Top surgery is often the first major procedure transgender patients consider in their quest to align their physical appearance and gender identity. It’s one of the fastest ways to profoundly relieve gender dysphoria, making it popular with transgender patients at Longwood Plastic Surgery. How soon can you expect to feel the relief that comes with top surgery? Here are some guidelines.

Before & After

subcutaneous mastectomy Boston
subcutaneous mastectomy Boston

How Does Top Surgery Work?

The majority of transgender surgeries LPS surgeons perform are top surgeries. The most common procedures our transgender patients seek are (female to male or chest masculinization) FtM top surgery, and (male to female or chest feminization) MtF top surgery.

FtM top surgery involves removing glandular and fatty tissue in the chest region to achieve a flatter, more masculine presentation. The techniques used depend on the individual patient’s breast size and skin elasticity. For trans men with larger breasts, Double-Incision top surgery is recommended. Patients with smaller breasts, tighter skin, and good skin elasticity may have success with Periareolar or Keyhole techniques. Your LPS surgeon will help you understand each type and which is best for you.

MtF top surgery enhances breast size and shape using breast implants. For trans women, many of the same techniques used for cisgender women apply, mostly involving the choices of implant—saline versus silicone, implant shape and volume, and placement of the incisions. Each strategy has advantages and can be tailored to the patient’s unique anatomy.

Am I a Good Candidate for Top Surgery?

LPS requires MtF patients to receive at least 1 year of Hormone Replacement Therapy (HRT) prescribed by an endocrinologist or physician who monitors your hormone levels. Your breasts will grow naturally for up to 18 months with estrogen therapy. Giving them a chance to reach their full size will enable you to make more informed choices about the implants you ultimately select.

FtM patients do not need Testosterone therapy to undergo top surgery at LPS, though it may help build the muscles of your chest in advance.

How Long Does Top Surgery Take?

Your top surgery will take place in our accredited surgical facility under general anesthesia, and you’ll likely be discharged the same day for comfortable recovery at home.

The length of FtM top surgery depends on the technique used. DI surgery takes 2-4 hours, Keyhole takes 3-4 hours, and Periareolar takes around 1.5-3 hours. MtF top surgery averages 1-2 hours in duration.

Top Surgery Consultations Available

How Long Does Recovery Take?

Recovery can vary depending on the patient’s healing patterns and adherence to the detailed post-op instructions they receive.

FtM Top Surgery 

For patients with less strenuous jobs or who attend school, you can expect to return within 1-2 weeks. For men with more physically demanding jobs, it can take 4-6 weeks depending on how strenuous the job is or how much lifting is required. It can take between 6-8 weeks before you’re cleared to resume weight training workouts.

MtF Top Surgery

Trans women can routinely expect to return to their work within 1 week. You may still experience discomfort or pressure on your chest as you acclimate to the weight of your implants, and it’s recommended you wear a surgical support bra for a few weeks. Bras with underwires and aggravate healing incisions, particularly if your incisions are located in the area under your breast. It can be several months before your implants settle into their final position.

The results of your top surgery can alleviate the mental burden that comes with fear of being “clocked” in public or being treated as your birth gender rather than your true self. Schedule a consultation at LPS to get started.

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 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.