1. Regarding top surgery. I assume you are asking about gender affirming top surgery, which has very different goals than a mastectomy or a reduction. Top surgery is done to create an aesthetically pleasing masculine appearing chest. Reduction removes some tissue to reduce breast size. Mastectomy removes all breast tissue for cancer treatment/prevention.
2. There are obviously pros and cons to elective surgery. For example, anesthesia risks increase if you are over 65, and/or if you have multiple or prolonged exposure >3 hours. Among other things, the risks of prolonged anesthesia include deficits in executive function and ADHD symptoms.
3. A dear friend decided to have a breast reduction at age 66 after years of back pain and difficulty exercising. She was also frustrated about finding comfortable bras and clothing that fit. In the end she was very happy with the result, however, three years on she is still figuring out how to dress her new figure.
4. My friend's recovery was complicated by formation of uncomfortable keloid scar tissue and unexpected abnormal pathology results showing cancerous or maybe pre-cancerous tissue. I don’t recall the exact diagnosis. I do know she had to see an oncologist and another surgeon, and she had additional evaluations and biopsies. They concluded she was still at increased risk so they recommended something akin to tamoxifen. She decided to forgo the medication after weighing pros and cons. Her keloids were treated using Red LED Light therapy and they improved.
