Female to Male Breast Surgery

    Last updated date: 14-May-2023

    Originally Written in English

    Female to Male Breast Surgery

    Female to Male Breast Surgery

    While most men desire a physically fit masculine chest, some have small breasts or relatively large breasts. In most cases, this causes discomfort, hence the need to modify the chest region. Female to male breast surgery, also known as top surgery or masculinizing chest surgery, is the corrective procedure to consider. 


    Transgender breast surgery female to male

    Generally, female to male breast surgery is designed for people with intend to adjust the breast shape, size, and overall appearance. The primary aim of the procedure is to remove the breast tissue from the breasts. This is to form a more masculine and flat chest appearance among men with feminine-shaped and sized breasts. 

    Top surgery, along with hormone therapy, is generally one of the initial stages for patients transitioning from female to male. Top surgery is performed in a single stage.

    Subcutaneous mastectomy is generally the initial surgical procedure in sexual transition for female-to-male transsexuals. Subcutaneous mastectomy's major goal is to achieve an aesthetically appealing male chest shape by eliminating all glandular tissue while reducing chest-wall scars.

    Bilateral subcutaneous mastectomy in female-to-male transsexuals is one of the most important steps in gender reassignment surgery because achieving a male chest configuration with this first operation, importantly, facilitates living in the chosen gender role, especially when they have large breasts. In these individuals, mastectomy entails surgically removing all gland tissue as well as the necessary amount of skin and subcutaneous fat tissue.

    After thorough psychiatric examination and endocrine therapy, chest masculinization with subcutaneous mastectomy is typically the first and most significant stage in the gender reassignment process for female-to-male transsexuals. The primary objective of this surgery is to provide an aesthetically appealing chest shape with minimum scarring.

    Although the operative technique is similar to that of a gynecomastia correction or a mastectomy for breast disease in a female patient, subcutaneous mastectomy in female-to-male transsexuals is more difficult than both procedures due to significantly higher breast volume, a greater degree of skin excess, and lower quality skin elasticity. Breast binding also has an adverse effect on skin excess and elasticity.

    Patients who have undergone top surgery frequently ask if their breasts will "grow back" if they acquire weight. Because this surgery eliminates actual breast tissue (rather than merely fat tissue), patients would need to acquire a significant amount of weight for the chest to regain a feminine look. Keep in mind that the outcomes of top surgery are considered permanent and are not reversible.


    Best Candidates for Female to Male Breast Surgery 

    Generally, female to male breast surgery is a highly individualized approach. Most people opt for the procedure to make their bodies look good and physically fit. However, you might be an ideal candidate if you;  

    • Are at the right age to make consent 
    • Have been diagnosed with constant gender dysphoria 
    • Are under the comprehensive care of a mental health specialist who can give recommendation letters to support your decision about the surgery 
    • Have realistic expectations and a positive point of view 
    • Are living as a member of your preferred gender 
    • Have a mental health issue or well-controlled health condition 
    • If significant medical or mental health concerns exist, they must be reasonably well-controlled


    There are several ways used to conduct top surgery, and many criteria should be considered when determining which approach is best:

    • Amount of breast tissue
    • A desire for nipple sensation
    • Amount of excess skin


    A variety of surgical methods may be used to remove the desired breast tissue. The most frequent procedure is referred to as a "bilateral mastectomy with free nipple grafts."

    This procedure allows for the removal of almost all of the breast tissue (including milk ducts) and excessive skin, as well as the appropriate positioning and shrinking of the nipples. This technique is most commonly used because the majority of patients present with excess skin and a naturally low nipple position.


    Female to Male Breast Surgery Options 

    There are several surgical options that surgeons use to modify the breast. The incisions to create during surgery depend on the chest size and the firmness or elasticity level. Therefore, the common female to male breast surgery options can include the following; 

    • Double incision surgery 

    Double incision surgery is performed by creating horizontal or U-shaped incisions on the lower and upper breast tissue and chest muscles. Also, the surgeon will cut out both the nipple and areola. The skin is then peeled off from the backside to allow removal of the chest and fatty tissues. 

    After removal, the top and the bottom incision are joined and sutured together. This usually results in scarring that runs beneath the pectoral muscles after the surgery. The nipples and areola are defatted, resized, and grafted on the chest at an appropriate location. 

    • Keyhole surgery 

    A keyhole top surgical procedure is suitable for individuals with a smaller chest and elastic skin. It involves the creations of tiny incisions along the bottom part of the areola. Through the incision, the surgeon will take out the breast tissue. 

    With keyhole procedure, the nipple stalk remains intact and doesn’t also involve resizing the areola. Furthermore, it helps maintain the nerve sensation. In other cases, the surgeon can combine keyhole surgery with liposuction. This is to help flatten the regions surrounding the nipple and areola. 

    • Periareolar surgery

    Periareolar surgery is suitable for people with great skin elasticity and moderate chest tissue. It involves the creation of incisions around the areola and nipple area. Another incision is created in a concentric circle a few inches further from the nipple. The surgeon will also remove the skin around the incisions to make it easier to remove the tissue. Using the drawstring technique, the surgeon will reconnect the areola and the nipple. 

    • Inverted-T surgery 

    When performing inverted-T surgery, the surgeon will create horizontal incisions along the upper and lower chest muscles. This is similar to the double incision procedure. The breast tissue will be taken out through the incisions while the areola and nipple are left intact. 

    Another vertical incision is created on both sides of the breasts. The incision will run from the areola down towards the incision on the chest muscles. The additional incision enables the surgeon to reduce the nipple and areola and reposition them correctly without damaging the nerves. This helps preserve the breast sensation. 


    What to Expect From Female to Male Breast Surgery?

    The following will help you prepare in advance for the scheduled top surgery procedure; 

    During the procedure:

    Your surgeon will:

    • Examine your overall health as well as any pre-existing medical problems or risk factors.
    • Examine your breasts and take measures of their size and form, as well as the quality of their skin and the location of their nipples and areolae.
    • Get lab testing
    • Discuss your choices and make a treatment plan.
    • Discuss the most likely results of top surgery, as well as any dangers or potential problems.
    • Make sure to ask your plastic surgeon any questions you may have. You must comprehend every element of your top surgery. To assist you, we've created a list of questions to ask your cosmetic surgeon that you may bring with you to your consultation.
    • It's normal to have some anxiety, whether it's excitement for your upcoming new appearance or a little preoperative worry. Don't be afraid to express your emotions to your plastic surgeon.


    How should I prepare for transmasculine top surgery?

    In preparing for transmasculine top surgery, you may be asked to:

    • Please provide a letter of recommendation from your therapist.
    • Take specific drugs or make changes to your present medications
    • Quit smoking.
    • Aspirin, anti-inflammatory medications, and herbal supplements should be avoided since they might cause excessive bleeding.

    transmasculine top surgery

    Typically, female to male breast surgery is performed on an outpatient basis.

    • The first step will involve general anesthesia administration since this surgery is a major procedure. Hence the anesthesia medication is necessary to make you unconscious and prevent you from exercising pain during the treatment. 
    • Step 2 – Mastectomy to remove the breast tissue

    The breast tissue on your chest will be removed during a mastectomy. Excess skin may also need to be removed at times.

    • Step 3 – Creating a masculine shape

    After the breast tissue and any excess skin is removed, the remaining tissues must be repositioned to create a masculine contour to the chest.

    • Step 4 – Repositioning the nipple and areola

    After a mastectomy, the nipple and areola may need to be reduced and/or relocated on the chest. The nipple and areola are smaller and more lateral and inferior on the male chest.


    Female to male breast surgery is more than a mastectomy procedure conducted to treat breast cancer. Instead, it involves the use of special tools to reduce and contour the chest wall. This also helps position the areola and nipples and reduces scarring. 

    If the breast's size is smaller, the surgeon will recommend a procedure that spares the nipple, areola, and surrounding skin. This procedure is also known as a subcutaneous nipple-sparing mastectomy. It’s characterized by reduced scarring, a quick recovery process, and preserves nipple sensation. The approach involves the creation of incisions on the surrounding skin and around the areola borders. The surgeon will remove the breast tissue via the incision and can also remove a section of the skin. After that, he or she will reattach the remaining skin at the areola border. 

    For individuals with large breasts, the surgeon can remove the nipple and areola. They will then resize and place them back in a good position to give the patient a male chest appearance. However, this technique could result in loss of nipple sensation and more scarring. Non-erotic nipple sensation could return after a few months or even years. 

    In case you are a carrier of the gene mutation that might increase the chances of developing breast cancer, you can consider total removal of the nipples and areola. A subsequent surgery or tattoo can help recreate chest appearance. 


    After the Procedure:

    Following the surgical procedure, the chest will stay in a compression wrap for a few weeks. The surgeon might as well insert one or two tiny plastic tubes in the surgical area. This helps drain fluids that build up after the procedure. The surgeon will also recommend sleeping while the torso is raised for at least one week. It’s essential to refrain from lifting heavy stuff weighing ten or more pounds for the first few weeks. 

    Regardless of the treatment procedure, a small amount of breast tissue is likely to remain. Therefore, the surgeon will advise you to continue with the regular screening for breast cancer. 

    Besides, additional surgery might be necessary to correct chest contour and scarring. It can also help with the placement of the areola and nipples. 


    Follow Up and Additional Treatment:

    After six months following the procedure, the surgeon will review the condition and assess the recovery process. Through this, they can also determine if additional surgery is required. Examples of other surgical procedures that might be considered include; 

    • Liposuction to remove extra glandular or fatty tissue from the breast to create a flat contour 
    • Nipple reconstruction to replace the nipple lost during surgery 
    • Areola and nipple tattoo to enhance chest appearance 


    Recovery after transmasculine top surgery

    Gauze or bandages will be placed on your wounds following your transmasculine top surgery. An elastic bandage or support bra will help to reduce edema and provide support for the rebuilt chest. To drain any extra blood or fluid, a small, thin tube may be temporarily inserted under the skin.

    Specific instructions will be given to you, such as how to care for your surgical site(s) after surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to see your plastic surgeon.

    Healing will continue for several weeks as swelling decreases and the chest shape improves. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.


    What results should I expect after transmasculine top surgery?

    • The final results of transmasculine top surgery may assist to alleviate feelings of gender dysphoria that certain people may have.
    • When female breast tissue is removed, some sensation in the chest is usually lost as well. Some feeling in the chest skin and nipples may return over time, and scar lines will improve, though they will never fully disappear. Although there are trade-offs, most transmen believe they are minor in comparison to the significant improvement in their quality of life and ability to appear and feel like a man.
    • Even though breast tissue is removed during the surgery and breast tissue development is slowed by testosterone therapy, the danger of breast cancer does not go away. Self-examination is an important part of keeping track of your breast's term health.
    • If you have shortness of breath, chest aches, or irregular heartbeats when you get home, get medical help right once. If any of these problems arise, you may need to be admitted to the hospital and get further treatment.
    • Medical and surgical practice is not a precise science. Although positive outcomes are anticipated, there is no assurance. In some cases, a single surgical operation may not be enough to produce ideal outcomes, and another procedure may be required.
    • The outcome of your operation depends on you following your doctor's recommendations. During the healing process, the surgical incisions mustn't be exposed to undue force, abrasion, or motion. Your doctor will provide you with detailed advice on how to take care of yourself.


    Risks and Complications of Female to Male Breast Surgery 

    The decision to get top surgery is a highly individual one. You must choose if the advantages will help you reach your objectives and whether the risks and potential problems are acceptable. Many people consider this surgery to be a vital step in overcoming their gender dysphoria.

    Your plastic surgeon and/or team will go through the dangers of surgery in great detail. You'll be asked to sign consent documents to confirm that you understand the treatments you'll be having and any risks or issues that may arise.

    As with any other type of surgery, female and male breast surgery also carries several risks complications. They include; 

    Hematoma: This involves accumulations of the partially clotted blood beneath the skin at the surgical site. Depending on the seriousness, additional surgery might be necessary to drain the fluid. 

    Asymmetry: This problem arises when the two sides of the breasts appear uneven after surgery. Another procedure might be necessary to address the issue. 

    Bruising: This is common after the procedure. However, it can sometimes make the breast to discolor, and the discoloration can spread to the abdomen. With time, the body will suck up the bruising. 

    Infection: Regardless of using antibiotics, infections on the surgical wound can still occur. Its thus essential to see the doctor if you notice signs like redness, discharge, heat, and high temperature. 

    Seroma: This occurs when the serous fluid accumulates between the breast skin and the tissues. Although the body usually absorbs the fluid, it may cause discomfort if they collect in large amounts. 

    Loss of nipple sensation: Depending on the type of surgery, nipple sensation can be completely lost, or small loss might occur. In other cases, the feeling can increase, especially if the nipple area is retained during surgery. 

    Scarring: This is likely to occur after surgery and can slowly fade off with time. However, this can vary from one person to another. People who develop an infection in the surgical area are likely to have a scar that thickens and takes an extended period to fade. Also, without infections, people with Keloid condition where excess tissue grows around the wound might experience scarring. 


    Other risks and complications associated with female to male breast surgery include; 

    • Bleeding 
    • Formation of blood clots 
    • Synmastia 
    • Fat, skin, and nipple necrosis 
    • Loss of skin sensation around the surgical site
    • Loss of nipple graft


    The physiotherapist will show you your exercises and make sure you perform them the day after your operation. You should continue with this exercise as recommended by the physiotherapist because it will help you regain your full range of upper-body mobility and prevent any extra fluid from accumulating.

    This sort of operation usually requires a two-day stay. The day after your surgery, you will be evaluated by your surgeon, and if everything goes well and you have had no complications, you may be discharged at this time.

    You'd have to remain in the area, therefore a room at the hotel would be necessary. You won't be able to travel until the next day. This night would necessitate the presence of another person. If you're traveling by automobile, a cushion or soft pillow should be placed under your seat belt for comfort and protection. Seat belts are still required by law.

    The recovery time after surgery usually lasts 4-6 weeks. Some bruising and swelling are to be expected, but this will go away with time. You are free to leave the house and engage in usual activities, but heavy lifting and lifting your arms over your head are not recommended. We do recommend that you take some time off work; the amount of time you should take depends on the sort of employment you have.

    Driving a car at this time is not recommended since you will require a complete range of upper body motions and the ability to make an emergency stop. We recommend that you keep doing the exercises that the physiotherapist showed you until you have regained full range of motion.

    You can remove your binder out after six weeks. You'll need to keep using the micropore tape for three months after surgery. After that, you can start applying bio oil to your scars. If everything is recovered and healthy after six weeks, you may start going to the gym and swimming. You can undertake a more difficult job and drive.


    How much does a female to male surgery cost?

    The cost of transmasculine top surgery varies according to the surgeon's skill and geographic area. Ask your plastic surgeon about patient payment options for transmasculine top surgery.

    Transmasculine top surgery costs may include:

    • Surgeon's fee
    • Hospital or surgical facility costs
    • Anesthesia fees
    • Prescriptions for medication
    • Post-surgery care
    • Medical tests and x-rays

    Remember that the surgeon's experience and your comfort with him or her are just as essential as the final cost of the operation when picking a board-certified cosmetic surgeon for transmasculine top surgery.

    The cost of a Mastectomy can range from $8400 to $8600. The exact prices will be established once we have a better understanding of your specific needs and desires for the process. Transmasculine top surgery is a reconstructive operation that is usually funded by insurance. However, your insurance may only pay a portion of the overall cost.



    Female to Male Breast Surgery

    Female to male breast surgery is generally a procedure to take out breast tissue from a person’s breasts. It aims at creating a better masculine appearance of the chest. There are several techniques that surgeons often use when performing the surgery. The suitable approach will depend on factors like the amount of breast tissue, skin, and nipple sensation desire. 

    CloudHospital specializes in top surgery for transgender men to help every person in need. It works with renowned surgeons and doctors to perform the surgery and provide comprehensive care to individuals with gender dysphoria.