Is it possible to have FTM top surgery after a breast reduction?

Question

I had a breast reduction in order to alleviate severe back pain about two years ago. The reduction was accomplished using a free nipple graft method due to the size of my breasts. However, I am also a transgender man who is currently pre-op and not yet on testosterone. I was wondering if my previous breast reduction would prohibit me from getting FTM Subcutaneous Mastectomy and male chest contouring in the future.

Gary J. Alter, MD · Answer

I have done top surgery on several patients who had previous breast reductions with excellent results.

Krishna Vyas, MD, PhD, MHS · Answer

Yes, it is absolutely possible to have top surgery (chest masculinizing procedure) after a breast reduction. Many individuals who have previously undergone breast reduction surgeries are able to pursue chest masculinizing top surgery with good results. 
Residual breast tissue can be removed, and the chest can be contoured to create a more masculine shape. If your original reduction involved free nipple grafts, these can be resized and relocated as needed during top surgery (if desired). The nipple and areola can be reattached and repositioned to achieve a more masculine chest appearance. 
Testosterone is not a prerequisite for top surgery. If you choose to start/stop hormones around surgery, be sure to let your surgeon know, as this may affect results and scarring.
It is important to consult with an experienced plastic surgeon who can customize your surgical plan and determine the best technique for you based on your individual anatomy and goals.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Babak Dadvand, MD · Answer

Hi,Thanks for the post. It is absolutely possible to have TOP surgery after breast reduction. I have performed these surgeries with excellent results. Testosterone is not a pre-requisite for having FTM TOP surgery. Sincerely,Dr. Dadvand

Michael Eisemann, MD · Answer

Hello and thank you for your question. Yes, you can have an FTM top surgery after having had a breast reduction procedure. In these cases, your original incision location can often be re-used, and your grafts resized and relocated where appropriate. Select a board-certified plastic surgeon with a speciality in FTM top surgery who also has ample experience in performing these surgeries. When you are ready, schedule several in-person consultations with board-certified plastic surgeons in your area to discuss their experience and see before-and-afters photos of actual patients. Best of luck!Michael Eisemann M.D.
Plastic Surgeon
Houston, Texas

Chris Porter, MD · Answer

Absolutely you can. Your PLastic Surgeon will take into account your previous surgery, your current scars and the nipple grafts. The grafts can again be elevated, resized and relocated. The residual breast tissue can be excised and the current fold scar can be re-used. Make sure you are treated by a Plastic Surgeon with a keen interest in FTM top surgery.

Sheldon Lincenberg, MD · Answer

Yes of course it is possible. We understand that the earlier breast reduction was also a way to de-feminize the chest. You are now ready for a male chest and your procedure should finally give you the result that you desire.

Robert H. Hunsaker, MD · Answer

Not at all. In some ways this makes it even more predictable as you already have the maximum amount of scars possible and preserving sensation/blood supply to the nipple/areola is not a concern since you would have another free nipple graft.

Carlos Gonzalez Legarda, MD · Answer

Yes you can, but of course take the same nipple for a second graft can give a no good aesthetical result. If that is your case, then you can have a secondary areola nipple reconstruncion

Is it possible to have FTM top surgery after a breast reduction?

Answers (8)