There is a lot of different answers to these questions, I'll give you the jist, then my specific answer.

Where does the breast tissue come from?

There is two main ways to do reconstruction - the most comment is breast implant. In this case they remove all of the breast tissue and leave just the skin. The remaining space is filled with a implant and the size of the implant is determined by how much skin you have. The second way it can be done is to transplant tissue from another part of your body to the breast area, it is usually from either the belly area (DEIP Flap) or from the back area (TRAM Flap). This type of surgery requires the surgery match up the tissue transplant on a vascular level (vein by vein) to make sure the transplanted tissue does not die.

I had a DEIP flap reconstruction - it requires almost a week hospital stay due to how complex the surgery is and recovery is 6-8 weeks, but honestly its been just about a two years and I am still recovering and also I have an additional revision surgery that I still need because - no I am not even close to being even.

How does one sculpt a nipple?

They typically do not. Normally the nipple is removed entirely. In the reconstruction I have heard of the nipple being rebuild but, its not nipple tissue, so its not the right color and it cannot react to environmental stimuli and from what I've seen, gets stuck sort of "hard". When the nipple is removed most people will opt for a tattoo replacement. They look very very real and you don't have the issue permanently smuggling raisins around. I was able to keep my nipple, visually it looks like a nipple, but I can no longer feel it.

Are they as sensitive as before?

No they lose all sensation, can't even feel the skin, so not even like elbow skin, totally numb. They had to rebuild my stomach and belly button, so I also cannot feel anything across my lower abdomen either.

Does having breast cancer on one side automatically increase the chances of cancer on the other side? I would think symmetry isn't a given?

No, the risk of recurrence is the same. If I was to have the same type of cancer in my other breast it would be a recurrence, not new cancer and after treatment my risk of recurrence is lower than my chance of getting a totally new type of cancer.

Were you able or allowed to choose size and shape? (If so, did you go for the tried and true original?)

Short answer no, long answer I was not very well endowed to begin with and my reconstruction was limited by the amount of tissue I could use for transplanting. So, again no and also they aren't both the same size anymore, the reconstructed one is quite a bit smaller and not really the right shape, which is what I am going back in for more surgery to fix. If you had way more breast tissue than I did, there is more options for reconstruction, but from the woman I have talked to, most people end up going smaller or staying the same. Going up larger brings in a lot of complication and can only happen if you get a implant reconstruction and not a transplant.

Hope you're doing well today. Not a question, I just wanted to say (write) it. Live long and prosper.

Thanks I plan on it 🖖

Just want to also point out for readers that this entire comment is only about gender affirming care and has nothing to do with medically treating cancer, but because we are affirming my breasts for my gender as a cis woman, its just healthcare.

Not the OP, but knowing someone who's been through something similar I can answer a few of your questions. She had this surgery nearly two decades ago, so modern procedures may be completely different:

• Adipose tissue and skin from the belly was moved to the breast. The tissue was left completely intact, including nerves and blood vessels.
• A nipple was tattooed onto her skin, no tissue sculpting, etc.
• Since all the nerves and vascular system was intact, any sensation on her new 'breast' was still mapped to her belly.
• Her new breast was sculpted to be the same size and shape as the healthy one.
• Since her new breast was made with belly tissue, any weight gain/loss may be uneven compared to her other breast.

Self care is important for one's mental health

This one is very common is cis-het men. Know people in Trump country that have had it done.

I rub it into my underarms where the skin is thinnest. It just increases your T levels so more body hair starts growing, it's not like rogain.

It definitely works, I go into a 3rd party lab for a blood test every three months so I can see exactly where my hormone levels are at, they also test liver, blood numbers, and look for any cancer signifiers.

These was perscribed to me by one of those online telehealth deals, they also do boner pills and hair loss stuff.

I'm sure the internet is full of scam gels. In the US, I'm pretty sure you need a doctor's prescription for the real thing.

Just a heads up so you're sure you're both talking about the same thing here.

This is definitely because a lot of cis ppl don't even know that what they are doing is gender affirming care.

Getting Viagra is GAC. Cis men don't love talking about how they got out on Viagra or need T shots or gels.

Women going through menopause and being given HRT to manage the symptoms are getting GAC. They don't call it that, but that's what it is.

Your argument is deeply flawed, like people who insist that autism didn't exist 100 years ago. It definitely did! We just didn't call it that. Just because you don't call it that, doesn't mean it doesn't exist.

I sincerely doubt that. Almost every plastic surgery that's not a result of a disfiguring accident is gender affirming care. Viagra is gender affirming care. From hair plugs to Corvette is gender affirming care.