Male to Nonbinary Looking to Remove Breast Tissue (Photo)

Question

I took estrogen as a trans individual and do not like the breasts tissue that formed as a result. I am 40 years old and want a reduction or removal without scaring. I am an A cup and athletic / in good physical condition (155 lbs 5'11"). I have two letters for the surgery and looking for any sort of non scaring ./ nonbinary breast tissue removal to get as flat as possible with minimal scars.

Gary J. Alter, MD · Answer

The breast tissue can be removed through an incision around much of your areola. Hopefully, the skin will contract requiring no further surgery as your skin looks tight. However, that is unpredictable. If you need more skin removed after the surgery, it would require much smaller incisions than removal at the initial surgery.

Dr. Alter

Sincerely,

Dr. Alter

Sincerely,

Krishna Vyas, MD, PhD, MHS · Answer

It is important to note that any surgical procedure to remove breast tissue, such as a breast reduction or chest masculinization surgery, will typically leave some form of scarring. While techniques like liposuction or minimally invasive methods can help minimize scars, achieving a completely scar-free result isn't possible for most patients. Since you're looking for minimal scarring, a skilled plastic surgeon specializing in gender-affirming surgery can offer options like a periareolar (around the nipple) incision, which can be discreet.

The periareolar technique involves making an incision around the areola, the darker skin surrounding the nipple, which helps minimize visible scarring by concealing it within the pigmented skin. This technique is particularly beneficial for individuals with smaller to moderate breast sizes and is ideal for those who want a flatter chest while preserving a natural-looking nipple-areola complex. It allows the surgeon to reposition the nipple to achieve a more masculine or neutral chest appearance, with minimal scarring visible around the areola’s edge. Though the periareolar method generally preserves nipple sensation, there is a small risk of changes or loss of sensation due to tissue manipulation. Each case is unique, so it's essential to consult with a surgeon experienced in nonbinary and gender-affirming chest surgeries to discuss your goals and the best approach for minimal scarring and optimal results.

Dr. Krishna Vyas, MD, PhD, MHS
Harvard, Johns Hopkins, & Mayo Clinic Educated
Double Fellowship Trained 
Aesthetic Plastic Surgeon
New York, New York

Eric Swanson, MD · Answer

Unwanted breast tissue in males (gynecomastia) or in trans-patients is treated the same way, using an incision along the edge of the areolar (periareolar) to access the breast tissue that is then removed, leaving a pad under the nipple and areola. It is common to perform liposuction simultaneously. The skin tends to contract and the results usually look great.

Jaime Caloca, Jr., MD · Answer

Hello. Since you are an A-Cup and do not want extensive scars, I recommend the Periareolar, Subcutaneous Mastectomy. That means that through an inconspicuous incision placed exactly on the lower half of the areola borders, I can remove all unwanted gland and fat in order to comnsiderably flatten your chest.

Elizabeth Kiwanuka, MD, PhD · Answer

Based on you photos, a periareolar top surgery with a "donut" skin excision might indeed be a suitable option for you. This type of surgery is often recommended for individuals who have a smaller amount of breast tissue and limited excess skin, which matches your situation as someone with an A cup size. The periareolar technique involves incisions made around the areola, which can minimize visible scarring compared to other methods. Additionally, your good physical condition and specific requirements for minimal scarring align well with this approach.

Longwood Plastic Surgery - Brookline · Answer

You can look into peri areolar top surgery. With this method a small incision would be made underneath each nipple to remove the breast tissue, rather than one or two larger incisions across the chest. This option allows for very minimal scarring, making this a good option for you. This technique is generally done on individuals with small amounts of breast tissue and with good skin quality, meaning skin generally on younger people that has not been overly stretched. Ultimately, the decision is up to your surgeon as it depends on each individual.