I can’t comment at all about the BMI aspect of it but please reconsider GRS Montreal, I’m looking into surgery too and I originally looked into GRS Montreal because Brassard can work with Michigan insurance but I have heard a lot of bad things about GRS Montreal, they make all patients sign an NDA which is a giant red flag. You can’t even find result pictures on their website if I remember correctly. Brassard also advertises his surgery as a one step surgery which I guess technically it is but that because he only creates the vaginal cavity, clitoris etc, he doesn’t do anything as far as the external aesthetics go so you have to go back for a revision at some point when you are healed enough down the line. Also again a surgery that usually takes most surgeons 4-6 hours he claims to do in 1-2, you can’t in my opinion cut the surgery time down that much without taking some shortcuts

YOU should want to loose that weight before going into surgery. Having a higher BMI puts you at risk for a lot of complications and potentially having a much longer recovery. Wound dehenisence is a big one as the weight pulls at the sutures. Personally, it’s not a risk I would take.

As you suggested, BBL might be the way to go as you can loose the weight and have it redistributed at the same time. Even still, with BBL, they recommend you hit your target weight and then get it.

My honest recommendation, focus on bringing your BMI down before any surgery. It’ll be worth it in the long run.

I had GRS with Brassard two months ago, at a 37ish BMI. Between 35 and 40, they basically want you to do a sleep apnea screening (depending on a few other risk factors — this turned out to be good for me, because I didn’t know I had it!) and then will do a tiny bit of extra monitoring during early recovery (just someone coming and checking your vitals a couple times a day, not sure how often they did that for other people). No negative experiences with them about weight at all, nobody yelled at me or anything about it (other than my sleep apnea doc was a little shitty but she’s unrelated to them). They also didn’t do a “weigh-in” or anything, they had a weight on the referral form from my doctor and then just asked “so are you about the same weight?” day of. (My recovery is going well — I think it’s a very slight elevation in risk, it’s a totally arbitrary threshold to say “oh that’s an okay risk for THESE people and not for THOSE ones.)

They do say in the documents that they won’t operate above 40. I wasn’t / am not, so don’t know how that works there.

In terms of “material”: nobody looked at what I was “working with” until the meeting with Brassard the morning of, when he said he thought it’d be enough but asked whether I wanted him to do a skin graft if it wasn’t. We talked briefly about consequences of that, I said yes, but then it was enough so 🤷‍♀️.

I'm 6'3" 280 lbs , 300 lbs at my consult. Mine was for mayo in Minnesota but they ideally wanted my bmi of 38 to be between 25-30 but said insurance would let me proceed if I was under 35. I know for myself personally they said they had enough material to work with but if they didn't the more weight I could lose would give them more to work with in the form of skin grafts. Due to the atrophy of my hrt for 8+ years they are proceeding with a PIV hybrid procedure.

GRS Montreal has some strict rules in place. A BMI 35-40 will need additional testing (looking at things such as obstructive sleep apnea). Over 40 and they won't do surgery.

PI (and zero depth) is the only method currently used at GRS Montreal. If it helps, I've known people with very "limited material" get good depth.

I was right on the dot at 35 BMI when I went into surgery. 6'2" 260lbs. I posted my results a few days back if you look at my post history.

I also had a PI.

I was about 400lbs 2 years ago,and lost about 140 so I could qualify for surgery.

I honestly am extremely happy with my results. 😁 and FUPAs are awesome. I wouldn't worry a about that