 60k was a shock. There was no cut deal for combining several procedures together (Dr. Ley/Meltzer’s was a lot cheaper because they were already there working on me and the other procedures were just “time on the table”). He quoted me the same total price as if I did each procedure separately.

That slowed my roll immediately and right now I am not sure if I would do it. He does great work, however he is not quite the bone experience that Dr. Ley is (she was a cranial/facial reconstruction expert for children before doing this) and she was very informed about my bone structure. The local doctor mistook my forehead for muscle not bone (Ley knew it on sight) plus I have heard he doesn’t do much bone work, and he really pushed a lot of soft tissue/face lift instead.

However, I do need to say he does excellent breast implants. He also stated he could do them with my insurance coverage. He had me try on some implant prosthesis and I found it looks like 650cc boobs is great, but not overly huge on my chest.

 

I may very well go to him for my breast augmentation when my year has passed and insurance will pay. However, not so sure about the FFS. I am still withholding judgment until I see Dr. Ley/Meltzer for a complete/in-depth consult on December 3rd. They are wonderful surgeons and unless they stick me with another 60k bill I suspect they will be the winner. However, we will have to see.