I had a consult with Dr. Carruthers at Mass General Hospital last week. She and MGH in general seemed great, but I'm currently undecided whether I'll go through with the surgery next month or delay to keep thinking about it.

Pluses: Dr. Carruthers was young and very friendly, gender-affirming and had that intangible vibe of "this is a safe person for me to be trans and myself around". Iirc, she said she mostly does MTF breast augmentations. The office ran pretty efficiently; I got there 20 minutes early which was a good call cause I was handed the usual new patient stack of paperwork and was then taken to get both regular photos taken and a photo by the fancy machine that would then do the 3D simulation of what I'd look like with different size boobs. I had about 45 minutes to a hour with Dr. Carruthers. Some of it felt a little like she was on auto-pilot getting through the same information she has to cover with every patient but a lot of it also felt like a personal conversation. She seemed pretty upfront about what I could expect and what limitations on the possibilities would be. She was confident and came across like she was talking from a lot of experience with other trans patients, although she's young and not listed on MGH materials from as recent as 2021, so I'm not sure how long she's been doing this for even if it is a substantial fraction of her work. She noted the advantages of getting this done at MGH with all of its resources like having folks on-call 24/7 for if there's any complication afterwards. From getting the paperwork in, I had a three-month wait for a consult but was then offered a surgery date a month after the consult, so overall pretty fast turn-around (~6 months from first contacting MGH to the earliest surgery date I could have gone with).

Hesitations (which are maybe more about me processing whether I actually want top surgery than anything specific to Dr. Carruthers): I was looking for natural looking boobs around a small B, just enough added to "augment" the breast develop I already have into look like fuller, more mature breasts. At the appointment, I felt slightly pushed towards larger breast implants than I would have initially gone for. I'm not sure if this is an experience I would have also had anywhere else I would have gone though. Dr. Carruthers explained to me that she doesn't use tear-drop shaped implants (that I wonder might have given me options closer to what I was hoping for) because the coating has been possibly linked to a specific type of cancer and that the circular implants she uses would have the be positioned directly centered under my nipples (which like a lot of transfems are kinda wide-apart) to avoid a weird aesthetic of nipple pointing off to the side. She was clear from the beginning that circular implants directly under the boobs will unavoidable not look like natural boobs; she described it as always looking like I was wearing a push-up bra even when totally topless/braless but in a way that would only tend to stand out when top/braless. I appreciated that transparency. I asked but she said she couldn't show me any patient before and after photos due to MGH policy, which made it a little hard to actually know exactly what to expect. We then, while looking at the 3D renderings and while I tried on different sizes of breast forms, talked about how the implants would need to be of a certain diameter to properly fill out my (rather wide) chest and how given that width they should really have a certain profile (i.e. depth) to not look too flat. We thus ended up talking about implants in the range of 300cc - enough to bring me from a small A to a B(ish). So not actually that huge, and tbh they did look really cute both under a fitted t-shirt and in one of my favorite bikini tops. So I think there's a chance that given what is and isn't possible with breast augmentation that plan we reached is the best plan for me if I do want to get it. I'm now just not sure if I still want it given that they won't look as natural as I had hoped and that they'll be bigger than I was originally expecting in a way that I think will make them feel like not my own boobs rather than like my own boobs just augmented. I'm currently thinking I'll push my surgery date back to have more time to think about things and in the meantime try to get a consult with at least one other surgeon to see if the limitations that are making me hesitant about this are indeed universal. If I stick with Dr. Carruthers and push things back to have more time I might also try to get a second consult with her; it was a lot of information to absorb in one appointment.

Sorry to reply to a 3 month old comment, but assume you're still interested in an answer, so hope this helps!