Am I eligible to undergo periareolar top surgery? (photos)

Question

I’m a trans ftm person, height of 5’6, 145lbs. Circumference of under my breast is 33.5 inches while the circumference of the fullest part of my breast is 36 inches. Would I be able to undergo periareolar top surgery as I don’t want scars underneath my chest.

Krishna Vyas, MD, PhD, MHS · Answer

Thank you for sharing. A key goal of chest masculinizing top surgery is to effectively remove excess skin and reshape the chest. 
Due to the presence of extra skin, a periareolar approach may not be the ideal choice for you. This method is generally best suited for individuals with less skin excess and smaller breast volumes. 
A double incision approach would be a more appropriate solution. This technique allows for the removal of a larger amount of skin and tissue, as well as better control over resizing and repositioning the areola compared to the periareolar approach.
If minimizing scars beneath the chest is a priority, it's important to discuss all potential options with your plastic surgeon. It is also important to consult with a qualified gender-affirming breast surgeon who can assess your goals and anatomy to customize the procedure for optimal results.
Krishna Vyas, MD, PhD, MHSHarvard and Mayo Clinic Trained Aesthetic and Plastic SurgeonNew York, New York

Elizabeth Kiwanuka, MD, PhD · Answer

Given your measurements and the presence of extra skin, a periareolar top surgery might not be the best option for you. This approach is typically more suitable for those with minimal skin excess and smaller breast sizes. Since one of the primary goals of top surgery is to remove extra skin and reshape the chest effectively, a double incision mastectomy would likely be more appropriate for your needs. This method allows for the removal of a significant amount of skin and tissue, and also provides the opportunity to resize and reposition the areola more effectively compared to the periareolar approach.
Considering your desire to avoid scars underneath your chest, it's important to discuss all potential options and outcomes with your surgeon. They might offer techniques to minimize and improve scar appearance, or suggest alternative strategies that could meet your goals while addressing the excess skin effectively.

Russell Sassani, MD · Answer

Panda_Boy, thank you for your question. It appears that you have breast "ptosis" which means there is a fair amount of excess skin and breast tissue below the level of your inframammary fold. In addition your areola is large and also below the level of the inframammary fold. This situation does not lend itself to a minimal scarring, per-areolar approach to top surgery. In order to make your chest as tight, flat and masculine as possible, a double incision approach with free nipple grafting is going to be necessary, otherwise, you will end up with significant deflated and wrinkled skin below the level of the lower border of the pectoralis muscle and also there will be nipple malposition below the pec border. The areola will also be oversized if not reduced and repositioned. The best candidates for minimal scarring/ peri-areolar approach are small breasted patients with smaller nipple-areolae that are above the level of the inframammary fold. As always, an in-person consultation with a plastic surgeon, well-versed in top surgery can discuss the risks and complications of all of the different procedures and help you determine the best approach for the best aesthetic outcome. Good luck

Jaime Caloca, Jr., MD · Answer

Thank you for your question. In your particular case, you have too much loose skin that will sag after Gland and fat removal from the brest mounds. 
Your Double incision mastectomy would be a wonderful procedure that will be very aesthetic and conform to masculine anatomy.

Am I eligible to undergo periareolar top surgery? (photos)

Answers (4)

Answer: Periareolar Top Surgery NOT recommended.

Answer: Periareolar Top Surgery NOT recommended.

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Everything you need to know about Masculinizing Top Surgery

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Am I eligible to undergo periareolar top surgery? (photos)

Answers (4)

Answer: Periareolar Top Surgery NOT recommended.

Answer: Periareolar Top Surgery NOT recommended.

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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.