FTM: I'm a bigger transman and I want a flat chest, what surgery do I need to achieve this? (Photo)

Question

I have 48 dd and I want a males chest I haven't started my t shots yet does that matter I wanna know what surgery do I need do to have a flat chest.

Jaime S. Schwartz, MD, FACS · Answer

Excellent question. Thank you for sharing your photo. 
In my practice, we understand that transgender patients are on a journey to aligning their physical body with their gender identity, and that the journey can be a long and sometimes difficult one. Some transgender men may consider a top surgery to help them feel more like their authentic selves. FTM top surgery (breast reduction) can provide you with the masculine looking chest that better represents your gender identity, reduce body dysmorphia, and result in better overall body confidence. But ultimately the decision will be yours. 
  
During your initial consultation, we determine based on your individual goals and desired body shape how to tailor your top surgery specifically to you. 
The two major methods I use for FTM top surgery are double incision mastectomy with nipple grafting and keyhole. Keyhole (also known as peri-areolar) is ideal for small chested transgender men, up to a b-sized chest, with good skin elasticity. Double incision mastectomy procedure is ideal for medium to large chested transgender men, such as yourself. During this procedure, the skin on the chest is opened along two horizontal incisions, at the top and bottom of the pectoral muscle. (The muscle itself is not touched.) The skin is pulled back and the breast tissue is then removed. In both techniques, additional liposuction may be performed to adjust the contour of the chest, and the areola complex can be resized and made smaller and more oval for a more masculine appearance. 
Which method we choose for your top surgery will depend on the size of your breasts. But, rest assured, no matter how much breast tissue there is to remove, there is a surgery for you. Our goal is to help you feel comfortable, happy, and confident in your own skin. 
  
The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery. best of luck!
  
Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Jed H. Horowitz, MD, FACS · Answer

Top Surgery is the #reduction and masculinization of the breasts and chest for a person who wants a more #masculine chest.  This is often an individual who desires #gender reassignment. Breast tissue is #removed and the #nipple position is usually made smaller and then placed in a more masculine #anatomic #position.  Top surgery allows for a more #comfortable chest with improved psychosocial benefits. Clothing fits better, physical activity may be easier. The chest can also be made more masculine with fat #grafting or #implants to provide a more muscular and #sculpted #appearance. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Babak Dadvand, MD · Answer

Hi transman101,Thanks for the post and photo. Refer to the link provided for a more detailed explanation but generally speaking, larger breasts will require double incision with free nipple grafts. Sincerely,Dr. Dadvand

Josef Hadeed, MD, FACS · Answer

If you have a large breast size, you will likely require a mastectomy with nipple grafting in order to masculinize the chest.

Sheldon Lincenberg, MD · Answer

The most important factor to consider is your choice for a surgeon.Your plastic surgeon must be familiar with mastectomy for gender transition as well as very experienced with performing this procedure in the heavier man. You do not want to end up with an overly flat chest.

FTM: I'm a bigger transman and I want a flat chest, what surgery do I need to achieve this? (Photo)

Answers (8)

Answer: FTM top surgery

Answer: FTM top surgery

Answer: FTM mastectomy for heavier men

Answer: FTM mastectomy for heavier men

Recommended reading

Everything you need to know about Masculinizing Top Surgery

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FTM: I'm a bigger transman and I want a flat chest, what surgery do I need to achieve this? (Photo)

Answers (8)

Answer: FTM top surgery

Answer: FTM top surgery

Answer: FTM mastectomy for heavier men

Answer: FTM mastectomy for heavier men

Browse related questions

Recommended reading

Everything you need to know about Masculinizing Top Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.