On top of this, someone who really wants top surgery you would expect to want to end up with a good cosmetic result: as in tidy, minimal scarring.  So sure. Go in with a BMI > 30 and say "YOUR COMPLICATIONS ARE BULLSHIT" and then enjoy having your wound break down and get infected and end up having a hideous battleground across your chest. edit: which obviously wouldn't have happened to the trans guy who took some damn care of his body first.