Here is a list of the most common types of enquiries we receive on a daily basis. If there are any other questions you may have then please get in touch with us using the contact form. We are here to help and listen. 

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  • How do we access top surgery?

    We accept referrals from recognised accredited gender specialists who confirm that surgery is the right choice and that there is a persistent well documented gender dysphoria.

    Please see the page listing a database of specialists from whom we’re happy accepting referrals. This is a database of gender specialists with training and often long experience in gender dysphoria working in the context or with Gender Identity Clinics and with ongoing links to MDTs (multi disciplinary teams associated with the GICs) and/or with peer networks that meet regularly.

    If your gender specialist is not on the database, to avoid wasting your time and money please confirm with us that the specialist conducting your assessment and referral is acceptable.

  • Do you have a policy regarding nicotine?

    Yes, we do require patients to be nicotine free for at least 6 weeks before surgery. This helps with nipple viability and wound healing.

  • Once referred, how long till we get an appointment?

    A consultation can be arranged within a couple weeks of receipt of referral.

  • How long is your waiting list for surgery?

    Mr Rubin devotes most of his working time to top surgery and so is fortunately able to keep his waiting list to between 2 and 6 weeks from the time of consultation.

  • What approaches do you offer in top surgery?

    The key approaches to top surgery include the double incision technique (with or without free nipple graft) which is suitable for the majority of chests particularly where there is some ‘droop’ (ptosis) to the breast. Here is a short animated illustration of the technique.


    There is also the circumareolar (otherwise known as periareolar) technique suitable for small breasts. This has pros and cons. But some of the difficulties and disadvantages with this technique can be overcome with the circumareolar technique with medial and lateral extensions. Here is a short animated illustration of the two techniques.



  • Do you use drains?

    Mr Rubin recommends the use of drains in order to remove fluid that tends to accumulate in the chest in the early postoperative period. Most drains are removed on the day after surgery prior to discharge home.

  • How long do we stay in hospital following surgery?

    Most patients require only one overnight stay, however approximately ten percent of patients (usually higher BMI patients) require an extra night.

  • What sort of aftercare do you offer?

    Patients are seen in the dressing clinic at around 7 days following surgery for a nipple and wound check. Thereafter patients can usually self manage, although we are to offer continued support where required. Mr Rubin is happy to deal with queries by e-mail and aims to respond within 24 hours.

    Outpatient clinic follow up takes place by 3 months and a year following surgery.

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