I am Trans Non Binary. Is it possible for someone with a C cup breast to undergo a periareolar top surgery? (Photo)

I do not consider that periarolar technique will be adequate. Although permanent, the double incision may be discrete and would provide the possibiity of a flat chest.

Thank you for your question and photos.  The skin is the key.  The amount of skin and the elasticity of the skin.  As you get into a C cup, you are definitely trending towards a larger breast with more skin.  In these situations, a periareolar or extended periareolar incision can have higher revision rates because of unwanted excess skin and folds.  Best to have an examination by an experienced surgeon.  Best wishes 

Dear Edrike, Thank you for your question. Unfortunately, it is not possible to determine if you would be a candidate for the periareolar approach. I suggest scheduling a consultation with a Board Certified Operating Surgeon for an in person assessment. At this time, he or she can determine what the best surgical option is for you. Best of luck to you!

Your photos are not helpful (clothed), though they suggest that skin-reducing mastectomies may indeed be required due to the size of your breasts seen in the lateral views. Photos of your chest unclothed may allow an online answer, but in "borderline" cases, a physical examination and personal assessment will be required, not to mention a surgeon who has years of experience doing top surgeries for transgender patient of all anatomic types. (I have been doing both periareolar and skin-reducing (double incision) mastectomies (top surgery) for 3 decades, and now do this operation dozens of times per year, in addition to hundreds of other non-transgender breast operations).Of course, every patient wants the fewest incisions and least scars, but please search "botched transgender surgery" on this (RealSelf) site for a few examples of keyhole surgeries (because the patient "really had to have periareolar incisions" or "really important for my dysphoria to not have any horizontal scars") gone bad, rather than what their second operation will require--double-incision skin-reducing total mastectomies with nipple/areola grafts in proper size and position.Unfortunately, there are well-trained, ABPS-certified plastic surgeons with years of experience (even decades) who will refuse to admit they have little experience with transgender mastectomies. They think lots of cis-gender breast surgeries "automatically confers transgender wisdom" and perform Wise-pattern breast reductions or near-total mastectomies, and then rationalize bad results with "preserving tissue so nipple sensation is preserved," or positioning the lower double incision above your present inframammary creases (leaving both a scar AND your old crease), or simply telling you what you want to hear, doing the surgical procedure you want rather than what is needed, and end up surprising both you and themselves! (Can you imagine ANY ethical and reputable plastic surgeon who has results like these "botched cases" and doesn't avoid ever doing that again?I fear you will end up like these examples if you are unwilling to accept the reality of your own anatomy. Double-incision top surgery is ALWAYS required with breasts above a certain size, and these sizes will differ with age, skin thickness, skin elasticity, and healing. "Finding the right surgeon" cannot supersede the biophysics of skin stretch and healing, regardless of what someone with "special skills" may tell you. And, of course, you really WANT to be told this, so you will pay thousands of dollars (insurance may not cover this surgery--again, regardless of what some surgeons may tell you), undergo the WRONG surgical procedure, and end up here on RealSelf asking how this can be "fixed."Then you have the surgery you should have had in the first place (more cost, another surgery, another time off work and social activities, another year for scars to mature and fade), not to mention your final result may not be as good as the one you might have had if you had received the PROPER advice and surgical procedure as your FIRST operation. Some things can be improved, but not always completely "fixed."So please have a more open mind, see experienced top surgery experts who are also ABPS-certified plastic surgeons. and get a couple of opinions. The wisdom of my advice will then become apparent.  BTW, for a few examples of my own top surgery patients (some non-binary like you), click on the web reference link below (all of the top surgery patients are mine) or refer to my FTM Chest Masculinization Surgery photos (drop-down menu under Photos) here on RealSelf. Best wishes! Dr. Tholen    

Thanks for your question and photo.  Although it would be more accurate to comment with an unclothed photo, it appears that you have a moderate amount of breast tissue and skin. Although, in theory a periareolar resection could be done, it will likely leave a significant amount of loose skin. This needs to be weighed against the additional scar. I recommend you consult with a surgeon who has significant experience with transgender and non binary breast reconstruction. Each surgery needs to be tailored for the patients needs.  Best Regards.Dr Deboni@drdeboni

Hello ,
To assess for surgery it is very difficult or impossible to do through clothing. I see that you do have moderate sized breasts so that makes it most likely you are a DIM candidate. For smaller breasts there is sometimes the possibility of a keyhole pattern where the only scars are under the areola. Some surgeons I have seen do a complete Periareolar approach but I have rarely seen good results with that technique.SincerelyDr.G

While the keyhole method is technically possible on anyone, it does not always yield the most ideal or natural looking results if done on someone who has excess skin, as this can lead to malposition of the nipple or a deflated skin appearance. From your photos, it does appear that if you are going for a flatter look, you may more want to strongly consider a method that allows more skin removal such as double incision. Of course, this completely depends on what your final goals are. 

Hello and thank you for your questions and your pictures.
From your pictures and your description, it appears that you have a fair amount of skin and breast tissue that will need to be removed. Using a periareolar incision only without any horizontal extension is possible but will limit the amount of excess skin and breast tissue that can be removed. You will have to discuss this in detail with your plastic surgeon so an appropriate surgical plan can be made for you.
Best wishes!
Olivier A. Deigni, MD, MPH
Houston Plastic Surgeon