Female-to-male transition questions?

Alright. I am a young man trapped in a young woman's body, and I am likely going to start hormone therapy within the next month. Of course, I have the "breast problem". I currently have a 36 A breast size. Once I start hormones, is there any way to tell how much breast fat will transfer to the abdominal region? And how much surgery would be necessary in the future to get the remaining tissue out? The best estimate you can give would be very greatly appreciated.

Doctor Answers 3

Double incision mastectomy with nipple graft

Treatment with T may change the breasts to some degree, but the only way to achieve the look you are wanting is with double incision mastectomy with nipple graft.

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Female to male top surgery questions

The use of male hormones will change a number things, but is not likely to result in the "transfer" of fat from the breasts to the abdomen.   The male hormones will likely change your fat distribution and increase your muscle mass, but are not required prior to F-to-M top surgery.  The type of surgery required is highly dependent on your current breast size and shape.  You state that you're currently a 36A, which is favorable in terms of F-to-M top surgery.  As a general statement, the smaller the existing breasts, the more straightforward the surgery.  The surgery is designed not only to decrease the contents of the breast (fat and breast tissue), but also to address the skin envelope.   The position and size of the nipple also needs to be addressed in most cases.  The best way to answer your question is to arrange a consultation with a Board Certified Plastic Surgeon experienced with this type of surgery.  Best wishes.

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 20 reviews

Female to male transgender questions about top surgery.

Although you have small(er) breasts (36 A-cup), starting hormone therapy does not cause "transfer" of breast fat to any other area of your body. However, testosterone does cause some reduction of fatty tissues (breasts and elsewhere), strengthening of muscle and increase of muscle mass, hair growth, voice deepening, etc. You do not need to be on testosterone therapy to undergo "top surgery," but should have lived full time as a male for at least a year. Depending on the amount of breast tissue present at the time of transgender mastectomies, periareolar excision (scar only around the areola) of the breast tissue may be possible, though this would not be recommended if you have larger areolas, or large(r) amounts of breast tissue and skin that would require skin-reducing, areola-reducing, and nipple-reducing mastectomies.

For examples of each of these types of transgender mastectomies, click on the web reference link below. Seek ABPS-certified plastic surgeons who have performed transgender surgery for many years, as top surgery is not something that is taught as part of "standard" plastic surgical training, and requires experience with this subset of patients. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 178 reviews

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