What is Transgender Surgery?
Transmasculine Top Surgery
The goal of transmasculine top surgery is to remove breast tissue and fat from both breasts and resize the nipple areolar complex in order to create a masculine appearance to the chest.
Transfeminine Top Surgery
Transfeminine top surgery often involves the use of saline or silicone breast implants. Autologous fat grafting may also be used to enhance and improve the results.
Quick Facts
- ANESTHESIA: Light general. Usually outpatient surgery.
- SIDE EFFECTS: Temporary bruising, swelling, numbness, soreness, burning sensation.
- RISK: Infection. Injury to the skin. Rippling or bagginess of skin. Asymmetry. Excessive scarring if tissue was cut away. Need for second procedure to remove or add additional tissue.
- RECOVERY: Tasks of daily living may be resumed immediately. Back to non-strenuous work (no lifting greater than 10 lbs) in 5 to 7 days. No strong pushing, pulling or repetitive upper body movements for 3 weeks.
- EXERCISE: Resume low impact activities at 2 – 3 weeks (1/3 duration of exercise, repetitions, amount of weight and pulse rate). Moderate impact activity @ 4 – 6 weeks. Full intensity including high impact (running, horse back riding, high impact aerobics) @ 8 weeks.
- FADING & SCAR IMPROVEMENT: 6 to 12 months.
- SWELLING: Moderate/Significant 4 weeks, Subtle/Mild 2 to 3 months, all of which are dependent upon extent of procedure(s).
- DURATION of RESULTS: Variable. Breast size may fluctuate with hormonal shifts, weight changes and age.
- OFFICE VISITS: 1st 3 to 5 days / 2nd Visit 10 to 14 days. Anticipated office visits: 4 to 5 the first 3 months then yearly.
- GARMENT WORN: Elastic support vest (male) or bra (female) for 3 to 4 weeks.
- PAIN MEDS: Ibuprofen or Narcotics as needed.
Considerations
The goal of transmasculine top surgery is to remove breast tissue and fat from both breasts and resize the nipple areolar complex in order to create a masculine appearance to the chest. Top surgery is performed as either a single stage or two procedure. There are many techniques used to perform top surgery, and many factors should be taken into consideration when choosing which technique is best:
- Amount of native breast tissue
- Amount of excess skin
For smaller breasts (generally A and small B cups without significant sagging) a single incision technique can be utilized. A small incision is made at the base of the areola and the breast tissue is removed. A second procedure may be required to resize the areola when the breast has fully healed. It is important to note that not all of the breast tissue is removed during the procedure. The operation is not a mastectomy but a breast reduction, leaving enough tissue and fat to create the most masculine chest appearance possible. For larger breasts or breasts with significant sagging, a double incision technique is often utilized. The nipple is removed, resized, and grafted back onto the chest in the correct masculine anatomic position.
The goal of transfeminine top surgery is to enhance the size and shape of the breasts to create a more feminine appearance to the chest. Top surgery is performed as a single stage procedure. There are many techniques used to perform top surgery, and many factors should be taken into consideration when choosing which technique is best:
- Desired amount of breast enlargement
- Placement of the incisions
- Type of implant used
