The revelation that you could be transgender can be powerful and terrifying. What does this mean? How will this change your life? What happens next? Because transgender people often feel a great deal of chest dysphoria, top surgery is one of the biggest steps you can take toward aligning your physical characteristics with your identity. Longwood Plastic Surgery has the expertise, compassion, and skills to answer any questions you may have about everything top surgery involves.
How Does Top Surgery Work?
The goal of top surgery is to align the physical body with the gender identity of trans patients, whether you have Female-to-Male (FtM) top surgery or Male-to-Female (MtF) top surgery. Those constant self-criticisms about how our clothes fit, how others perceive you, and how much you may pass as your true identity can be reduced or vanish entirely with top surgery. It’s about more than physical improvement. It’s about feeling comfortable in your own skin as the person you really are.
FtM Top Surgery
 For FtM top surgery, hormone replacement therapy (HRT) is not required. There are different techniques for sculpting a masculine chest: double incision, periareolar, and keyhole. Double incision involves two horizontal incisions at the inframammary fold to remove breast and glandular tissue. The nipples may need to be repositioned as well or even removed and replaced as skin grafts (free nipple grafts). Periareolar is for smaller breasted patients, with semi-circular incisions around the areola. Breast and surrounding chest tissue is additionally removed via liposuction. Keyhole is for FtM patients with small breasts and a mild to moderate amount of chest skin excess that can be sculpted by excision of the breast tissue and removal of a doughnut of skin, if necessary, allowing your LPS surgeon to also remove excess skin through a circular incision around the areola. All three procedures involve shaping a masculine chest, which can be helped along by both HRT and exercise.
MtF Top Surgery
 MtF patients should be on HRT for 1 year prior to having top surgery, giving your breast tissue and skin a chance to grow naturally. This provides your LPS surgeon a bigger breast pocket in which to place breast implants. There are a multitude of choices in type, shape, and material for breast implants that can enhance your feminine breasts.
Am I a Good Candidate for Top Surgery?
Ideal candidates for top surgery are those who feel chest shaping will align you with your true gender. MtF patients need HRT for a bit before considering the procedure to allow a greater chance of success. If you’re a relatively healthy non-smoker, your chances of successful results increase. The best place to pursue top surgery is to start with a consultation at Longwood Plastic Surgery. In both MfF and FtS Top surgery, patients will need at least one letter of support for their candidacy for top surgery from a primary care physician, psychiatrist, therapist, etc.
What is Top Surgery Recovery Like?
Both FtM and MtF top surgery procedures are performed outpatient at Longwood Plastic Surgery’s accredited surgical suite, so you may return home for a comfortable recovery the same day. Your procedure will be tailored to your specific goals and physical anatomy for the most successful outcome possible. You’ll awaken in recovery wearing compression garments both to reduce swelling and hold your newly sculpted chest in position. For FtM patients, you may have drains that will come out after about a week.
What Results Can I Expect?
For both gender identities, results will be immediately noticeable. Trans men will see an appreciable flatness to their chest even through the compression garment. Trans women will have larger breasts with an unmistakable feminine curve, which aids in achieving the traditional female hourglass shape. In the next 4 weeks, swelling will subside, and your newly contoured physique will be more obvious. Your clothes will fit how they’re supposed to, and you can walk with your head held high knowing you’re well on your way to who you are on the outside matching what’s on the inside.
“Dear Dr. Morris, I truly cannot thank you enough, not only for your extreme generosity and waving my surgery fees, but for being able to fix something that has been such a huge insecurity of mine for the past 20+ years. My note was a relatively involved/difficult surgery and I am so grateful to you for doing it for me.* “
Take the Next Step
Interested in learning about FtM or MtF 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.