Transmasculine Top Surgery (Mastectomy)
Breasts are a major source of gender dysphoria for FTM (female-to-male) transgender people. Hormonal therapy with testosterone can reduce breast tissue over time. However, a mastectomy procedure is usually required to achieve a completely flat and more masculine chest.
Plastic Surgery Procedure
Transgender top surgery for FTM patients is done under general anesthesia. Your plastic surgeon will start by removing breast tissue. In some cases, they will also remove excess skin from your chest. Remaining skin, fat, and muscle are repositioned to create a more masculine contour.
Altering the appearance of nipples is also an important part of the surgery. Usually your surgeon will reduce the size of the areola (darker skin around the nipple) and will reposition the nipple to be more lateral and lower on your chest.
Mastectomy Recovery and Results
As with any plastic surgery, Dr. Hess and Dr. Sandeen will make individual recommendations for steps you need to take during the healing process. Most patients require drains after top surgery. You will also likely need to keep the area bandaged and will need to reduce your level of activity. Make sure to talk to your plastic surgeon to get answers to your specific questions.
This type of surgery involves an incision across your chest which will leave a visible scar. This may appear less prominent over time, but it will never disappear completely. The surgery also results in reduced nipple and breast sensation. For a significant number of transgender men, these trade-offs are small compared to the benefits. Many men feel more confident and feel reduced gender dysphoria following surgery. After appropriate recovery time, you will be able to enjoy going to the beach topless and will usually look more masculine due to your flatter chest.
Breast Implants for Transgender Women
MTF (male-to-female) transgender individuals often experience some degree of breast development during hormonal therapy. However, many of these women desire larger breasts in order to achieve a more feminine appearance. This can be incredibly helpful for your self-confidence and can reduce gender dysphoria.
Breast Augmentation Surgery
Breast augmentation for transgender women is often very similar to the process for cisgender women. An incision is made on the breast and the implant is placed either under the skin and glands or under the pectoral muscle. You will be able to choose between silicone, saline, or mixed implants. This will depend on your desired breast size and shape.
In same cases, transgender women do not develop enough breast tissue during hormone replacement therapy to support a breast implant. In these cases, your plastic surgeons will perform breast augmentation surgery in two steps. Before implants are placed, you will need to stretch the skin of your chest with skin expanders. These are inserted at the same location as your future implants. Your surgeon will slowly increase the size of the expanders over time until there is enough coverage to complete breast augmentation.
Transgender Surgery Recovery and Results
The recovery process for breast implants is different for every individual. Dr. Hess and Dr. Sandeen will go over specific recommendations for your recovery. In general, you should expect to reduce your activity. There is usually some pain and swelling and you may require a drainage tube. We always work with our patients to reduce recovery time as much as possible.
After breast augmentation, you will have larger breasts that contribute to a more feminine appearance. Our highly-skilled plastic surgeons always strive for the most natural-looking results possible. We will work with you to meet your individual desires.
Does Insurance Cover Transgender Surgery?
Transgender surgery is not usually covered by medical insurance, so you should have a plan for covering the cost of the procedure. However, it’s always a good idea to call your insurance provider and check to see if they do cover top surgery for transgender individuals. Coverage varies between providers and plans. Hess and Sandeen Plastic Surgery also offers financing options, such as Care Credit, allowing you to make payments over time rather than covering the full cost upfront. We are happy to discuss options for financing your procedure.