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?
What's my Best Surgical Option for Gynecomastia/FTM Top Surgery? (photo)
Doctor Answers 13
Mastectomy with nipple graft
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
Given your size, you would probably need double incision mastectomy and nipple/areola grafting.
Our office is set up to handle a lot of patients that travel in for surgery for our expertise.
We can help set up recovery facilities, hotels and make the experience wonderful for you.
Because of this you may even come by yourself.
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 aesthetic and restorative breast surgery.
best of luck!
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Double Mastectomy with Free Nipple Graft Technique
Whenever there are drooping breasts, the chest contouring will require removal of the extra skin and repositioning of the nipples up to where they should be at the lower edge of the pectoral muscles. To accomplish this, there will be sizable scars on the chest, although the scars are a fair trade-off for the greatly improved contour.
Best Surgical Option for Gynecomastia/FTM Top Surgery
FTM Top Surgery Options
Thanks for the post and pics. The only procedure you should even consider having is double incision top surgery, with mastectomy, free nipple/areolar graft, and skin excision. Any other "less invasive" surgery will leave you very unsatisfied.
FTM Breast Reduction
Double incision mastectomy
Gynecomastia/Female to Male top surgery technique
Healing from this type of surgery should be reasonably quick. Most patients would be able to return to work and most activities within 2 weeks. Drains would remain in place, in most cases, for 5-10 days. Patients are up and moving around almost immediately after surgery. Revisions (usually dogears) are not that uncommon in this type of surgery and are generally done--at the earliest--about 6 months after the initial procedure. Most revisions can be done under local anesthesia in an office setting. Best of luck.
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