What type of top surgery do I have a chance at? (Photo)

Question

I was always a 36A, on the larger side of A, until this spring when I started birth control. Now I fill a B cup, and think I am a larger B. But this also doesn’t account for regular weight lifting and benching, etc. that comes with college sports. I don’t know how much pec muscle I’ve gained. From what I can tell I have good skin elasticity, but is it worth waiting until getting on T to make a decision? Ultimately I’d rather have Peri or keyhole if possible. I also have Grade 3 inverted nipples.

Jaime S. Schwartz, MD, FACS · Answer

Great question, and thank you for sharing your photos. In my practice, we require all transgender (and non-binary) clients who are considering a top surgery to have been on hormones for at least 18 months prior to their top surgery. The reason for this is that hormones alone may result in a decrease of breast tissue, increased body and facial hair, and other significant physical changes. The two major methods I use for this type of surgery are double incision mastectomy with nipple grafting and keyhole. Double incision mastectomy procedure is ideal for medium to large chested women. Keyhole (also known as peri-areolar) is ideal for a small chested woman, up to a b-sized chest, with good skin elasticity. 
    
Which method we choose for your 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. 
  
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 mastectomy, transgender top surgery, and aesthetic and restorative breast surgery. 
  
best of luck! 
  
Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Harun Zekirovski, DO · Answer

I would definitely recommend starting testosterone first and waiting to see how your body changes. The hormones can potentially decrease the volume of your beasts and give you more surgical options. Right now, your volume may be too large for a periareolar procedure. My preferred procedure is the partial mastectomy with free nipple grafts. It places the scar in the most anatomical position and gives the best chest contour. The drawback is loss of nipple sensation. I recommend being on testosterone for at least a year and reevaluate the chest at that time. Good luck with your decision!

Rukmini S. Rednam, MD, FACS · Answer

Hello izperry,Certainly the birth control can be a reasons why you have a larger cup size in addition to pectoral muscle mass.  Waiting 6-12 months after starting testosterone should show a decrease in breast size but the extent is not always predictable.The double incision approach often provides the most aesthetic male chest contour and allow repositioning of the areolas to a more masculine positioning. However using a keyhole or periareolar approach provides the option of retaining partial nipple sensation in some cases and vascularity but does require that some breast tissue remain to be successful.Make sure to seek out a board certified plastic surgery with experience in FTM top surgery who makes you feel comfortable and who can help you achieve your goals with transitioning journey.Best of Luck!Dr. Rednam

Jaime Caloca, Jr., MD · Answer

Hello and thank you for your photos. I recommend the double incision mastectomy that will enable us to remove all excess skin, fat and gland. The relocation of the areola and nipple complex to a masculine position is also an advantage of this procedure.

Karthik Ram, MRCS, DNB · Answer

Hello, thanks for sharing your pics.  Exercising doesnt change the breast size may be the birth control pills and weight gain has added volume. Testosterone definitely reduces the breast size and may take over 6 months of usage to attain results. Hopefully you can get away with periareolar mastectomy if the size comes down significantly.

What type of top surgery do I have a chance at? (Photo)

Answers (8)

Answer: FTM CHEST SURGERY

Answer: FTM CHEST SURGERY

Answer: FTM Top surgery

Answer: FTM Top surgery

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Everything you need to know about Masculinizing Top Surgery

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What type of top surgery do I have a chance at? (Photo)

Answers (8)

Answer: FTM CHEST SURGERY

Answer: FTM CHEST SURGERY

Answer: FTM Top surgery

Answer: FTM Top surgery

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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.