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.