Reconstructive Surgery

FTM Top
Surgery

Female-to-Male (FtM) gender-affirming surgeries focus on masculinising the chest through mastectomy, reconstructing the external genitalia and modifying facial characteristics to align with a male appearance. Chest masculinisation surgery, commonly known as “Top Surgery”, is the most frequently performed procedure among individuals with gender dysphoria. In most cases transgender mastectomy represents the initial and often sole surgical step in the transition process.

BRIEFLY

Duration of procedure

Procedure time
2-3 hours

Type of anesthesia

Anesthesia
General

Hospital stay days

Hospital stay
1 night

Return to work after surgery

Back to the office
10-14 days

Female to Male Top Surgery

For healthy individuals, a preoperative assessment is conducted on the day of surgery. The procedure itself is performed under general anaesthesia and typically takes between 2-3 hours, depending on the preferred surgical technique. The excised breast tissue is always sent for histological examination.

Absorbable internal sutures are used, thus eliminating the need for removal. The patient remains in the hospital overnight for post-op care and monitoring and is discharged the following day with comprehensive instructions and a prescribed course of antibiotics.

About FtM Top Surgery

Upon discharge, the patient will have an elastic compression bandage around the chest and two drains in place in order to remove excess fluid from the surgical site. These drains are removed within a few days at a follow-up clinic appointment. The elastic bandage is then replaced with a special compression vest, which is worn for approximately 4-6 weeks.

Most individuals can resume daily activities within 7-10 days, while strenuous physical exercise is permitted after one month.

All surgical incisions result in scarring. Despite advanced surgical techniques, some individuals may experience hypertrophic or keloid scars at the incision sites or around the areolas.

To optimise healing, patients are provided with specific scar management instructions, including the application of silicone dressings and healing creams. Chest hair growth in the area can also help conceal minor scarring or slight asymmetry.

Early complications include haematoma, infection or nipple and areola necrosis. These are very uncommon and can often be prevented with meticulous surgical technique and patient compliance to postoperative care guidelines.

When the Double Incision technique is performed, the nipple and areola are repositioned as grafts, leading to a sensory response akin to normal skin. In all other techniques, nipple sensitivity is generally preserved.

FTM_Topsurgery_Double_Incision_beforeFTM__Topsurgery_Double_Incision_After

FtM Top Surgery techniques

The primary goals of Top Surgery include the removal of breast tissue, the elimination of excess skin and the fixation of the nipple and areola at the location of the masculine breast. The choice of mastectomy technique depends on the size and degree of ptosis (sagging) of the breasts, as well as the patient’s individual preferences:

  • Double Incision with Nipple Grafting: The most widely used technique, yielding excellent results. The nipple and areola are resized and repositioned as a graft.
  • Periareolar Technique: Suitable for patients with small breasts and minimal excess skin.
  • Keyhole Technique: Ideal for very small chests without excess skin.

Photos Before & After

DO YOU HAVE QUESTIONS?

What You Need to Know

Chest masculinisation surgery is performed on adult patients and, in some cases, minors with parental consent. The procedure is suitable for Trans men and Non-Binary individuals. It is also safe for those undergoing hormone therapy; however, a temporary pause in hormone use may be recommended preoperatively to minimise the risk of thrombosis.

The appropriate surgical technique depends on factors such as breast size, skin elasticity and individual preference. A consultation with the Plastic surgeon will help determine the optimal approach to achieve the desired outcome.

No, as the breast gland is completely removed. However, significant weight gain may lead to fat accumulation in the chest area.

In most cases, no further surgery is required. However, minor revision procedures may sometimes be necessary to refine the aesthetic outcome.

Strenuous physical activities can typically be resumed one month after surgery. Lighter activities may be reintroduced gradually under medical guidance.

All publicly available images have been shared with patient consent. During your consultation, additional images of different techniques and outcomes can be reviewed to provide a clearer understanding of the results.

The total price varies depending on the surgical technique and patient anatomical characteristics and is determined following a clinical assessment.

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