I am an FTM transgendered person and I had a terribly botched surgery. My surgeon opted for a small incision around the nipple and Mayo scissor dissection of tissue. The breast tissue removed was 450 grams on one side and 475 on the other. I wanted a double incision mastectomy but he decided at the last minute to give me this type. I need multiple revisions, lost a nipple, and had many infections. Can anyone tell me if that was a good type of surgery for me based on my chest size?
Answer: FTM SURGERY Thank you for your question. Based on your pictures and the procedure and amount of breast tissue removed. I personally would have done a different procedure for you that would have yielded a much different result. Having said that you would need about about year before undergoing a restorative procedure and possibly a secondary procedure to get you to your goal.
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Answer: FTM SURGERY Thank you for your question. Based on your pictures and the procedure and amount of breast tissue removed. I personally would have done a different procedure for you that would have yielded a much different result. Having said that you would need about about year before undergoing a restorative procedure and possibly a secondary procedure to get you to your goal.
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January 24, 2019
Answer: FTM Top Surgery Scar Revision Expert The treatment of FTM scars is different than normal scar revision and is a focus of our office. There are at least seven different priorities in FTM Top surgery revision, including: Reduction of High Tension Scar Widening Revision of Areolar scar width, size, position, and texture.Pigmentation correction for the scar and areola (especially if there is areolar/nipple hypo pigmentation)Textural improvement in scarsContour Correction of the scarContour Correction of the glandular part of the male breast pectorisPectoral footprint reestablishment (concavity or convexity)Hyperemia correction of the scarsOur office specializes in the management of Top Surgery corrections using a Hidef combination approach that minimizes scar visibility and maximizes the footprint of a male pec. This can be achieved with a combination of surgery, RF, laser therapy, intralesional injections, PRP, and scar modulation. Sometimes, liposuction or fat grafting is indicated. Best, Dr. Karamanoukian Realself Hall of Fame
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January 24, 2019
Answer: FTM Top Surgery Scar Revision Expert The treatment of FTM scars is different than normal scar revision and is a focus of our office. There are at least seven different priorities in FTM Top surgery revision, including: Reduction of High Tension Scar Widening Revision of Areolar scar width, size, position, and texture.Pigmentation correction for the scar and areola (especially if there is areolar/nipple hypo pigmentation)Textural improvement in scarsContour Correction of the scarContour Correction of the glandular part of the male breast pectorisPectoral footprint reestablishment (concavity or convexity)Hyperemia correction of the scarsOur office specializes in the management of Top Surgery corrections using a Hidef combination approach that minimizes scar visibility and maximizes the footprint of a male pec. This can be achieved with a combination of surgery, RF, laser therapy, intralesional injections, PRP, and scar modulation. Sometimes, liposuction or fat grafting is indicated. Best, Dr. Karamanoukian Realself Hall of Fame
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April 30, 2017
Answer: Options for a FTP Top Revision Surgery It's usually suggested to wait 6 to 12 months depending on the reason for a #revision and it's still early in your healing. The ideal technique best for you is difficult to determine online by photos alone. 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 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. A board-certified plastic surgeon with specialization is such breast procedures will #confirm the technique best suited for your revision during an in-person evaluation.
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April 30, 2017
Answer: Options for a FTP Top Revision Surgery It's usually suggested to wait 6 to 12 months depending on the reason for a #revision and it's still early in your healing. The ideal technique best for you is difficult to determine online by photos alone. 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 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. A board-certified plastic surgeon with specialization is such breast procedures will #confirm the technique best suited for your revision during an in-person evaluation.
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April 9, 2020
Answer: I am a female to male transgender person who had a botched surgery. Can you tell me what type of surgery I should of had? I generally dislike terms like "botched" surgery, but your surgeon is NOT experienced in transgender top surgery if (s)he truly believed keyhole surgery would leave you with a reasonable result that even would be close to a masculine chest. Especially with the amount of tissue removed! This should have been a star-pattern nipple reduction, areola reduction, and after biconvex elliptical skin-reducing total mastectomies (not an anchor pattern), reconstruction of the nipple/areola complexes as full thickness skin grafts in masculine position (lateral and inferior, at the edge of the pec muscle). For examples of this (proper) operation, and a few examples of (proper) keyhole top surgeries, click on the web reference link below. All examples are my patients over a nearly 3 decade experience with transgender surgery. Sorry you had this (lack of) experience. This is truly one operation that even ABPS-certified plastic surgeons have no business doing unless they have experience with this specific procedure, and can show photographic evidence they know how to choose and do the proper procedure for each transman's anatomy. Revision can correct this pretty effectively. Best wishes! Dr. Tholen
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April 9, 2020
Answer: I am a female to male transgender person who had a botched surgery. Can you tell me what type of surgery I should of had? I generally dislike terms like "botched" surgery, but your surgeon is NOT experienced in transgender top surgery if (s)he truly believed keyhole surgery would leave you with a reasonable result that even would be close to a masculine chest. Especially with the amount of tissue removed! This should have been a star-pattern nipple reduction, areola reduction, and after biconvex elliptical skin-reducing total mastectomies (not an anchor pattern), reconstruction of the nipple/areola complexes as full thickness skin grafts in masculine position (lateral and inferior, at the edge of the pec muscle). For examples of this (proper) operation, and a few examples of (proper) keyhole top surgeries, click on the web reference link below. All examples are my patients over a nearly 3 decade experience with transgender surgery. Sorry you had this (lack of) experience. This is truly one operation that even ABPS-certified plastic surgeons have no business doing unless they have experience with this specific procedure, and can show photographic evidence they know how to choose and do the proper procedure for each transman's anatomy. Revision can correct this pretty effectively. Best wishes! Dr. Tholen
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May 19, 2016
Answer: FTM Top Surgery - Double incision with free nipple grafts Sorry to see that you have had such an unfavorable outcome. Based on the volume removed from each breast, you were likely a better candidate for a double incision approach with free nipple grafts. It appears that you still have a moderate amount of excess skin inferiorly as well as some residual breast tissue that can be removed with a revision of your surgery to the double incision approach. With the standard double incision top surgery with free nipple grafts, the contour will be superior, scar placement can be optimized into the inframammary crease and nipple placement can be achieved into a more masculine position further lateral on the pectoralis muscle. We have also had patients that have opted to not have the nipple grafts placed at the time of surgery and will then seek nipple tattooing postoperatively to place the nipples into the location of their choice. This is a decision you will have to make since you lost one of your nipples - you will either have to sacrifice the remaining nipple and have them both tattooed postoperatively or replace the surviving nipple as a nipple graft and do a nipple reconstruction on the one you originally lost. By all means place yourself into the care of a board certified plastic surgeon comfortable with FTM top surgery and more specifically top surgery revisions. I hope this helps and best of luck with your continued transition!!
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May 19, 2016
Answer: FTM Top Surgery - Double incision with free nipple grafts Sorry to see that you have had such an unfavorable outcome. Based on the volume removed from each breast, you were likely a better candidate for a double incision approach with free nipple grafts. It appears that you still have a moderate amount of excess skin inferiorly as well as some residual breast tissue that can be removed with a revision of your surgery to the double incision approach. With the standard double incision top surgery with free nipple grafts, the contour will be superior, scar placement can be optimized into the inframammary crease and nipple placement can be achieved into a more masculine position further lateral on the pectoralis muscle. We have also had patients that have opted to not have the nipple grafts placed at the time of surgery and will then seek nipple tattooing postoperatively to place the nipples into the location of their choice. This is a decision you will have to make since you lost one of your nipples - you will either have to sacrifice the remaining nipple and have them both tattooed postoperatively or replace the surviving nipple as a nipple graft and do a nipple reconstruction on the one you originally lost. By all means place yourself into the care of a board certified plastic surgeon comfortable with FTM top surgery and more specifically top surgery revisions. I hope this helps and best of luck with your continued transition!!
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