BCS Guide

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This Guide

This guide outlines the steps for accessing breast construction surgery in British Columbia. Please note that you don’t need to be or identify as feminine or female to have this surgery.

There are many diverse experiences people have had with breast construction surgery, and it isn’t possible to capture it all in one resource. It is valuable to connect with other people who have had this surgery and learn from their experiences.

Explore this guide

To explore this guide, click through the categories listed above.

To use the menu feature, click on the green bar located on the left side of the page (computers), or at the top of the page (mobile devices).

Contact us

Trans Care BC’s Health Navigation Team is available to help you at any point in this process. You can find a link to our contact page in the bottom right corner of this guide.

Workbook for Breast Construction Surgery in BC

Preparing for breast construction surgery is a physical, emotional, mental, and spiritual process. We’ve created a workbook called the Workbook for Breast Construction Surgery in BC to help you along the way. It contains some of the information on this website, along with worksheets, checklists, and exercises.

You may wish to download and print the full workbook or individual support tools, which can be found throughout the guide, and on the Support Tools page in the resource section.

Funding

In British Columbia, funding requests for gender-affirming breast construction surgery for Two-Spirit, transgender, and gender diverse individuals are reviewed by MSP on a case-by-case basis and publicly-funded in certain circumstances.

The criteria for MSP to fund breast construction are:

Once you are referred to a surgeon, the surgeon must submit a funding request to MSP (using this form: Provincial Coverage of Breast Construction Surgery).

Some surgeons also provide breast construction surgeries through private-pay avenues.

See ‘Step 3 Choose a Surgeon’ for more information.


Frequently Asked Questions

If I do not think that I meet MSP’s criteria for coverage of breast construction surgery, can I still apply to have it funded?

Yes, you can request that your surgeon apply to MSP for funding, as cases are assessed case-by-case.

What can I do if funding for this procedure is denied?

Unfortunately approval for funding may be denied.

If funding is denied, you can ask your surgeon if they will appeal this decision for you.

If your surgeon does not agree to appeal the MSP decision, you have the following options:

  • If your consult was with a surgeon working from the central waitlist for upper surgery: Contact the central waitlist for upper surgery and ask to be referred to another surgeon OR have your primary care provider refer you directly to surgeon providing gender-affirming breast construction surgeries
  • If your consult was with a surgeon not working from the central waitlist: have your primary care provider refer you directly to another surgeon who provides gender-affirming breast construction surgeries OR refer you to the central waitlist for upper surgery using the Trans Care BC Upper Surgery Referral Form

It is important to know that going through an appeal process, or applying for funding with a different surgeon, does not guarantee that the decision will be reversed.

My surgeon appealed the MSP decision, but the decision did not change. What can I do now?

For more information about how you can advocate for yourself advocacy for coverage of breast construction and recourse in the case that a person is denied coverage, information can be found on theTrans Rights BC “Healthcare” (under the “how can I stand up for my rights”section) page as well as the “Take Action” page:

Terminology

Breast construction:

This procedure (also called breast augmentation) is a gender-affirming, upper body surgery that creates, enhances or shapes one’s breasts by placing implants underneath natural breast tissue and muscle.  The goal is to have breasts and nipples with sensation, a larger cup size and minimal scarring. This surgery is done by a plastic surgeon.

Compression bra/garment:

You may be asked to purchase a compression bra/garment. This is often used immediately and in the weeks after surgery to help reduce swelling.

Drains:

You may have surgical drains inserted during surgery. A surgical drain is a tube placed at the surgical site to allow fluids (like blood and pus) to leave your body. The fluid will collect in a plastic pouch. You will be taught to regularly empty your drains into a small measuring cup and record the amount of fluid each time. This record will help your healthcare providers decide when the drains can come out. Once the flow slows or stops, your surgeon, doctor, or nurse practitioner will remove the drains. The amount of time drains are needed varies from person to person.

Nipple-areolar complex:

The nipple-areolar complex is made up of the nipple, the areola (the pigmented skin that surrounds the nipple) and sebaceous glands, nerve endings, smooth muscle and lymphatic tissue.

Scars:

As surgical incisions heal, they turn into fibrous tissue called scars. The appearance of scars depend on several factors:

  • The location on the body
  • Surgical technique used (sutures, staples, etc)
  • Internal (personal) factors (age, genetics, etc)
  • External (behavioural and environmental) factors (smoking, sun exposure, etc)

Although scars fade with time, they may still be visible to varying degrees. You can take steps to reduce scarring by following your surgeon’s advice about getting rest, avoiding the sun, doing scar massage and using silicone gel or tape (if recommended). Severe scarring may require surgical revision. Some tattoo artists specialize in ‘skin/scar camouflage’, meaning that once the scars have fully healed, they may be able to make them appear less noticeable by blending them into the surrounding skin. Silicone products or tattoos are a personal expense.

Procedures

Click on a box below to learn more about the subject.

Breast Construction

Breast Construction – Procedures

Breast construction (breast augmentation) is a gender-affirming, upper body surgery that creates, enhances or shapes one’s breasts by placing implants underneath natural breast tissue and/or muscle. The goal is to have breasts and nipples with sensation, a larger cup size and minimal scarring. This surgery is done by a plastic surgeon.

There are different surgical techniques and types of implants that can be used. The technique and the type and size of implant used depends on several factors, including your goals and your anatomy. Your surgeon will provide recommendations that are suited to your body shape and goals. You will be part of this discussion.

What your surgeon tells you may not be what you had hoped for. When this happens, you may want to reach out to your support people for help to come up with a new plan. You can also ask for a second opinion, or reconnect with your initial surgeon.

The section below is intended to provide information about the different considerations that your surgeon will talk about. It is not intended to suggest that each technique is available for each person. There may be options that are not listed below.

Here are some of the considerations your surgeon will speak with you about:

Size of implants

This is an important decision to make. Implants are measured in terms of ccs, millilitres or grams, not cup sizes (this is because “cup size” is a concept based on the size of your body and ratio of your breast volume to your body shape). It can be helpful to bring in photos of what your goals are.

Often times you and the surgeon will choose a range, and at the time of surgery, the surgeon will use their judgment and experience to find the ideal size of implant for your goals and anatomy.  You will also discuss the ideal height and width of your implant as well.

Type of implant

Saline

  • May have smooth or texture silicone shell 
  • some are pre-filled with a specific amount of saline, while others are filled to the desired volume once the shell is in place
  • More common to experience“ripple effect”, which can be visible on the skin (many factors contribute to rippling, including shape of implants, size of the implant pocket, size of the scar capsule that develops around the implant, and amount of fluid in the implant)
  • May make a “sloshing” sound during vigorous activity
  • If under filled, may be a bit “noisy”, like gurgling water

Silicone

  • May have smooth or texture silicone shell
  • Options vary in firmness and have a different feel than saline implant

Gel-saline expander breast implants

  • Implants consist of two envelopes: one envelope is pre-filled with silicone gel and the other envelope is unfilled
  • The second envelope is filled with saline overtime until the final desired volume is achieved

Fat grafting

  • Less commonly done
  • Liposuction is done on one area of the body and then fat is injected back in small quantities in to the breast
  • Common complications include not all the fat staying in place, and it is not uncommon to lose up to 50% of the volume within the first year of surgery
  • Theoretical possibility of adipocyte derived stem cells transforming in to other cell types
  • Risk of fat necrosis causing lumps
  • Risk of oil cysts
  • Less predictable than an implant and generally requires multiple surgeries, with an incremental “take” of the grafted fat with each procedure

Placement of implants

Subglandular

  • Implant is placed above the pectoral is major muscle and under the glands of the breast.
  • This positioning may result in the breasts being positioned more towards the centre of the chest (vs positioned closer to the sides). This may also create a more rounded appearance.

Subpectoral

  • The implant is placed below the glands of the breast and under (or partially under) the pectoral is major muscle.
  • This positioning may lessen the possibility of developing capsular contraction. This positioning may also push the implant to the side of the chest.
  • You will notice animation of the implant when the pectoral is major is contracted, which will temporarily distort the implant.

Incision locations

Though the incisions are intended to be placed in away that reduces the visibility of scarring, they may still be visible to varying degrees. 

Inframammary fold

  • Incision is below the breast, where the breast connects to the chest.
  • Though the incision is partially concealed in this fold, the scar may still be visible.

Axilla

  • Incision is in the armpit area, to the side of the breast.
  • Though the incision is partially concealed in the armpit, the scar may still be visible.

Periareolar

  • Incision is made all the way around the outside of the areola.
  • Though the incision is partially concealed in the edge and texture of the nipple and areola, the scar may still be visible.

Type of silicone shell (implant surface)

Smooth shell

  • Can move within the capsule that forms around the implant, which may create more natural movement.
  • The risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is much smaller with this option

Textured shell

Breast Construction – Complications

Here is a list of possible complications that can be experienced after breast surgery. Your surgeon will give you a detailed list of possible complications.

Rainbow Health Ontario’s Breast Augmentation Surgical Summary Sheet provides a detailed list of potential complications, including ones that are specific to breast surgery, some that are related to surgery in general, and some that are related to having general anesthesia.

Complications specific to breast construction surgery

Dissatisfaction:

While many people are very happy with the results of their breast surgery, it is possible that the outcome of your surgery may not be what you pictured. For example, you may notice changes in the skin, or that your breasts, nipples or areolas are asymmetrical in size, shape or position.It is very common for someone to have some breast asymmetry in general(regardless of whether or not someone has had surgery). Significant asymmetry may require further surgery. Breast construction does not fully re-shape the chest, so breasts may be spaced in a way that does not create a lot of cleavage.

Some tattoo artists specialize in ‘areola restoration’, meaning that they may be able to tattoo the breast (after it has healed) to add more detail to the nipple. This can include making the nipple appear more pronounced, or increasing the appearance of the size of the areola.The anatomy of your breasts does dictate the position of the implants.

Scarring:

All incisions cause a scar. Although incisions are usually located in a way that reduces the visibility of scarring, they may still be visible to varying degrees. You can take steps to prevent severe scarring by following your surgeon’s advice about getting rest, avoiding the sun, doing massage exercises and using silicone/recommended ointments. Scars can become thickened, hypersensitive, and may even cause distortion. Severe scarring may require surgical revision. Some tattoo artists specialize in ‘skin/scar camouflage’, meaning that once the scars have fully healed, they may be able to make them appear less noticeable by blending them into the surrounding skin.

Lifespan of the implant:

A breast implant generally has an average lifespan of 10-15 years (it is rarely going to be in the body for life). There is a high chance it will need to be replaced at some point. This means that patients will likely need surgery later in life- either to replace the implant, or to manage a complication.

Capsular contracture:

Scar tissue that develops around the implant may become tight or painful. This may change the shape of the breast. Sometimes the capsular scar tissue may need to be removed and the implant may either need to be removed or replaced. Your surgeon will give you post-operative instructions to follow that will help reduce the chances of this happening.

Complications with the implant:

The implant may break (rupture), leak, or deflate. If this happens, it will need to be exchanged.

Migration or dislocation:

The implant may migrate (move) or change position (rotate) in the breast.

Skin necrosis:

Poor blood supply may result in death of the skin surrounding the implant (very rare).

Implant extrusion:

The skin around an implant may break down, resulting in the implant being visible through the skin. If this happens, the implant will need to be removed temporarily, then replaced a few weeks or months later.

Calcification:

Calcium deposits can form in the scar tissue that surrounds the implant. These may feel firm and even painful. If you develop any bumps or lesions, contact your surgeon or primary care provider. Any bumps and lesions need to be examined to determine whether they may be a normal bit of calcium buildup, or a sign of breast cancer.

Changes in sensation:

You may experience a loss of sensitivity in the skin of the breast and/or in your nipples and the

skin of your breast. This may be a reduction in sensation, or areas of complete numbness. Sometimes these changes may be temporary (sensation improves in the month after surgery) or permanent.

Tenderness & inflammation:

Sometimes veins under the breast become inflamed and clotted (also called superficial thrombophlebitis). They can look like thick vertical chords. This is often a temporary complication.

Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL):

This is a rare form of non-Hodgkin lymphoma which may occur next to the implant. To learn more about this, see Trans Care BC’s handout Information about textured breast implants and BIA-ALCL.

Other information about breast construction surgery

Breast construction is usually an “outpatient surgery”, meaning the patient usually gets discharged from the hospital later the same day.

Sometimes breast construction is a two-part process. In the first surgery, tissue expanders are inserted to stretch the skin, so that it will be able to accommodate the implant. Saline is injected into the tissue expander. This process will gradually inflate the tissue expander until the desired volume is achieved- this can take a few months.

Depending on what was discussed with your surgeon, incisions will be made under the breasts (inframammary fold), in the armpit(axilla) and/or around the areola (periareolar).

Once the skin has stretched enough to fit the implants, another procedure is done to remove the tissue expander and insert the breast implants. Implants can be placed just under the breast tissue (subglandular) or under the muscles of the chest (subpectoral).

ATTENTION: This section is to supplement what you receive from your surgeon. If there are any differences, you should follow the advice provided by your surgeon.

COVID-19

Planning for gender-affirming surgery in BC during the COVID-19 pandemic

If you plan to have surgery in BC during the COVID-19 pandemic, prepare with pandemic safety in mind. Take time to review the checklist that is right for your situation with your GP or NP and the people who will be supporting you after surgery.

Here is a checklist of things to consider if you are having gender-affirming surgery in BC during the COVID-19 pandemic.  


How to Access

  • Step 1

    Connect with a practitioner
  • Step 2

    Get a Surgical Readiness Assessment
  • Step 3

    Choose a surgeon
  • Step 4

    Surgical consult

Step 1

Connect with a practitioner

The first step to access breast construction surgery is to connect with a doctor (GP) or nurse practitioner (NP). The role of the GP or NP is to support you in accessing the care you need. This includes:

  • referring you for a Surgical Readiness Assessment,
  • helping you meet surgical requirements, and
  • assisting with things you need after surgery.

Ask your GP or NP to refer you to a Qualified Surgical Assessor. If they don’t know of one, they can refer you to Trans Care BC’s Health Navigation Team. This team will coordinate an assessment appointment for you.

If your GP or NP happens to be a qualified surgical assessor, they can do the Surgical Readiness Assessment with you.

If you do not have a GP or NP, contact Trans Care BC’s Health Navigation Team and they can help you find one.


Frequently Asked Questions

I don’t have a doctor or nurse practitioner. What can I do?

Contact Trans Care BC’s Health Navigation team  for help connecting with a doctor or nurse practitioner.

Step 2

Get a surgical readiness assessment

You will meet with a qualified surgical assessor for a Surgical Readiness Assessment. The surgical readiness assessment confirms that you meet the World Professional Association for Transgender Health (WPATH)criteria for breast construction surgery. It also helps ensure you are prepared and supported before, during, and after your surgery.

Many people feel anxious about the SurgicalReadiness Assessment. They worry about saying the wrong thing and being denied a surgery that is very important to their health and well-being. It may ease your fears to know that these assessments have changed as understandings of gender and human rights have evolved. The focus is on supporting you.

Together, you and the assessor will discuss your gender, your health, your support people, and details about the surgical procedure.

After the appointment, the assessor will write a recommendation for surgery based on the criteria for approval and the information you’ve shared with them.

MSP-funded surgery

The assessor will send their recommendation to your doctor or nurse practitioner, who will send your surgical assessment along with their referral to Trans Care BC. Your name will then be added to the central waitlist.

Private pay surgery

Some surgeons may not require a readiness assessment, while others will. The best way to find out is to contact the surgeon directly. If you do have a surgical readiness assessment, the assessor will send their recommendation to your doctor or nurse practitioner, who will then include it in the referral to your surgeon of choice.


Frequently Asked Questions

What are the WPATH criteria for breast construction surgery?

The criteria for breast construction surgery is guided by the World Professional Association for Transgender Health’s (WPATH) most current Standards of Care. The criteria are:

  • Persistent gender dysphoria,
  • Age 18 years or older, with some exceptions,
  • Ability to understand and consent to the surgery,
  • Physical and mental health conditions are reasonably well-managed.(Examples include a physical disability, hearing and visual impairment, mental and cognitive disability and/or being in recovery from addiction.)

How long is the wait for an assessment?

The waitlist to have a publicly-funded Surgical Readiness Assessment varies widely, depending on the availability of qualified surgical assessors near you. You can contact Trans Care BC’s Health Navigation team to learn about options for publicly-funded readiness assessments.

Are there private pay options for Surgical Readiness Assessments?

Yes. Some people choose to pay for an assessment if they are having difficulty getting an appointment with an assessor. You can contact Trans Care BC’s Health Navigation team to learn about options for private-pay readiness assessments.

How many assessments do I need?

Usually only one readiness assessment is needed for breast construction surgery. There are times when additional assessments may be recommended by your doctor, nurse practitioner, qualified surgical assessor, or surgeon.

There are no assessors in my area. What are my options?

You can contact Trans Care BC’s Health Navigation to confirm whether there are any assessors near you. If there aren’t, we can help you arrange a publicly-funded virtual appointment with an assessor at Trans Care BC.

Do I need to have a surgical readiness assessment if I am paying for my surgery?

Some surgeons may not require a readiness assessment, while others will. The best way to find out is to contact the surgeon directly. If you do have a surgical readiness assessment, the assessor will send their recommendation to your doctor or nurse practitioner, who will then include it in the referral to your surgeon of choice.

What kinds of questions will the assessor ask?

Physical and mental health:

Gender:

  • What pronouns do you use?
  • How would you describe your gender?
  • When did you start living outwardly as yourself?
  • How long have you been thinking about gender-affirming treatment? 

Physical health:

  • Have you ever been diagnosed with a physical health condition?
  • Have you ever been diagnosed with a mental health condition?
  • What is your height and weight?
  • What medications are you on?
  • Have you had any surgeries before? Did you receive anesthesia? Did you have any problems with it?

Support people:

  • Who are your main support people? Will they be able to help you after surgery?
  • Do you have a GP or NP, and are they supportive?
  • Is there anything you think would be important for me to know to help with your care planning?

Here is a downloadable list of common question that you may be asked, during a readiness assessment for gender-affirming surgeries.

What do I need to know to make an informed decision about getting surgery?

It’s important to understand the following information:

  • details related to the procedure,
  • potential benefits and risks of the surgery,
  • the lifespan of the implant and whether there are any costs associated with revisions or replacement,
  • possible need for revisions,
  • timeline for healing, and
  • what to expect for aftercare in the months after surgery.
  • if paying privately: detailed list of anticipated costs

Your assessor will help you understand these details. You should ask them any questions you have. Your surgeon will be able to answer your more detailed questions.

Do I need to be on hormones to qualify for publicly-funded breast construction surgery?

Funding requests for breast construction surgery are reviewed by MSP on a case-by-case basis and publicly funded in certain circumstances. The criteria for funding are:

  • You have been on hormones for at least 18 months (unless hormones are not clinically indicated for you); and
  • You have had little to no breast growth; and/or
  • Significant asymmetric growth as determined by plastic surgeon

I don’t identify as feminine or female. Can I still be approved for breast construction surgery?

Yes. The most current WPATH Standards of Care support access to breast construction surgery for people who have a non-binary gender and/or people who do not dress or identify as feminine or female.

I am Two-Spirit and am seeking gender-affirming surgery. Can I still get breast construction surgery?

Yes. The most current WPATH Standards of Care support access to breast construction surgery for people who are Two-Spirit and seeking gender-affirming surgery.

How long will the assessment take?

Surgical Readiness Assessments are usually completed in one appointment. The visit lasts for 1-2 hours and there is no physical exam. Extra visits may be booked for individuals that need extra support.

What happens if the assessor decides I’m not ready for surgery?

If there are areas of your health or well-being that need attention to make sure you recover safely after surgery, the Qualified Surgical Assessor will recommend that you make a plan with your doctor or nurse practitioner to address them. This can include managing acute or chronic health conditions, getting help with housing, or finding mental health supports that you may not already have.

This does not mean you will be denied surgery. Instead, you will be presented with ways you can work towards a safer surgery and recovery. By addressing these areas, you start your healing process before your surgery and reduce the chances of having complications.

Step 3

Choose a surgeon

Publicly-funded surgery

In BC, there are two ways to access publicly-funded breast construction surgeries:

Through a surgeon that works from the central waitlist for upper surgeries, managed by Trans Care BC.

  • To learn more about these surgeons, check out Meet the Surgeons. If you have questions about a surgeon’s requirements or would like up-to-date estimates of wait times, you can call the surgeon’s office or Trans Care BC’s Health Navigation team.
    • Your provider sends your referral package to the central waitlist for upper surgeries and your name isa dded in the order in which your referral was received.
    • When your name is next on the waitlist, Trans Care BC will contact you to talk about your choice of surgeon. Trans Care BC will then send your information to the surgeon of your choice. The surgeon’s office will contact you to book a surgical consult.

Through a surgeon that does not work from the central waitlist for upper surgeries.

  • Your provider sends your referral directly to the surgeon’s office (not to the central waitlist for upper surgery managed by Trans Care BC). 
    • Not all plastic surgeons have experience providing gender-affirming breast construction surgery or they may not be familiar with how to apply to get MSP funding for this surgery.
    • In light of this, you may want to consider choosing a plastic surgeon who has experience providing this affirming surgery.
    • Trans Care BC’s HealthNavigation team may be able to provide the names of surgeons that do not work from the central waitlist, who are known to provide this care.
  • Your name is added to the surgeon’s waitlist in the order in which your referral was received.
  • When your name is next on the surgical waitlist, the surgeon’s office will contact you to book a consult.

Private-pay surgery

Private-pay breast construction surgeries are provided by plastic surgeons across the province (and in other provinces/countries). People may choose to pay for their breast surgery for several reasons (including but not limited to the following):

  • access surgery faster;
  • application to MSP to fund the surgery has been declined;
  • appeal process for MSP to fund the surgery has been declined;
  • to work with a surgeon in a different province or another country.

To learn about surgeons that offer this surgery through private-pay, you can search online or ask your primary care provider for suggestions.  Not all plastic surgeons have experience providing gender-affirming breast construction surgery, so you may want to try and choose a surgeon who has experience providing this affirming procedure. Trans Care BC’s Health Navigation team may be able to provide names of some surgeons that do not work from the central waitlist for upper surgeries known to provide this care.

How to choose

Factors you might consider when choosing your surgeon include:

Step 4

Surgical consult

A surgical consult is an appointment with your surgeon to talk about your goals for surgery and your options in terms of procedures. It’s also an opportunity for you to ask questions.

Tips for preparing for this visit:

  • Read up on different surgical techniques and common complications for breast construction surgery
  • Search online for before-and-after photos of each surgery type, including photos of people who have a body similar to your own.
  • Consider inviting someone to write notes so you can focus on the conversation.

What should I bring?

  • A list of your current medications and supplements (including traditional medicines, such as herbs and teas; vitamins; minerals; amino acids; and probiotics). Make note of  the dose and how often you take them.
  • A list of questions you have for the surgeon. You can find common questions in the Workbook for Breast Construction Surgery.
  • A pen for taking notes.

Click this support tool to review both lists.

These lists are included in the Workbook for Breast Construction Surgery.


What to expect from this visit:

Each surgeon does things a bit differently, but generally the surgeon will:

  • ask questions about your gender, general health, and family history
  • ask you to remove your shirt and undergarments for a physical exam of your breasts and underarm area
  • use a tape measure to record breast and nipple measurements
  • take pre-operative photos of your breasts
  • check blood pressure

  • talk about possible surgical outcomes
  • give instructions for aftercare, including return to physical activity
  • ask you to get blood work done before surgery
  • depending on age and risk factors, the surgeon may ask for a mammogram or an anesthesia consult
  • you might book the date of your surgery, or the surgeon’s office will call you later with the date

Frequently-Asked Questions:

What are the criteria for publicly-funded breast construction surgery?

In British Columbia, funding requests for breast construction surgery are reviewed by MSP on a case-by-case basis and publicly in certain circumstances for transgender, gender diverse, and Two-Spirit individuals seeking gender-affirming care.

The criteria for publicly-funded breast construction surgery are:

  • You have been on hormones for at least 18 months (unless hormones are not clinically indicated for you); and
  • You have had little to no breast growth; and/or
  • Significant asymmetric growth as determined by plastic surgeon

Once you are referred to a surgeon, the surgeon must submit a funding request to MSP (using this form, Provincial Coverage of Breast Construction Surgery).

What can I ask my surgeon about?

Trans Care BC’s Workbook for Breast Construction Surgery in BC provides examples of questions you can ask the surgeon during your consult. You may want to ask your surgeon about:

  • The different options for implants available
  • The advantages and disadvantages of each option
  • What your options are if you are not satisfied with the appearance of your breasts
  • Whether they have before-and-after photographs of their own patients, including those of both successful and unsuccessful outcomes
  • The risks and possible complications of the various techniques
  • The surgeon’s complication rates for each procedure

What if the surgeon recommends something different from what I’m hoping for?

The surgeon will recommend the size, type and shape of the implant that they think will provide you with the best surgical outcomes related to your goals. Their recommendation is based on their extensive training, research, and experience. If this is different from what you want, you are encouraged to let them know. This will lead to a conversation about the pros and cons of the different options as they apply to your goals.

What are my options if I do not get MSP funding for my surgery?

Unfortunately approval to have this procedure funded by MSP may be declined. If this happens, you have the option to appeal the decision or pursue private-pay surgery. To appeal this decision, you can ask the surgeon who submitted the application to submit an appeal. You can also be referred to a different surgeon, and ask them to submit a new funding request to MSP (this option will take more time due to wait lists).

Appealing this decision, or submitting a new funding request with a different surgeon, may not change the decision byMSP. Information about how to advocate for coverage of breast construction and appealing denied coverage can be found on the Trans Rights BC website, in the “Healthcare” and “Take Action” sections.

I have been referred for an anesthesia consult. What does this mean?

Before surgery, you will be given anesthesia. (Rollover definition: Drugs that cause you to be temporarily asleep and unable to feel pain.) Some health conditions can put you at higher risk for complications from anesthesia. In this case, your surgeon may refer you to an anesthesiologist for further assessment.

Having a consultation with an anesthesiologist is a normal part of the surgical process for many people. We are all complex beings and some of us need more support than others. The purpose for anesthesia referrals is to make sure all measures are taken to keep you safe both during and after surgery. Because there are a number of different anesthesia options, meeting with the anesthesiologist will help determine which one will best suit you and your health needs.

The anesthesia consult can be different based on the provider, but the doctor generally looks at a number of factors, including blood pressure, Body Mass Index (Rollover definition: The Body Mass Index (BMI) is an estimation of someone’s tissue mass (muscle, fat and bone) based on their height and weight. It is a limited tool and does not measure a person’s health.) and the presence of other medical conditions such as asthma or diabetes.

Depending on these factors, some patients with higher anesthetic risks may need to have surgery in a hospital operating room (rather than a private surgical centre) for safety reasons.  Currently, access to in-hospital surgical time is more limited than private surgical centres, and this may result in longer wait times for these patients.

Waiting and having challenges accessing surgery can be stressful. Many people find it helpful to connect with others who have gone through similar experiences. You might meet people who have had gender-affirming surgery through friends, support groups, or online networks.You may also find it helpful to talk to a counsellor during this time.

If you are experiencing challenges accessing surgery, or if you have questions about this process, call Trans Care BC.

Application to MSP for pre-authorization of payment

This applies to publicly-funded breast construction surgery only:

In British Columbia, funding requests for breast construction surgery are reviewed by MSP on a case-by-case basis and publicly in certain circumstances for transgender, gender diverse and Two-Spirit individuals seeking gender-affirming care.

The criteria for publicly-funded breast construction surgery are:

  • You have been on hormones for at least 18 months (unless hormones are not clinically indicated for you); and
  • You have had little to no breast growth; and/or
  • Significant asymmetric growth as determined by plastic surgeon

Once you are referred to a surgeon, the surgeon must submit a funding request to MSP (using this form, Provincial Coverage of Breast Construction Surgery).

What are my options if I do not get MSP funding for my breast construction surgery?

Unfortunately approval to have this procedure funded by MSP may be declined. If this happens, you have the option to appeal the decision or pursue private-pay surgery.

To appeal this decision, you can ask the surgeon who submitted the application to appeal it. You can also be referred to a different surgeon, and ask them to submit a funding request to MSP (this option will take more time due to wait lists).

Appealing this decision, or submitting another funding request, may not change the decision by MSP. Information about how to advocate for coverage of breast construction and appealing denied coverage can be found on the Trans Rights BC website, in the “Healthcare” and “Take Action” sections.


The waiting process:

Waiting and having challenges accessing surgery can be stressful. Many people find it helpful to connect with others who have gone through similar experiences. You might meet people who have had gender-affirming surgery through friends, support groups, or online networks. You may also find it helpful to talk to a counsellor during this time.

If you are experiencing challenges accessing surgery, or if you have questions about this process, call Trans Care BC.


How to Prepare (COVID-19 Disclaimer)

  • Buy, borrow, and do
  • Arrange help
  • Make travel arrangements
  • Make a self-care plan
  • Know what to expect on the day of your surgery

Buy, borrow, and do

From post-op compression vests to prune juice, there are lots of items you’ll need to gather and prepare in advance of your return from surgery.

Check out this checklist of items to gather and prepare before surgery.

This checklist is included in the Workbook for Breast Construction Surgery.

Frequently Asked Questions

What costs associated with surgery are not covered by MSP?

While MSP pays for the cost of certain surgeries, there can be additional costs that are not covered. These include costs associated with:

  • Travel and accommodation (See ‘Make Travel Arrangements’ for more information)
  • Compression bra/garments
  • Wound care supplies for dressing changes at home
  • Any extra supplies you would like to have while you heal
  • Costs associated with travel to and from your appointments
  • Cost of the surgery itself (if you are paying privately)

Important: You may want someone to travel with you. Keep in mind that this person’s travel and accommodations will not be covered by MSP.

How do people pay for the extra costs associated with surgery?

Here are some funding strategies people have used to cover these costs:

  • First Nations Health Authority benefits:
    • Individuals who are Indigenous, have status, and live in BC are able to access FNHA benefits.These benefits can provide coverage for gender-affirming resources, like binders and post-operative supplies, like compression vests.  To learn more about how to access gender-affirming products available through FNHA benefits, you can call the FNHA Benefits Program call 1-800-317-7878 and select option 2.
    • FNHA benefits can also cover the costs of travel, accommodation and meals when you need to travel for medically necessary care (including chest construction and revision surgeries). You can learn more about this by:
      • calling the FNHA Benefits Program call 1-800-317-7878 and select option 2
  • If you are on provincial disability assistance, you can contact the Ministry of Social Development and Poverty Reduction to discuss funding for travel,support garments and other medically necessary supplies. Your GP or NP can write you a letter of support to access these funds
  • Medical EI can be an option for individuals who are working and meet the eligibility criteria
  • Speak with your employer or Human Resources department about any Short Term Disability, sick time, or vacation time you can use during your time off work for surgery
  • Check your extended benefits program if you have one
  • Consider organizing online or in-person fundraisers

Arrange help

You’ll likely need some support after surgery. For example, you might need someone to help with meal preparation, childcare, elder care, laundry, pet care, or garbage and recycling.

Important: After surgery, you will need someone 18 years or older to escort back to your home or accommodations. You won’t be able to drive. You will also need someone to supervise you for 24 hours following surgery.


If you find it hard to ask for help, you aren’t alone. Many people have a hard time with this.

Fortunately, lots of people like to help. It gives the helper a chance to feel good and show they care.

People often feel flattered and happy to pitch in, especially if you ask for help with something specific.


Support Checklist

Here is a checklist that you can give to people looking for ways to support you before and after surgery.

The checklist is included in the Workbook for Breast Construction Surgery.

You can also send people to the Tips for Family and Friends page, in the Resource section.

Make travel arrangements

If your surgery is taking place outside your home community, you will need to arrange transportation and accommodations.

Transportation

Book your mode of transportation (bus, air, rail, or ferry). If you are travelling by car, you will need someone else to drive you from the surgical centre to your accommodations and later on, back home.

If you qualify for the First Nations Health Authority’s Health Benefits Program, you may be able to access Medical Transportation Benefits.

If travel costs are a barrier, you might qualify for the Travel Assistance Program.

To access the program:

  1. Ask your doctor or nurse practitioner to fill out a Travel Assistance Program (TAP BC) form.
  2. Two weeks before surgery, call TAP BC to get your confirmation number. Write it on your form.
  3. Show your form at the time you make air, rail, or ferry reservations.

If you are approved for TAP BC, you may also qualify for Non-Local Medical Transportation Assistance to help with food and accommodation costs. Ask your doctor or nurse practitioner to fill out a Request for Non-Local Medical Transportation Assistance form.

If you qualify for the First Nations Health Authority’s Health Benefits Program, you may be able to access Medical Transportation Benefits.

If you are flying, find out if you qualify for Hope Air, a Canadian charity that arranges free flights for low-income Canadians who must fly to get healthcare. 

Otherwise, book your flight early to get the best deal.

Accommodations

Find out how long your surgeon requires you to stay nearby. Around three days is common. Book your lodgings early to get the best deal. Some hotels provide lower rates for people travelling for medical reasons. You can contact hotels directly or search the Government of BC’s Medical Travel Accommodation Listings.

If you qualify for Hope Air, you may also qualify for their Hope Air Accommodations Program- details are available on the Hope Air Frequently Asked Questions page, in the Accommodations section.

Frequently asked questions

I don’t have a ride home from the hospital– are there any patient transportation services available?

You are expected to arrange a ride when you are discharged from the hospital. If you do not have someone who is able to drive you, you have some options available:

I’m travelling by plane. What else do I need to arrange?

  • Ensure you have the necessary ID documents/passport.
  • Ask your doctor or nurse practitioner for a travel letter if you feel worried that your appearance differs from the picture on your ID documents/passport.
  • Ask your doctor, nurse practitioner or surgeon for a letter indicating that you just had surgery and should not raise your arms when going through security.

Make a self-care plan

It is important to follow your surgeon’s instructions for how to prepare for surgery. The information below is a brief summary and does not replace the information you receive from your surgeon. If there are any differences, you should follow your surgeon’s instructions.

You can reduce complications from surgery by starting the healing process beforehand. Below are some steps you can take before surgery to help your body recover. For most of us, these strategies are easier said than done. Remember that self-care includes doing what is manageable and trying to love ourselves no matter what. 

  • Enjoy foods that promote wound healing. Look for foods with protein (meats and nuts); zinc (whole grains, spinach, nuts); vitamin A (carrots, broccoli, eggs); & Vitamin C (citrus fruits, strawberries, peppers).
  • Do simple and fun exercises to build strength and support your heart and lung health, like dog walking, dancing, hiking, stretching or weight training.
  • Drink enough water to have clear, light yellow-coloured urine.
  • Get 7-9 hours of sleep each night. If you have any trouble sleeping, speak with your doctor or nurse practitioner about strategies for better sleeping.
  • Take time to slow down and relax before your surgery. Practice the deep breathing or coughing exercises, since this can help with relaxing and will speed up your recovery after surgery.
  • Work towards your personal health goals- this might include controlling blood sugar or improving anemia (low iron). Good iron stores allow you to heal better and have more energy when you go home. Maintaining blood sugar helps with wound healing after surgery.
  • Quit smoking. We know – it’s a big ask. Lung health is an important helper in healing, and smoking cigarettes can disrupt the healing process. This is why surgeons and healthcare providers recommend avoiding cigarettes before and after surgery. Smoking cessation supplies are provided at no-cost to people with MSP at any pharmacy in BC. If avoiding smoking for 2-3 months will be hard for you, call Trans Care BC for more information on your options.
  • If you smoke marijuana and going 2-3 months without it will be hard for you, consider switching to edibles, concentrates, or tinctures.
  • Other substances like methamphetamines, cocaine, heroin and alcohol also disrupt the healing process. It is recommended to avoid these substances before and after surgery. If you need help with this, your healthcare provider can help you make a plan.

Self-care planning exercises

Here are some holistic self-care planning exercises to help you prepare for before and after surgery. These exercises are also included in the Surgery Workbook.

Know what to expect on the day of surgery

Below is description of what generally happens on the day of surgery. Each surgical centre is different, so your experience may vary.

  • Follow the instructions from your surgeon and the surgical booking office for when to stop eating and drinking or taking medications.
  • Follow the instructions from your surgeon about bathing.


  • Arrive at the surgical centre and check in.
  • You’ll get a wristband with the same name and gender found on your BC Services Card. If this is different from the name you use and your gender, you can ask for an extra “Name Alert” wristband with your correct name and pronouns. You can also ask for this information to be put on the front of your chart.
  • Spend some time in the waiting room until you are called.

  • You will either be taken to a room or a curtained area with a hospital bed. 
  • A nurse will talk with you about what to expect. You’ll be given a hospital shirt to change into and a basket to hold all of your clothing, including undergarments. The nurse will remind you to remove your jewelry. You can ask the nurse any questions you have.
  • The nurse will check your blood pressure and may give you some pills or start an IV. You may also be given an injectable blood thinner.
  • The surgeon will make some drawings on your chest to guide to the procedure. 
  • The anesthesiologist may visit you to talk about the anesthetic and answer questions.


  • You will be taken to the Operating Room.
  • The nurses will help you onto the surgical table and put on a blood pressure cuff and some monitors. The surgeon may ask you to confirm the name of the procedure you are receiving. The anesthesiologist will talk you through going under anesthesia.
  • Once the anesthesia has made you fall asleep, the surgeon will begin the procedure.

  • When the surgery is over, you will be taken to a recovery area. Nurses will monitor you closely until the anesthesia wears off. They will help you get out of bed, walk around, and go to the washroom. They can also call your supports at that time with an update.
  • You may wake up from anesthesia already wearing your compression bra/garment.
  • Your breasts may feel like a heavy weight on your chest. This sensation usually goes away after a few days.
  • Your breasts may feel hard and firm to the touch. They will slowly soften as your body heals over the next few months
  • You will likely be discharged from the hospital the same day. Before you leave, the nurse will give you papers containing your Discharge Instructions and maybe a prescription.


ATTENTION: During the COVID-19 Pandemic, having surgery may require extra considerations and safety precautions. Click here for the Planning for gender-affirming surgery in BC during the COVID-19 pandemic checklist.


Post-Surgical Care (Disclaimer)

  • Monitor your surgical site
  • Take Good Care of Your Body
  • Beat the post-surgery blues
  • Mindfully return to usual activities
  • Breast screening
  • Upper Surgery Patient Experience Survey

Monitor your surgical site

ATTENTION: It is important to follow your surgeon’s instructions for aftercare. The information here does not replace the information you receive from your surgeon. If there are any differences, you should follow the advice provided by your surgeon.

Signs of complications

Call your surgeon, doctor, or nurse practitioner if you experience:

  • Excessive wound redness
  • Excessive bruising or swelling
  • Excessive yellow or green pus-like drainage
  • The area around the incision is hot or hard and painful to the touch
  • Chills or a fever over 38.5 degrees Celsius (101.3 Fahrenheit) by mouth
  • Pain that is not relieved by prescribed medications or gets worse a few days after surgery

If necessary, go to the Emergency Room.


Bruising and swelling

It is normal to have bruising and swelling after surgery. You may have more swelling on one side than the other, and it can change throughout the day. It will go down gradually, taking up to 6 months to resolve.

Changes in sensation

It is common to have changes in sensation on your breasts and chest wall. You maybe less sensitive to pressure, temperature, pain, or sexual stimulation. It can take 6-12 months for the nerve endings to heal or grow back into these areas.  Once in awhile, you might even feel prickly, stinging, or burning sensations as the nerves heal and grow. There can be permanent changes to sensation, including areas of complete numbness. Erotic sensation may change permanently. Sensation may be permanently reduced.

Itchiness

Recovering from breast construction surgery can involve some itchiness. Itchiness is caused by the reduction of swelling. It can also be caused by your compression garment or an allergic reaction to the adhesive in your bandages. If it’s accompanied by swelling and redness, itchiness can be a sign of infection. Ask your healthcare provider how to manage this side-effect.

Incisions and scars

It is normal to have redness along the incision and sutures that can be seen or felt. Surgeons will often recommend that you avoid getting direct sun on your scars and nipples for up to a year, to help prevent colour changes on the scar tissue. Talk to your surgeon if you find that your scars are starting to thicken up.

Surgical revisions

Surgical revisions can be common. Six to eight months after your surgery is complete, you and your surgeon can determine whether a surgical revision is needed. With a letter of recommendation from your surgeon, the cost of your revision should be covered by the BC Medical Services Plan.

Common reasons for a surgical revision include:

  • To improve contour (with liposuction)
  • To address scarring
  • To correct skin excess, bulges or puckering
  • To adjust the nipple-areola complex position or size

Take Good Care of Your Body

Get lots of rest

Plan to do less activity during the day and allow yourself to nap. Your body needs extra sleep while you are healing.

Relaxation techniques can help your body heal from surgery, too. They reduce the effects of stress on your body, letting your body’s systems focus on the healing process.


Limit arm movement

There are variations in recommendations among surgeons for how to limit your arm movement after surgery- follow the instructions given to you by your surgeon.


Wear your compression bra/garment

You may come out of surgery wearing a compression bra/garment to help reduce swelling. It may feel uncomfortable overtime, but it is very important to continue to wear it as directed by your surgeon.

If you have problems or concerns related to the compression bra/garment, contact your surgeon.

Manage nausea

Experiencing some nausea and vomiting after surgery can be normal. You can try taking Gravol or ginger.

If it persists for several days, call your healthcare provider.


Manage constipation

Constipation is a common side-effect of pain medication. If you experience this, try increasing the number of walks you take, drinking more water, eating more fruits and vegetables, eating prunes, or taking a stool softener. Get protein from food sources other than dairy. If constipation continues for several days, call your healthcare provider.


Manage pain

It is normal to experience a moderate amount of pain during the first few days after your surgery. Take your pain meds on time to keep your pain under control, manage stress, promote healing and decrease complications.

You may wish to use the pain medication tracking chart, featured in this support tool.

This chart is included in the Workbook for Breast Construction Surgery.


Follow Post Operative Massage Instructions

Your surgeon may give you instructions on how to gently massage your breasts to help keep the skin soft and pliable. If so, following these instructions will help to reduce complications, such as capsular contraction.

Take care of your scars

Your surgeon may give you instructions on how to care for your scars. Ask about when, how and for how long you can massage your scars with an unscented/non-fragranced moisturizer and apply silicone gel pads. Scars can take up to 18-24 months to mature.


Move to promote healing

Go for little walks after your surgery. Walking increases your blood flow, which speeds up the healing process.

If walking is not an option for you, or if you are lying down for long periods of time, leg exercises and breathing exercises will also increase your blood flow and support your healing.

See the Workbook for Breast Construction Surgery for exercise suggestions.


Attend your check-ups

You will make a plan with your surgeon for check-ups after surgery. Your health care providers will make sure your incisions are healing well.

They may ask about pain, bleeding, bowel movements, fever, and how you are feeling physically and emotionally.

Beat the post-surgery blues

The after-effects of medications, surgery and the activity limitations required during recovery can lead to something called ‘post-operative blues.’ This can include feelings of low mood, loss of appetite, difficulty concentrating and even self-doubt. This is a temporary and normal part of the healing period. Here are some suggestions for making it easier.

  • Put your self-care plan from your Surgery Workbook into action. See below.
  • Before surgery, ask yourself:
    • What does it look like when I start to feel low?
    • How will people know that I’m feeling that way?
    • Who can I share this information with in advance?
  • Make lists of things you love and reflect on how you can experience more of what you love while you heal from surgery (eg. lists of activities that bring you joy, ways that you connect with others, ways that you show yourself love, foods you love to eat, smells that calm & refresh you, sounds that inspire you, textures that you love to feel on your skin).
  • Write letters expressing thanks to people who helped you during surgery
  • Keep a journal

Self-Care Planning Exercises

Here are some holistic self-care planning exercises to help you prepare for before and after surgery. These exercises are also included in the Surgery Workbook.

Mindfully return to usual activities

Ask your surgeon when you can resume your usual activities, such as:

  • Taking a bath or shower
  • Going to work
  • Driving a car
  • Swimming
  • Participating in a sweat
  • Having a sauna
  • Playing instruments

  • Lifting more than 10 pounds
  • Exercising
  • Participating in rituals and ceremonies
  • Dancing
  • Sunbathing
  • Sexual activity

First 10 days after surgery

Avoid activities that can lead to elevated blood pressure. Increased blood pressure in this post-operative time frame increases the risk of internal bleeding (hematoma).

This includes:

  • Having any kind of sex (alone or with a partner)
  • Having an orgasm
  • Activities that create risks for bleeding, increase the risk of discomfort or pain or that may disrupt your anatomy while it heals. This can include:
    • Running (increases heart rate, can lead to elevated BP)
    • Biking (increases heart rate, can lead to elevated BP, extending arms to reach the handles)
    • Driving (extending arms to reach the wheel)
    • Walking a dog (risk of pulling on the leash)

First 4-6 weeks after surgery

  • Keep in mind that any activities involving another person (or a pet) are less predictable than those done on your own 
  • Avoid activities that can cause rubbing/shear on the incisions or nipple areola complex: this can cause infection, graft failure and inflammation of incisions, etc
    • Be careful about activities running, walking, biking etc, where a repetitive motion causes a garment to subtly rub over the healing tissue
  • Avoid activities that can lead to internal or external bleeding, compromised blood flow, and injury to nerves and healing tissues:
    • tiring and repetitive movements
    • activities that could affect (stretch/tear) incisions (inner or outer) until your surgeon confirms that your incisions have healed
    • reaching/extending arms
    • sudden or vigorous movements
    • lifting more than 10 lbs
    • strenuous activity (including certain kinds of sexual activity)
    • bondage, suspension, pinching, squeezing, vigorous massage
    • giving or receiving percussive activities, including flogging, spanking and paddling 
    • very hot and very cold temperatures until nerves have fully healed

Sexual activity

Lots of people have questions about returning to sexual activity after surgery. This can include, but is not limited to, masturbation and sex with other people. The above recommendations apply to sexual activity. As with all other activities, speak with your surgeon about when it is safe for you to be sexually active after surgery. 

It can be helpful to speak with your surgeons before starting any BDSM activities in the months after surgery. Your surgeon will likely welcome these questions. If you are shy, you can be creative and ask about returning to full contact sports, swinging a tennis racket, receiving vigorous massage, riding a horse, using a heating pad or wearing restrictive or tight body-shaping clothing, etc.

More general information about returning to activity after surgery

  • Follow your surgeon’s recommendations regarding return to sexual and other physical activities.
  • Follow your surgeon’s recommendation about how long you should avoid sleeping on your stomach or breasts (usually about 3 months)
  • Ease back into your regular activities (shorter and less intense)- start off gentle
  • Pay attention to whether your swelling or tenderness increases after activity- if so, you may want to wait until you are a bit further along in your healing before trying that activity again.
  • You may find that your energy and stamina are different from before surgery. This is a normal part of your healing journey and will balance out over time.
  • You may find that your endurance or tolerance for different activities and sensations is affected by your surgery or pain medications. This is a normal part of your healing journey and will balance out over time
  • Stop or take a break if you feel pain, or you feel anxious or scared.

Breast screening

Your primary care provider can give you an individualized recommendation for whether or not to have breast screening, and when and how to do it. BC Cancer’s Breast Screening program has a helpful resource for providers: Breast screening for transgender, gender diverse and non-binary people.

Breast screening & hormone therapy:

There are no evidence-based guidelines for screening in transgender and gender diverse patients on estrogen-based hormone therapy. Your primary care provider can give you individualized recommendations.

Breast screening & breast implants:

Breast implants may make mammography more difficult and may obscure the detection of breast cancer. This can happen with any implant type or shape, and with any implant location (under the muscle or breast tissue). Capsular contraction can increase the difficulties associated with imaging and cancer detection. The compression that happens during mammography can cause an implant to rupture. If you go for a mammogram, make sure to tell the technologist that you have breast implants so they can accommodate you appropriately.

There may be other appropriate imaging techniques that can be used to evaluate any lumps or the condition of implants.These can include ultrasound, specialized mammography and MRI studies.

Your primary care provider and surgeon will be able to help you decide what screening options would be best suited to your unique situation.

Upper Surgery Patient Experience Survey

Have you had gender-affirming chest or breast surgery in BC since 2015?

Tell us about your experience through the Trans Care BC Upper Surgery patient experience survey and enter into a draw for a $25 Starbucks gift card.

Feedback will be used to improve the surgical experience for future clients in BC. Click here to take the survey.


ATTENTION: It is important to follow your surgeon’s instructions for aftercare. The information here does not replace the information you receive from your surgeon. If there are any differences, you should follow the advice provided by your surgeon.


Resources

  • Tips for family and friends
  • Support Tools
  • Additional resources
  • Guide feedback

Tips for family and friends

It can be very helpful for people having surgery to have support from family members and friends. This section is to learn more about how to help.

Support person

We suggest that everyone getting surgery ask someone to be their support person. The support person can coordinate a team of friends or family to help out. Here are some important things to know.

As a support person it will be important for you to also make sure you are taking care of yourself, in order to offer support to others. Here are a few considerations to help support people prepare. 

Considerations for support people

  • I have scheduled time to take care of myself (eat, shower, have some quiet alone time, participate in meaningful activities, go to work, etc).
  • I have a good sense of what to expect leading up to, during, and after my friend or loved one’s surgery.
  • I have spoken with my family or loved one and we have the same understanding about what kind of support I will be providing.
  • I feel as prepared as I can be to handle supporting someone after they have surgery.
  • I feel as prepared as I can be to care for myself during this time.
  • I have a plan for what to do if I feel stressed while my friend or loved one is healing from surgery.

Supporting someone having surgery

Here’s a checklist for people supporting someone having surgery. This checklist is also included in the Surgery Workbook.

Some helpful ideas for support

Help in advance

It can be a lot of work to prepare for surgery. Here some suggestions on how to help your friend or loved one leading up to surgery:

  • offer rides to and from appointments
  • offer to take notes during appointments
  • pick up supplies and helpful items
  • help prepare food and groceries
  • help coordinate a group of people that can prepare meals, help with chores and visit after surgery
  • ask if there are any specific ways you can support them as they get ready for surgery
  • remember that it can be hard to ask for help, so check-in regularly to see how they are doing and what they need

Take over some of their responsibilities

After surgery, your friend or loved one will not be able to take care many of their day-to-day responsibilities for many weeks. This includes physical tasks like household chores and taking care of family members or pets, as well as more subtle activities, like re-arranging pillows, putting fresh sheets on the bed and preparing food.

Doing these things or helping to organize friends who can help, is one of the best ways to support someone after surgery. Keeping a schedule to make sure these things are taken care of can be a huge help in avoiding restricted activities and focusing on resting and healing.

Be present after surgery

Letting people know you are thinking of them is a great way to show how much you care. This can include visiting them, bringing a card or some games, or simply sitting with them and watching a show.

When a person knows they are cared for, it reduces stress and helps with healing, and it also just feels good!

Be a positive distraction

Distractions help people manage pain, avoid boredom and recover more quickly.

This can include listening to an audio book together, going on walks, sending texts and pictures, and dropping in for short visits.

Take care of yourself

Caring for yourself is one of the most important things you can do as a caregiver. When your needs are taken care of, the friend or loved one you are helping will benefit too.

If you are a primary support person, it is important to regularly take time to be alone or to go out and do something you enjoy. There may be other people who would be more than happy to help out if they knew what was needed, so just ask.

Preparing yourself

Seeing someone you care about feeling pain or discomfort can be hard, and taking on extra responsibilities can, at times, be stressful.

This is a temporary and normal part of the process of care giving, and it can be made easier by reflecting in advance about what’s ahead and thinking of ways to also care for yourself during this time.

How to be there

It’s also helpful to remember that your role isn’t to be a magician and fix everything or make all pain or discomfort disappear – it is just to be with your friend or family member on their healing journey.

Just knowing someone understands can be a really big help. Even though it doesn’t “fix” anything, empathy creates connection and makes it just a little easier to live through the harder parts of healing.

Support tools

Here are the worksheets, checklists, and exercises found throughout the breast construction surgery navigation guide. Most are included in the Workbook for Breast Construction Surgery.

Assessments

Assessment Questions

Surgical Consult


Buy, Borrow, and Do

Self-Care Before

Self-Care After


Supporting Someone

Day of Surgery

Track Your Medication


COVID-19: Surgery in BC

COVID-19: Surgery in Montreal 

Guide Feedback

We believe your feedback is one of the best ways to improve our resources. If you have any comments, suggestions, or questions related to one of the Trans Care BC client-centred navigation guides, we would love to hear from you!

Share your feedback by survey:

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SURVEY LINK


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  • Do you have suggestions on how to improve the navigation guides?
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Click here to contact Trans Care BC’s Care Coordination Team