Hello, I previously posted a question about laser liposuction and trying to figure out if it was possible to have surgery with a desired result using that method. I lost weight with the intentions of reducing the size of my chest and was successful going from what I think was a DD to maybe a C cup. I'm looking for something that will give minimal scarring, and little down time. Also, what common problems I might run into given my size and shape?
Answer: Top surgery with your anatomy will require skin-reducing mastectomies and nipple areola grafts. Thanks for including photos, as they are critical in giving you advice specific to your anatomy. Keyhole (periareolar) incisions leave nearly imperceptible scars, so of course every trans patient would prefer essentially "invisible" scar mastectomies. However, to create the most natural, normal male chest appearance requires the areolas be much smaller than your present areola size, the nipples themselves to be much smaller and less protruding, not to mention having the glandular tissue removed in a way that creates a masculine pec area without loose hanging skin.Even after weight loss, your breasts still have excess skin and significant ptosis (droop), which would be retained if only the gland were removed via keyhole incision, whether this was done with lasers or any other method. So you therefore require skin-reducing mastectomies, nipple reduction, areolar reduction, and placement of your appropriately-sized nipple areola complexes as full thickness skin grafts in the normal masculine position (lower and more lateral than central and higher female nipple position).This is a common F-M transgender operation that I have performed for over two decades, and would require about 4 hours of (outpatient) surgery, drains for a week to 10 days, skin graft dressings and care while the grafts become durable for about 3 weeks, and reduced strenuous activity for 3-4 weeks. Scars usually fade nicely after 6-12 months, and if situated correctly, simulate a natural Inferior pec line reasonably well. Someone your size may require touch-up surgery to minimize dog-ears laterally, but this is individual, and can usually be done (if needed) under a small local anesthesia office procedure.For examples of some of my top surgery results, both skin-reducing and keyhole, click on the web reference link below. Best wishes! Dr. Tholen
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Answer: Top surgery with your anatomy will require skin-reducing mastectomies and nipple areola grafts. Thanks for including photos, as they are critical in giving you advice specific to your anatomy. Keyhole (periareolar) incisions leave nearly imperceptible scars, so of course every trans patient would prefer essentially "invisible" scar mastectomies. However, to create the most natural, normal male chest appearance requires the areolas be much smaller than your present areola size, the nipples themselves to be much smaller and less protruding, not to mention having the glandular tissue removed in a way that creates a masculine pec area without loose hanging skin.Even after weight loss, your breasts still have excess skin and significant ptosis (droop), which would be retained if only the gland were removed via keyhole incision, whether this was done with lasers or any other method. So you therefore require skin-reducing mastectomies, nipple reduction, areolar reduction, and placement of your appropriately-sized nipple areola complexes as full thickness skin grafts in the normal masculine position (lower and more lateral than central and higher female nipple position).This is a common F-M transgender operation that I have performed for over two decades, and would require about 4 hours of (outpatient) surgery, drains for a week to 10 days, skin graft dressings and care while the grafts become durable for about 3 weeks, and reduced strenuous activity for 3-4 weeks. Scars usually fade nicely after 6-12 months, and if situated correctly, simulate a natural Inferior pec line reasonably well. Someone your size may require touch-up surgery to minimize dog-ears laterally, but this is individual, and can usually be done (if needed) under a small local anesthesia office procedure.For examples of some of my top surgery results, both skin-reducing and keyhole, click on the web reference link below. Best wishes! Dr. Tholen
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Answer: Chest Masculinizing Top Surgery Aesthetics Thank you for sharing.
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Answer: Chest Masculinizing Top Surgery Aesthetics Thank you for sharing.
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April 7, 2020
Answer: FTM Thank you for your question and for uploading your photos. To give you correct answer you are not a candidate for laser lipo your result will be disastrous. I understand you are desiring now down time and minimal scarring. But the fact is that what you need is a mastectomy with nipple areola reduction and free graft and at the same time pectoral contouring with Vaser high def. Most important make sure you do your research and that your Plastic Surgeon is Board Certified by the American Board Of Plastic Surgery. Best of Luck
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April 7, 2020
Answer: FTM Thank you for your question and for uploading your photos. To give you correct answer you are not a candidate for laser lipo your result will be disastrous. I understand you are desiring now down time and minimal scarring. But the fact is that what you need is a mastectomy with nipple areola reduction and free graft and at the same time pectoral contouring with Vaser high def. Most important make sure you do your research and that your Plastic Surgeon is Board Certified by the American Board Of Plastic Surgery. Best of Luck
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March 5, 2019
Answer: FTM Top Surgery Scar Revision FTM Top Surgery can leave noticeable scars on the chest. Our office
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March 5, 2019
Answer: FTM Top Surgery Scar Revision FTM Top Surgery can leave noticeable scars on the chest. Our office
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April 30, 2017
Answer: Best Technique Options for FTM Top Surgery It's best to begin seeking a plastic surgeon with #board #certification and experience in this type of procedure. You should feel comfortable with your surgeon and his or her office staff. They should be open-minded regarding gender surgery. It’s important for your surgeon to have an aesthetic eye for body contouring, you should be comfortable with the surgical facility that your doctor uses and it should be certified. There are several methods used which depend upon the patient’s breast or chest #size before surgery. Considerations include the #laxity of skin, the #size of the #areola, the amount of #fat and recent weight #gain or weight #loss. The most common procedures which are described include the #periareola, #buttonhole, #double incision, and #anchor patterns. I often use #liposuction along with the double #incision for larger breasts, and, some variation for smaller breasts; depending upon the position of the areola. The female breast nipple and areola are often centered on the breast. However, the nipple and areola are lower and closer to the outside edge of the #pectoralis muscle in the male patient. Shaping the side of the chest may also be required and can be performed with #suctioning; along with contouring of the muscle, as noted above, to provide the best definition for the chest. Being each person varies, it’s important to be realistic about your goals and what is achievable. 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.
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April 30, 2017
Answer: Best Technique Options for FTM Top Surgery It's best to begin seeking a plastic surgeon with #board #certification and experience in this type of procedure. You should feel comfortable with your surgeon and his or her office staff. They should be open-minded regarding gender surgery. It’s important for your surgeon to have an aesthetic eye for body contouring, you should be comfortable with the surgical facility that your doctor uses and it should be certified. There are several methods used which depend upon the patient’s breast or chest #size before surgery. Considerations include the #laxity of skin, the #size of the #areola, the amount of #fat and recent weight #gain or weight #loss. The most common procedures which are described include the #periareola, #buttonhole, #double incision, and #anchor patterns. I often use #liposuction along with the double #incision for larger breasts, and, some variation for smaller breasts; depending upon the position of the areola. The female breast nipple and areola are often centered on the breast. However, the nipple and areola are lower and closer to the outside edge of the #pectoralis muscle in the male patient. Shaping the side of the chest may also be required and can be performed with #suctioning; along with contouring of the muscle, as noted above, to provide the best definition for the chest. Being each person varies, it’s important to be realistic about your goals and what is achievable. 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.
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August 23, 2016
Answer: FTM top surgery For FTM patients with larger breasts, the "double incision" is really the best option. Anything else simply won't give you a masculine chest contour, and will likely either leave you with extra skin, residual breast tissue, or both. Although the double incision leaves a scar, the trade-off is a much better contour and the freedom to do away with a binder. In order to get a qualified, expert opinion on your surgical options and expectations visit a plastic surgeon certified by the American Board of Plastic Surgery.
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August 23, 2016
Answer: FTM top surgery For FTM patients with larger breasts, the "double incision" is really the best option. Anything else simply won't give you a masculine chest contour, and will likely either leave you with extra skin, residual breast tissue, or both. Although the double incision leaves a scar, the trade-off is a much better contour and the freedom to do away with a binder. In order to get a qualified, expert opinion on your surgical options and expectations visit a plastic surgeon certified by the American Board of Plastic Surgery.
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