Cystic breasts and FTM top surgery?

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.  
It's best to begin seeking a plastic surgeon with #board #certification and experience in this type of procedure. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate due to your concern. Most likely, you will be screened for any contraindications prior to your procedure during your pre-op appointments. Such may include a mammogram and or ultrasound to name a few. 

I believe proper transgender mastectomies involve removal of 99+% of breast tissue, which would remove all of the cystic changes in your breasts. Only the reduced nipples and areolas, as well as microscopic bits of breast tissue on the underside of the skin/fat mastectomy flaps would remain. You would certainly be a candidate for this surgery. I also recommend sending your mastectomy specimens for pathologic examination (usually covered by insurance even if the top surgery is not).BTW, free nipple grafts would still leave you with large protruding female nipples if the papillae themselves are not concomitantly reduced prior to grafting, or with composite grafts that may not survive completely. I would recommend star-pattern nipple reductions, or at least inverted thinning of the female papillae to reduce protrusion but leaving a "splayed-out" nipple in the center of your areolar grafts. I also hope your surgeon does not use an inverted-T (anchor) pattern, as this is feminine, not masculine. For examples of my own patients undergoing this procedure, click on the web reference link below. Best wishes! Dr. Tholen

I appreciate your question.Having a history of cystic breasts should not interfere with this surgery. From what you are seeing the decrease in estrogen will cause the cysts to shrink.I would recommend a mammogram prior to the surgery and the breast tissue that is removed is sent to pathology.Also, the double incision mastectomy and free nipple grafting does seem to be the best procedure for youThe 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

This should not be a problem or prevent you from having FTM chest surgery.  Just remember that even though you identify as male, there still may be some residual breast tissue remaining and you will need to have regular exmas/screening for breast cancer.  Best of luck

Your cystic breasts are not a problem to get FTM chest contouring surgery.  You should be able to have the procedure without any problem.

Hi MrIncognito2017.  Thank you for your important question.  Cystic change in your breasts is not a contraindication to having FtM top surgery.  Provided you do not have any family history of breast or other cancers and if you are over 40 years you would need a pre-op mammogram +/- MRI to ensure that your breasts are healthy, you are suitable for mastectomy with free nipple grafts.  Please be aware that some surgeons try to leave some breast tissue to enhance a male chest shape instead of performing a complete mastectomy.  I consider this very bad surgery as it leaves Transmen with the terrible burden of having to have yearly or biannual mammographic screening.  What transman wants to sit in a waiting room filled with cis-females having mammograms???  My approach is always to remove ALL of the breast tissue so that future breast screening in unnecessary.  If after 6 months following your surgery you have not achieved a good male contour with regular exercise that I perform fat grafting to the pectoral muscles with provides excellent shape.  Hope that this is helpful an best of luck.

Depending on your age, you may need a mammogram prior to surgery.  Having cystic breasts should not interfere with surgery.  

Hi caldane,Thanks for the post. Having a history of benign cystic breasts will not keep you from getting top surgery. Depending on your age and family history of breast cancer, you may need a preoperative mammogram, but the fact that you have cystic breasts will not make the surgery any more challenging or any less successful. Sincerely,Dr. Dadvand

Your surgeon will not have any greater difficulty doing your surgery because of your cystic breasts. You might ask him/her to open and drain any cysts that are identifiable in the breast tissue that he/she needs to leave behind.