Being assigned female at birth (AFAB) when you identify as a man can be increasingly difficult with time. Being treated as a woman rather than a man, having your physical sex characteristics contradict your testosterone therapy, and being constantly conscious of being clocked—these things take a mental toll. The breasts are one of the most outward signs of a feminine identity, so top surgery is the treatment Longwood Plastic Surgery physicians recommend to alleviate this significant source of gender dysphoria.

Before & After

subcutaneous mastectomy Boston
subcutaneous mastectomy Boston

How Does FtM Top Surgery Work?

Your FtM top surgery is designed to shape a masculine chest after removing breast and glandular tissue. Your breast size will determine which techniques are the most suitable for your physique. Some patients who’ve been on Hormone Replacement Therapy (HRT) for a while will have built up muscles that may aid in shaping their chest, but HRT is not a requirement for FtM top surgery at LPS.

The most common technique is double-incision or DI top surgery. Your LPS surgeon will make incisions under your breasts at the inframammary fold before removing breast and glandular tissue and repositioning and resizing your areolas and nipples. Once this is done, excess skin is removed, and the incisions are closed. In many cases, liposuction is recommended toward the sides of the breasts to prevent the “dog-ear” effect.

Patients with smaller chests and less excess skin may be candidates for periareolar top surgery, This technique reserved for patients with small breasts and tight enough skin that there’s no need to remove any. The breast tissue is removed, and a masculine chest shape is sculpted via liposuction. This procedure is virtually scarless as the only incision is a well-disguised semi-circle around the bottom half of the areola. Keyhole or periareolar top surgery is also referred to as nipple-sparing subcutaneous mastectomy as it mostly preserves nipple sensation. This technique results in less visible scarring but often increases the need for revisions to achieve the desired chest flatness. 

FtM Top Surgery Consultations Available

Am I a Good Candidate for Top Surgery?

The positive impact on physical and emotional health of FtM top surgery cannot be overstated for transgender men. If you’re in generally good health, don’t smoke, and understand the kind of results you will enjoy with FtM top surgery, you may be an ideal candidate. Massachusetts also has some of the best insurance coverage for transgender patients available in the US. Check with your insurance provider to determine if some or all of your top surgery may be covered.

What is Top Surgery Recovery Like?

Your FtM top surgery recovery depends on the technique your LPS surgeon uses during your procedure. The first 2-3 days are the most uncomfortable. Your top surgery is performed on an outpatient basis, and you’ll be instructed to wear a compression garment for 2-3 weeks to help with any swelling. 

Some patients will have drains placed in each incision to help control fluid buildup following the procedure. You can expect to feel well enough to return to a desk job around 2 weeks if you’ve had DI top surgery. Keyhole or periareolar patients may feel well enough to do so after 1 week. Patients with more physical jobs may need to be off work for up to 3-4 weeks.

What Results Can I Expect from Top Surgery?

Upon awakening from FtM top surgery, you’ll notice the flatness of your chest immediately. For many patients, the relief of not having breasts is immense. People around you are more inclined to perceive your manhood and treat you accordingly. This makes confidence soar because patients can concentrate on living their life on their terms rather than hiding behind a binder or baggy clothing.

I was recommended to Dr. Morris through my doctor at BID-Needham. Due to prior surgeries, I had some issues and Dr. Morris is the best. He has done a fantastic job with my abdomen core and I feel and look fantastic.

Take the Next Step

Interested in learning about FtM top surgery? Schedule your consultation with Longwood Plastic Surgery today by calling our Brookline office at (617) 383-6250. We serve the Brookline and Greater Boston area with distinction.