I am 21, transgender, and I have discussed mastectomy with my doctor but I don't like the results I've seen: it's assumed the patient will start HRT which will give muscular definition to the chest post-op, without which it often results in a "hollow-chested" and overly flat (or even concave!) look. I don't want HRT, and I wouldn't be happy with this result, so I'm looking into mammoplasty as I don't mind a bit of fat left there. What is the smallest size possible? Do I have any other options?
What is the Smallest Reduction Possible from a 28E Measurement (For a Transgender Patient)? (photo)
Doctor Answers (3)
Female to male breasts
A vertical breast reduction scar on a male breast is difficult to explain and in my opinion is to be avoided. Rather, One should remove the breast using a long IMF incision (bottom breast fold) and re-insert the nipple as a free nipple graft. It will not have sensation (And obviously it will not be able to produce milk).
Transgender female to male
If you are planning to have a flat chest to go from female to male, then a mastectomy type reduction will be necessary to achive that goal.
Breast reduction for transgender patient
Hello 'frainbow', thanks for your question. If your goal is to obtain a masculine and flat chest, then the best option would be near-completion mastectomies with free nipple grafting. HRT should not be necessary for muscular definition, unless you will use it for other masculinizing effects. If you still wish to have some breast tissue but smaller, then a traditional wise-pattern breast reduction should be able to get you to an A or B cup. Either way, you will need to accept some scars from the incisions to achieve a significant reduction. Liposuction alone would not benefit you for your concerns. I would recommend consulting with a board-certified plastic surgeon in order to further discuss your goals and review your options. Hope that helps! -Dr.92660
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