Hey, i'm officially 26 days post-op now, i had top surgery at Gender Clinic Bosch en Duin, my surgeon was Wouter v.d. Sluis.

I've been on T 11 months, started with (Androgel 40mg 1x every day) for 4 months, then swapped to (Nebido, intramuscular 1x4ml every 3months) for about 7 months.

Now for the overview:

The surgery itself removed nearly 3kg of tissue, (\~2.7kg) it was done under full anesthesia. (He came into my curtained off area after giddy saying 'we removed nearly 3 KG!!!! WOW!!')

They used Monocryl 5.0/Stratafix for my stitches, i had a Tie-over bandage with fatty gauze and a sponge over my nipples, and during the surgery they gave me 1 gram Tranexaminezuur i.v. and 2 gram Kefzol

I had redonse drains for 24 hrs.

There were no real complications during surgery, it was smooth.

(And any that i did have were related to a human error from the (day nurses) nursing afterward. I was in a compression vest that was too tight for 24 hrs which created a pretty uncomfortable and dangerous situation, once they noticed they (night nurses) immediatley changed it and called it out and things were much better)

Side note, please use your voice if you think something is wrong or you dont have/know where the panic button is, it can save your life and prevent many unnecesary complications, post op is no time to be generous or soft

So far to me it looks fantastic, the bmi i had prior to surgery was right below/at 35. My chest used to be a H cup/triple D, so massive tissue, my nipples areola used to be 5cm in diametre but have now been shrunken down to 2cm. Prior to top surgery i had 20kg of weightloss over the span of a little less than a year. So lots of excess loose skin.

I did not work out prior to surgery, my build however is naturally muscular, even when i'm overweight. 

I have Neurological Amyotrophy (bracius plexus) in my right arm/shoulder, they accomodated by careful handling how they held me during surgery. 

My condition impacts my fine motor and causes nerve damage/overactive nerves.

So far no graft failure as far as i can see and my surgeon can see, it seems to be healing great. The only thing due to the huge amount of tissue removal is that theres quite some seroma in my chest, the middle of my chest is attached at the top but not at the bottom yet under the skin causing a dumbell shaped waterbag effect, this however is gradually lessening and i have to wear my compression binder about 1 week longer than planned (so 5 weeks total)

I was worried about my nipples because i smelled something akin to sweaty ass so i called and sent pictures and they assured me i'm healing good, and to just continue what i was doing and clean with water when i shower. 

After that it naturally cleared up, that was day 18-24

I used the method of fatty gauze + non-stick dressing on nipples.

At some point on my left side a stitch started to stick out and scratch my arm, i called them up sent pics and they told me to just cut the tip off, prior to that i put a dressing over it every change i did to prevent it dticking through the binder and causing damage.

Surgeon is not concerned overall, we are monitoring as we go.

The folds in my skin at the incisions used to be drastically more visible but they seem to be neatly and quickly dissapearing as fluid gets cleaned up inside and swelling settles. 

Im very happy with how natural the lines of the incisions look already, and how relatively thin they remained.

I couldn't find many examples from this surgeon his higher bmi top surgery results and the ones i did find made me kind of afraid i'd have wound seperating issues, but nevertheless i read up on it and decided to trust my gut and go for v.d. sluis instead of the originally scheduled surgeon, boeman.

Overall i can recommend Wouter v.d Sluis as a surgeon for people with higher bmi, i didn't get the traditional bigger people lines and he really follows your natural pectoral shape and adjusts based on your body type so you dont look off. I spoke only briefly with him both over the phone and prior to surgery but during those cotnact moments he was very kind and listened to me well/gave time to ask questions if i needed to, i never felt unsafe with him during this surgery.

So yeah, pretty positive. Other than the nursing mistake afterwards (which did cause me some trauma regrettably) i'm happy with the way things ended up :-)

Hope i can help someone get a better idea of what it like to be a bigger chested person and a bigger person overall in the netherlands.

26 days post-op Dr. Wouter v.d. Sluis, high BMI, big chested