How Does Top Surgery Work?
FtM top surgery is the masculine shaping of the chest and removal of excess breast tissue and skin to change a biologically female upper body into that of a man or a gender neutral individual. While the techniques used during the surgical procedure depend upon the patient’s body type, skin elasticity, and breast size, the goal is to bring the patient’s mental identity into alignment physically, allowing them to socially, and professionally present as their true gender.
MtF top surgery is the feminization of a masculine chest through hormone replacement therapy (HRT) supplied by an endocrinologist combined or complemented with breast augmentation. Trans female patients at LPS will need to have been on HRT for at least a year prior to undergoing top surgery. This is because estrogen can enact some impressive changes including breast development, which will impact on the size of implants you ultimately choose for your top surgery. Breast development also stretches the skin of the chest, which makes for a better breast pocket in which the implants will be situated.
Am I a Good Candidate?
Trans individuals most often have top surgery after they are 18. However, for some FtM patients, younger individuals may be considered for top surgery if their legal guardians and mental health providers believe the procedure is appropriate to their health and safety. The maturity level of the patient must be considered as well in such instances. Male chest reconstruction isn’t recommended for transmasculine or non-binary individuals with future plans to breastfeed, as the procedure interferes with the proper functioning of the milk ducts.
The situation is a bit different for trans women. Breasts will grow naturally for up to 18 months from the onset of estrogen treatment, and it’s best to wait until that growth has finished. In addition, the FDA has only approved the use of saline implants for women beginning at 18. You must be 22 to receive silicone implants per the FDA approval rules.
Your LPS surgeon can help you understand the timing of top surgery procedures as it applies to your specific case during a comprehensive consultation.