Gender-Affirming Top Surgery in Bellevue — A Surgeon Who Sees You
Gender-affirming top surgery is one of the most personally meaningful procedures Dr. Day performs. At Pacific Sound Plastic Surgery in Bellevue, he brings double board certification, Ivy League surgical training, and a genuinely affirming surgical environment to every patient who walks through the door. Whether you are pursuing chest masculinization through a double incision approach or exploring your options for the first time, you will receive honest, individualized guidance — and a surgeon who treats you with the dignity you deserve.
Double Board-Certified (ABPS + ABS)
Ivy League Trained
Highly Rated Bellevue Plastic Surgeon
Proudly Serving Bellevue, Seattle, Kirkland, Redmond, Mercer Island, Issaquah, Renton
What Is Gender-Affirming Top Surgery?
Gender-affirming top surgery refers to surgical procedures that reshape the chest to align with a patient’s gender identity. For transmasculine and non-binary patients, this most commonly means chest masculinization — removing breast tissue and recontouring the chest wall to create a flat, masculine profile. Dr. Day performs top surgery as a functional and identity-affirming procedure, not a cosmetic one, and his approach reflects that distinction from consultation through recovery.
Unlike many surgeons who see a limited number of gender-affirming cases per year, Dr. Day has built a dedicated patient community in the Pacific Northwest. His training in advanced soft tissue contouring and aesthetic balance directly benefits top surgery outcomes — particularly in achieving a natural, proportionate chest profile.
Surgical Approaches: Finding the Right Technique for Your Body
Not every patient is the same, and top surgery is not one-size-fits-all. During your consultation, Dr. Day will evaluate your chest size, skin elasticity, nipple position, and overall goals to recommend the most appropriate technique:
Technique | Best For | Nipple Grafts |
|---|---|---|
Double Incision (DI) | Moderate-to-larger chest size; most common approach
| Optional — patient preference |
Periareolar / Keyhole | Smaller chest, good skin elasticity, minimal tissue
| Preserved on pedicle |
DI + Free Nipple Graft (FNG) | Larger chest; repositioned nipples for proportion | Required — repositioned |
DI without Nipple Graft | Patient preference; may choose no nipple reconstruction | None — patient choice |
"I went to Dr. Day for gender affirming top surgery and I ended up getting a double incision bilateral mastectomy with no free nipple grafts which is a surgery I had wanted to have for years. Dr. Day was kind, straightforward, and honest when discussing surgical options and set realistic expectations for what a potential final result would look like based on my body shape and the amount of tissue that was being removed. He was transparent about the reasoning behind him suggesting I get liposuction on each side (which I ended up doing) and why it would produce the best result. In the end, I'm very happy with my results."
— Erin B., Top Surgery Patient • Google Review
The Benefits of Top Surgery at Pacific Sound
- Relief from gender dysphoria and significant improvement in day-to-day comfort
- Freedom from binding — with the physical and skin-health benefits that come with it
- A natural, proportionate chest contour tailored to your unique anatomy
- Surgery performed by a double board-certified, Ivy League-trained plastic surgeon
- Transparent, supportive consultation process — your goals drive the plan
- Insurance accepted — including Washington Apple Health for qualifying patients
- Close clinical follow-up with Dr. Day personally available post-operatively
- A trans-affirming surgical team that respects your identity and pronouns
Am I a Good Candidate for Top Surgery?
- Ideal Candidates
- Persistent gender dysphoria affecting quality of life
- Physically healthy with no uncontrolled medical conditions
- Non-smoker or committed to quitting before surgery
- Stable weight maintained for at least 6 months
- Able to take at least 1–2 weeks off demanding work; desk work often possible by Week 1
- Has (or is working toward) required insurance/WPATH documentation
- When to Wait
- Active smoker not willing to stop prior to surgery
- Unstable or rapidly changing weight (active weight loss)
- Uncontrolled diabetes, bleeding disorders, or cardiac conditions
- Currently adjusting hormones in ways that may affect healing
- Unrealistic expectations about scarring or nipple aesthetics
- Insurance prior authorization not yet initiated (may delay scheduling)
Not Sure If You're a Candidate?
Your Top Surgery Journey — Step by Step
Step 1 — Consultation
Your first consultation with Dr. Day is the foundation of your surgical plan. Expect a thorough review of your goals, surgical options, body anatomy, and any insurance or documentation requirements. Dr. Day will be direct and honest about what is achievable and will explain his recommended technique in detail. Most patients leave their first consultation with a clear surgical plan and a scheduled date — often within 4–6 weeks.
Step 2 — Pre-Surgical Preparation
Once scheduled, our patient care team will guide you through pre-operative requirements: lab work, medical clearance (if needed), stopping certain medications, nicotine cessation, and ensuring your insurance pre-authorization is in order. If you require a WPATH letter, the team can help coordinate timing with your therapist and referring providers.
Step 3 — Day of Surgery
Top surgery is performed under general anesthesia at one of Dr. Day’s accredited surgical facilities. Procedure time is typically 2–4 hours depending on technique. You will go home the same day with drains in place (if applicable) and a compression wrap. Dr. Day personally calls patients after surgery to check in.
Step 4 — Recovery Timeline
Days 1–3
Walking encouraged from Day 1. Rest, compression wrap, and limited upper-body activity. Drain care if drains placed. Pain manageable with prescribed medication.
Week 1
First post-op visit with Dr. Day. Drain removal (if applicable). Most patients return to desk work. No reaching overhead or heavy lifting.
Weeks 2–4
Light activity resumes. No strenuous lifting or chest-focused exercise. Scars beginning to settle. Chest contour becomes more visible as swelling resolves.
Weeks 4–6 & Beyond
Full activity cleared. Final results emerging at Month 3. Scars continue to fade. Follow-up visits to confirm healing trajectory.
Step 5 — Follow-Up Care
Dr. Day schedules multiple follow-up visits over the first three months to monitor healing, address any questions, and confirm you are on track for the results you planned. His availability extends beyond the clinic — he personally calls patients when concerns arise.
"I got top surgery with no free nipple grafts, a surgery I had wanted for years. The day of my first consultation we went over the surgery process where we discussed what I wanted my results to look like, recovery times, dates, etc. By the time I walked out of my appointment I had my pre op appt booked, my surgery date, and my supply list. Dr. Day's assistant Sophia was extremely helpful with reminders on what paperwork to get in for my therapist, primary, insurance, etc. Within a month I had my surgery. I am so beyond grateful and my chest looks amazing. My recovery went super smooth and my results look better than I could have anticipated."
Mars C., Top Surgery Patient • Google Review
Does Insurance Cover Top Surgery?
For many patients, insurance coverage is the deciding factor in whether and when they can pursue top surgery. The good news: coverage for gender-affirming top surgery has expanded significantly in Washington State, and Pacific Sound Plastic Surgery is experienced with navigating the pre-authorization process.
Washington Apple Health (Medicaid)
Washington Apple Health covers gender-affirming surgery — including top surgery — for eligible enrollees. This is one of the most comprehensive state Medicaid programs for gender-affirming care in the country. Our patient care team has experience working directly with Apple Health on prior authorizations and can help you understand what documentation is required.
Private Insurance
Most major commercial health plans in Washington State offer some level of coverage for gender-affirming top surgery when medical necessity is properly documented. Requirements typically include:
- A letter from a licensed mental health provider (WPATH-aligned documentation of persistent gender dysphoria)
- A referral letter from a primary care provider in many cases
- Prior authorization submitted to the insurer before scheduling surgery
- Confirmation of in-network status with Pacific Sound Plastic Surgery
Self-Pay Options
"I was referred to Dr. Day for my gender-affirming top surgery and having heard very little about him, I was hesitant. From the first consultation, Dr. Day was very clear and honest with me about what I could expect from the procedure. His explanations were extremely thorough and he answered all of my questions thoughtfully. Dr. Day went out of his way to make me feel comfortable and accepted, going as far as politely correcting nurses at the hospital on my pronouns on multiple occasions. In terms of actual results, I could not be happier."
Alex T., Top Surgery Patient • Google Review
What Results Can I Expect?
Top surgery results are visible immediately after surgery, though the final outcome takes time to emerge as swelling resolves and scars mature. Most patients describe their final result as noticeably better than their expectations — a testament to the personalized planning that goes into each procedure.
Results Timeline
- Day 1: Chest appears flat with compression wrap in place — early results visible even with swelling
- Weeks 2–4: Swelling begins to resolve, contour becomes clearer
- Month 3: Scars softening, final chest shape emerging
- Month 6–12: Scars continue to fade; results are stable with maintained weight
Top surgery results are long-lasting. Weight stability is the single most important factor in maintaining your outcome.
Significant weight changes can affect chest contour over time, which is why Dr. Day discusses weight stability during your candidacy evaluation.
"I went to Dr.Day for a double mastectomy with no nipple graft. The process was very straightforward, they were communicative + professional, and I am very happy with my results. I had no complications medically or aesthetically, and was kept informed throughout. It was also my first time getting an operation, the staff were kind and assuring. I would recommend Dr.Day for anyone seeking similar surgeries!"
Ashen W., Top Surgery Patient • Google Review
Top Surgery Cost in Bellevue
💰What Affects Price
- Surgical technique (double incision, periareolar, with or without nipple grafts)
- Whether liposuction is performed alongside (for improved contouring)
- Anesthesia type and facility fees
- Any additional contouring procedures
Financing Options
Pacific Sound Plastic Surgery accepts financing through two trusted healthcare lending partners:
- CareCredit — 6-month financing available
- Alphaeon Credit — flexible credit lines designed for healthcare procedures
Ask our patient care coordinator about financing during your consultation.
✨What's Included
- Surgeon’s fee
- Facility / operating room fee
- Anesthesia (administered by a board-certified anesthesiologist or certified registered nurse anesthetist)
- Enhanced Recovery After Surgery medication (Exparel)
- Cosmetic surgery insurance coverage (Cosmetasure)
- High-end compression garment (Isavella)
- High-end scar ointment (Biocorneum)
- Swelling and bruising ointment (Arnica)
- Post-operative recovery and follow-up care
- Clara Recovery Supplements
Price Range
For patients using insurance, out-of-pocket costs vary by plan, deductible, and prior authorization outcome. Our team assists with the pre-authorization process and will provide a detailed cost estimate once coverage is confirmed.
Why Patients Choose Dr. Day for Gender-Affirming Top Surgery?
✓ Double Board-Certified Surgical Expertise
Dr. Day holds dual board certification from the American Board of Plastic Surgery and the American Board of Surgery — a distinction that reflects comprehensive training in both reconstructive and aesthetic surgery. His expertise in soft tissue contouring, scar placement, and proportional results is applied to every top surgery case, producing outcomes that are natural, flat, and aligned with each patient’s goals.
✓ A Trans-Affirming Surgical Environment
Pacific Sound Plastic Surgery is a practice where every patient is treated with dignity. Dr. Day corrects pronoun misuse without prompting, leads consultations without judgment, and communicates directly and transparently — including about limitations and realistic outcomes.
✓ Ivy League Trained
Dr. Day’s Ivy League surgical training, combined with 10+ years of experience across thousands of procedures, brings an academic rigor to every case that his patients feel from the first consultation.
✓Insurance Navigation Expertise
Our patient care team has deep experience with the insurance pre-authorization process for gender-affirming procedures — including Washington Apple Health. Patients who work with Pacific Sound report a streamlined experience from documentation to surgery date.
"Dr. Day was able to fit me in so soon for a consultation, and not a month later a surgery date! He made my experience incredibly easy and created a safe space to express what I was looking for in my procedure. Definitely would be recommending him to a ton of my friends seeking gender affirming care."
Ryanne C., Top Surgery Patient • Google Review
Conveniently Located for Bellevue & Seattle-Area Patients
Pacific Sound Plastic Surgery is centrally located in downtown Bellevue, making Dr. Day’s expertise accessible to families throughout the region — without the stress of navigating Seattle traffic. Our patients enjoy a private, boutique surgical experience with on-site validated parking, just minutes from the communities they call home.
Seattle
~15 minutes
World-class plastic surgery results without the downtown Seattle parking hassle. A quick drive across SR-520 or I-90 to our private Bellevue office.
Kirkland
~10 minutes
Just minutes from downtown Kirkland and the Juanita waterfront via I-405 or surface streets.
Redmond
~10 minutes
Convenient for the Redmond tech community via SR-520 or surface streets.
Mercer Island
~10 minutes
A quick drive across I-90. Our discreet, private environment is ideal for discerning Mercer Island residents.
Issaquah
~10 minutes
Convenient for Issaquah Highlands and Gilman Village area families via I-90.
Renton
~5 minutes
Easy access from Renton and the Landing via I-405 North. Boutique care and personalized attention just minutes away.
Frequently Asked Questions
Does insurance cover gender-affirming top surgery?
Many insurance plans — including Washington Apple Health — cover gender-affirming top surgery when medical necessity is properly documented. Coverage typically requires documentation of persistent gender dysphoria, a letter from a mental health provider, and prior authorization. Pacific Sound’s team assists with this process. Contact us at (425) 818-8991 to begin.
What is the difference between double incision and periareolar top surgery?
Double incision (DI) is the most common technique, removing breast tissue through a horizontal incision and recontouring the chest. It is best suited for moderate-to-larger chest sizes. Periareolar (or keyhole) surgery uses smaller incisions around the areola and is suited for patients with smaller, more elastic tissue. Dr. Day will recommend the appropriate technique based on your anatomy during your consultation.
Do I need a WPATH letter to have top surgery?
Many insurance carriers require documentation of persistent gender dysphoria from a licensed mental health provider — aligned with WPATH Standards of Care. For self-pay patients, requirements vary. During your consultation, Dr. Day’s team will clarify exactly what documentation you need and help coordinate timing if letters are pending.
How long does top surgery recovery take?
Most patients return to desk work around Week 1. Light activity resumes at Weeks 2–4, with full activity cleared at Weeks 4–6. Arm and chest-specific restrictions (no overhead reaching) may persist longer depending on your technique. Swelling takes 3–6 months to fully resolve. Dr. Day will give you specific milestones at your post-op visits.
Will I have nipple sensation after surgery?
Nipple and chest sensation changes after top surgery depend heavily on technique. With double incision and free nipple grafts, sensation is typically reduced or absent initially and may partially return over 1–2 years. With periareolar technique, sensation is generally better preserved. Dr. Day discusses realistic expectations for your specific case during consultation.
Can top surgery be covered and performed at the same time as other gender-affirming procedures?
In some cases, yes — combining procedures may be possible depending on surgical time, anesthesia safety, and insurance authorization. This is a consultation-specific discussion. Dr. Day will advise based on your overall health, goals, and what insurers will authorize together.
What is the scarring like after a double incision mastectomy?
Double incision leaves a horizontal scar below each pec. Scars are pink and raised initially, then gradually flatten and fade over 12–18 months. Scar outcome depends on technique, healing, and scar care compliance. Dr. Day discusses realistic scar expectations during your consultation — no surgeon can guarantee scar-free results.
How soon can I schedule surgery after my consultation?
Many patients at Pacific Sound have surgery scheduled within 4–6 weeks of their consultation, depending on insurance authorization timelines. Self-pay patients may schedule more quickly. The team moves as fast as documentation and scheduling allow.
Is Dr. Day performing surgery at a hospital or surgical center?
Dr. Day performs top surgery at accredited facilities including Carillon Point Surgery Center, Swedish Medical Center, and Virginia Mason Franciscan Health — all in the Seattle/Bellevue area. The appropriate facility is determined based on your case and insurance.
How do I get started?
Call (425) 818-8991 or use the online scheduling form to request a consultation. Our patient care coordinator will guide you through the process — from your first appointment to insurance authorization to surgery date.
Schedule Your Top Surgery Consultation
You deserve a chest that aligns with your identity. Dr. Day and the Pacific Sound team create personalized surgical plans tailored to your unique goals.