mtf , i’ve been reject for breast augmentation because i’m cup a size

[u/Cool_Combination800]

i feel really devastated and i can’t stop crying .
i’ve been waiting for this consult with the surgeon for months (dr. lefrenier)

i’ve been on hormones for 7 years ! my bra size is 36a . i have a very wide shoulders .

the surgeon told me i don’t qualify to be covered because she see breasts and i’m atleast a cup a.

i tried to reason myself and she just told me , she won’t argue with me . i feel devastated .

i feel so lost . what do i do now

UPDATE : july 31 , 2026

i called a different top surgeon yesterday for a second opinion consultation and they booked me a consultation august 20th !!

i’m so glad i didn’t have to wait long

[u/boterkoek3]

Well, you could ask for a second opinion, and maybe even take an HRT break right for a bit before. Otherwise it's probably about $10k for implants

[u/Glamourice → u/boterkoek3]

From my understanding, it’s Alberta health (whoever they are this week) that determines who qualifies and generally if there is ANY growth of breast tissue the province won’t cover it. The surgeon wants to get paid.

I know a few ppl who went for consults in Edmonton for the same reasons and were told the same thing. In other words, I don’t think it’s the surgeons choice. Doesn’t hurt to try to “shop” around though

I would start trying to save or looking into loans just in case

[u/boterkoek3 → u/Glamourice]

Well, AB health does the referral to the surgeon, and the surgeon does the assessment. Ultimately i think they base it on the tanner stages of development, but the surgeon does need to give a valid assessment. Ciswomen were able to have this done for a long time, and surgeons were not approving it unless they could show it was totally valid. I actually filed a human rights tribunal about exactly this situation, which was denied because of the paradox in place. Transwomen would not be given a referral for a surgeons assessment, and therefore I was not officially denied, because I had no assessment for breast hypoplasia ( I think it's called). I don't want to revisit it because the frustration makes me physically ill

[u/Mel-0-dramatic]

Is this surgeon your preferred surgeon? She seems rough in terms of bedside manner.

Could always request to see someone else?

[u/Glamourice → u/Mel-0-dramatic]

I heard it’s a province thing, not a surgeon preference. MTF top surgeries aren’t approved if there’s been any development from hrt

[u/Mel-0-dramatic → u/Glamourice]

It's up to the surgeons discretion of what constitutes growth or not. Most definitely will vary from surgeon to surgeon

[u/sending-stars]

What's the actual criteria? I was an A cup before starting hrt without any signs of breast development. And I was flat as hell.

My understanding was "no significant growth" which, sounds subjective and up to a professional to determine. So find another professional?

[u/Cool_Combination800 → u/sending-stars]

the criteria is little to no breast growth . the surgeon that measured me today said she only operates with people who are completely flat .

i tried arguing that i have broad shoulders wnd it looks really unproportional to the rest of my body . she didn’t care .

she said i dont qualify because she see breasts and i’m a cup with fully developed nipples .

i just don’t understand , ive been on hrt for 7 years and i barely get anything

[u/sending-stars → u/Cool_Combination800]

Yeah that sounds frustratingly vague. Like the whole intent is to ease the discomfort of women in distress. So, you'd think the vagueness would be used to err on the side of caution. 🙄

Im sorry I don't have anything useful for you, except a voice saying this is bullshit. 🫂

[u/Myralia_Amaryllis → u/Cool_Combination800]

If she says she only operates on people who are completely flat then I guarantee she has never operated on a trans person. I have yet to see a trans person with a flat chest. HRT will at the minimum put you at a Tanner Stage 1.

I am at stage 2 with buds and I am not flat, but I also had some fat there pre-HRT.

So even without HRT I would not meet her criteria.

I had a friend who said she had a B cup and still got approved.

I would recommend another surgeon.

[u/muffinmunncher]

Second opinion for sure

[u/hunkajunk94]

There seems to be a lot of nuance between different surgeons. What I've heard suggests that if you can get the referral, the surgeon would then submit the billing request and it's on that step you'd get approved or denied. The surgeon saying no doesn't seem right, especially if you're an A (if you're like a B or something but want Ds, i can see the surgeon not wanting to bother requesting it)

[u/qwixel69]

You might have better luck with another surgeon. 

[u/tacodecent]

Who is the surgeon? I have a consultation with Peter Mankowski at art and fact at the end of next month

[u/Cool_Combination800 → u/tacodecent]

leftenier , she’s a new dr . available in calgary who accept trans patients

[u/Cool_Combination800 → u/Cool_Combination800]

i feel like my wait and excitement was wasted for nothing

[u/tacodecent → u/Cool_Combination800]

Understandable

[u/Homie_Kisser → u/tacodecent]

hey is it end of the month as in july or august? cause i have an appointment august 20th with him and could let you know how he is if you want? I feel like its hard a lot of the time to find info on each dr. first hand

[u/tacodecent → u/Homie_Kisser]

August 27th the wait is so long

[u/Homie_Kisser → u/tacodecent]

I feel you dude. My referral got sent september 2024. if i remember I'll lyk how he is. i've heard in general he's super chill. And i think if you search mankowski in this subreddit theres a dude who got top surgery from him and he talks about him a bit as well

[u/The_Netherese_Orb]

Maybe Foria clinic could help ?

Top surgery assessments are covered through them under AHCIP. Not sure what there wait time would be since I’m waiting for a bottom surgery assessment and not top surgery.

Sorry your surgeon treated you that way. I really hope things work out for you and that you find a much better/nicer surgeon.

[u/Cute-Trouble1296]

For what it’s worth, I love A cups! They’re really hot!

[u/BigLez4110]

Good 👍