FTM Female to Male Top Surgery in Melbourne
What is Female to Male Top Surgery?
Female to Male Top Surgery (FTM), Transgender Chest Surgery or Gender Cosmetic Mastectomy, is a surgical procedure performed to remove the breasts and shape a more masculine chest. The procedure includes the removal of breast tissue and excess skin, while properly repositioning and reconstructing the nipple area.
Dr Patrick Briggs, Specialist Plastic Surgeon (FRCS) has comprehensive experience in bilateral mastectomy and chest contouring that alters the female breast to mimic and function as a male form. However, several technical aspects need to be considered beforehand.
The primary goal of female to male – FTM top surgery is to remove breast tissue in order to make the chest appear more masculine. We typically perform a mastectomy for transgender men to remove their breasts. The surgery is also commonly called transmasculine top surgery and masculinising chest surgery.
FTM Top Surgery can be performed by two different techniques, depending on your breast size and physical appearance. Bilateral Mastectomy is a technique performed in patients with larger breasts, while the Perialeoral approach is applicable for patients with smaller breasts.
What are the benefits of Female to Male Top Surgery?
Since the effect of testosterone to reduce breasts in trans men is minimal, FTM Top Surgery plays an important role in relieving gender dysphoria and helping improve their quality of life.
Benefits that FTM Top Surgery patients experience are:
- Significant improvements in psychological and social functioning
- Enhanced body confidence
- More masculine look
- Lower future risk of breast cancer
- More masculine chest and sculpted appearance
- Improved self-confidence, feeling more comfortable in your own skin
- Increased ability to “blend in” in public, appear more traditionally masculine
- Results are considered permanent and typically not reversible
Am I a Good Candidate for Female to Male Surgery?
- Unhappy with your breast shape and size
- Have realistic expectations before undergoing surgery
- Good physical and mental health
- Non-smoker, or a smoker willing to quit
- 18+ years old
- Able to make a decision based on complete information and to consent to the surgery
Then you may be a good candidate for FTM Top Surgery.
FTM Top Surgery Before & After
Want to see more ‘real patient’ FTM Top Surgery before and after photographs, performed in Accredited Melbourne Hospitals by Dr Briggs, a highly experienced Specialist Plastic Surgeon?
What Should I Know About Having Female to Male Top Surgery?
Before the operation, you will have an appointment with a surgeon to determine and completely check your health and set a plan for your surgical approach..
This is a good time to ask questions to make sure you understand the procedure and to fully understand the reasons but also the risks of the surgery. Your surgeon will decide which surgical technique is best for your case.
Depending on your medical record, you will receive pre-operation instructions that may include:
- Not eating or drinking for at least 12 hours before the operation
- Avoid blood-thinning medications
- Refrain from smoking
- Refrain from drinking alcohol
FTM Top Surgery is usually performed under general anaesthesia, which means you won’t be conscious during surgery. Dr Briggs will make an incision around your chest and remove the breast and other tissues that need to be removed.
The incision is then closed with sutures.
Female to Male Procedure Details
There are several techniques for performing Female to Male top surgery which are based upon the incision given, size and shape of the breasts, size of the nipple, and areola. All the techniques have been discussed below:
- Double Incision with Free Nipple Grafts:
Several different techniques can be used to perform FTM top surgery. The double incision technique is the most common and most widely used method. During surgery for a double incision technique, your plastic surgeon will make two horizontal incisions at the top and bottom of your breasts. The incisions are designed to emphasise your natural pectoral muscles and will look more natural and masculine after time.
Once your plastic surgeon makes the incisions, they will lift the skin, and remove fatty tissue along with the nipple. Your nipple will then be resized and repositioned on your chest to create a more masculine appearance. Your plastic surgeon may also choose to pair the procedure with liposuction to shape your chest and achieve a firmer look.
It is also known as a bilateral mastectomy. This surgery is done if you have medium to large sagging chests. A horizontal or curved incision is made on the upper and the lower border of your chest muscle. The skin is peeled back then the exposed fatty tissue is removed. Another incision is made and nipples are removed, resized, and again grafted back in the necessary position.
This surgery is most beneficial if you are a transgender man whose position of the nipple is lower than the fold beneath the chest. Since the nipple stalk and nerves are cut to be repositioned and grafted, the sensation of the nipple is low. Hence, you may feel the loss of sensation, however, touch sensation is intact. Finally, the skin is sutured below the chest muscle i.e. pectoral muscle.
- Inverted-T Surgery or T-Anchor:
This surgery is for you if you have large chests with some extra skin. In this surgery, an incision is given as an inverted T shape or anchor shape where the nipple and areola are not touched. Since the nipple is preserved, the sensation is intact.
An additional vertical incision will also be required in this surgery.
The main advantage of this surgery over Double Incision surgery is that nipple sensation remains intact and nipple loss is not an issue. However, the drawback is that some tissue must be left behind which helps in blood supply to the nipple. This results in less flatness of the chest in comparison to the double incision surgery.
3. Keyhole Top Surgery:
The keyhole surgical approach involves a tiny incision made below the areola, where the breast tissue is removed. We use the keyhole surgical approach for patients with smaller chests. Using the keyhole technique, the areola and nipple stay intact, and most sensation remains. No excess skin is removed in this approach.
It is a perfect surgery for you if you have a small chest. Like the name says, your surgeon will make a small keyhole like incision under the lower border of your areola. The underlying tissue is removed and your nipple sensation will remain intact as well as you will get a comparatively high level of chest flatness.
Recovery From Female to Male Top Surgery
After surgery, you may feel pain and stiffness. The first couple of days are usually the most uncomfortable. Your surgeon and anaesthetist will prescribe some pain medication, but the pain level shouldn’t exceed a moderate level.
After your FTM top surgery, your plastic surgeon will apply gauze or bandages along with a compression wrap or support bra to minimize swelling and support the reconstructed chest. A small tube may also be temporarily placed under your skin to drain excess blood or fluid. You will continue to heal for several weeks as swelling subsides and your results improve. Your plastic surgeon will give you specific instructions to follow after surgery. Generally, you should:
You can expect going back to work or school 2-4 weeks after the surgery, depending on the surgical technique that Dr Briggs has performed and your overall health.
Most patients can go back to their usual physical activities 6-8 weeks after the surgery.
Swelling and pain will gradually decrease in the first couple of weeks, but you will have to sleep on your back for at least 10 days to minimise the pressure on your chest.
Dr Briggs will give you specific recommendations to minimise the scarring. Note that scarring can be dramatically increased by not following the advice given by Dr Briggs and his team.
Some FTM Top Surgery methods require patients to use drains for some time to prevent fluid accumulation.
- Take medication to aid healing and reduce the risk of infection
- Avoid lifting more than 5-10kgspounds for several weeks with your torso elevated for the first week
- Schedule and attend regular follow-up appointments
Also, because some breast tissue typically remains after FTM top surgery, we recommend you talk to your general doctor about routine breast cancer screening after treatment.
When will I see results from my surgery?
As your body heals, you will gradually see your chest taking on a new, more masculine shape and appearance. Mild swelling after surgery may make your breasts appear fuller than they actually are. However, after a few weeks, you can expect swelling to begin to subside. Overall, it will take about 6-12 months to see your final results.
Surgery Prices – FTM Top Surgery Cost & Fees
Every patient is different, therefore the prices vary. You will be given a price quote after your first consultation.
Your FTM surgery quote will include your surgeon’s fee, anaesthetist’s fee and the hospital fees.
It is advisable to check with your private health insurer to find out if you are covered for the surgery before you proceed.
Risks & Complications of FTM Surgery
Like every surgical procedure, FTM Top Surgery comes with certain risks and complications:
- Risk of Infection
- Scar formation
- Numbness under the arms
- Blood accumulation
- Dissatisfaction with the results
- Reduction or complete loss of the nipple sensation
- Failed nipple graft
What should I expect during a Consultation for FTM top surgery?
Your specialist plastic surgeon will evaluate your overall physical and mental health during your initial consultation. They will also take pictures, examine, and measure your breasts to prepare a customised treatment plan.
Next, they will discuss your options, different techniques, and the results you can expect from top surgery. During any FTM top surgery consultation, you should be prepared to discuss:
- Your transition
- Medical conditions, allergies, etc.
- Current medications
- Alcohol, tobacco, and/or drug use
- Previous surgeries
- Surgical Goals
How to prepare for FTM top surgery
Your plastic surgeon will give you specific instructions to prepare for a surgery that you should follow carefully to ensure a smooth recovery process. To prepare for FTM top surgery, you may be asked to:
- Stop smoking
- Avoid alcohol in the weeks before surgery
- Set up transportation for after surgery
- Provide a letter of recommendation from your therapist
- Take or adjust certain medications
- Dress in comfortable, loose clothes
- Stop eating or drinking the night before surgery
- Avoid taking aspirin or other drugs that may increase bleeding
Why Choose Dr Patrick Briggs?
With a wealth of experience and training, Dr Patrick Briggs is dedicated to best-practice patient care and education, customising FTM Top Surgery for each and every patient to best meet their needs and desired surgical outcomes.
Dr Patrick Briggs is fully qualified with current ASPS and ASAPS memberships. Also, when choosing a Plastic Surgeon word of mouth is always a great way to gain further knowledge.
Our Specialist Plastic Surgeon, Dr Patrick Briggs offers high quality, natural-looking surgical results and is highly experienced in gender confirmation surgeries.
FTM Top Surgery FAQs – Questions About Female to Male Top Surgery
Which FTM top surgical method is best for me?
The best way to find out is by consulting your surgeon. Not all patients and body types are the same. FTM Top Surgery is a highly personalised surgical procedure that differs for each and every patient.
What are the effects of hormones on the breast?
Usually, hormone therapy doesn’t assist with a significant change in breast size of FTM patients.
When can I shower after FTM Top Surgery?
You can shower after you have been advised By Dr Briggs at your first post-op appointment but please keep your incision away from direct contact with water. Using wet wipes to keep clean can help in the first days after the surgery.
How long will I have to stay in a hospital?
Some patients are discharged the same day, some stay overnight. It depends on the method performed and how you are feeling.
Will I wear chest garment after the FTM Top Surgery?
It is recommended to wear a compression garment to help the recovery process and get a better result.
Can FTM top surgery reduce nipple sensation?
Unfortunately, loss of some nipple sensation is common for FTM top surgery patients. If you have a double incision top surgery, you will likely experience loss of feeling in your nipples and chest wall skin for up to several months after surgery. Patients who have keyhole incision top surgery retain more sensation, but will still experience decreased nipple sensation for a few weeks after surgery.
What if I already have small breasts?
The keyhole technique is best if you have smaller breasts and tighter skin around your chest. The nipple is not removed using this method. Instead, your plastic surgeon will make a small incision along the bottom of the areola to remove breast tissue with liposuction. This technique reduces the loss of nipple sensation and results in less visible scarring than the double incision method.
Which surgery is best for medium to large breasts?
The double incision method is best if you have medium to large breasts with a slight overhang. In this procedure, your plastic surgeon will remove most of your breast tissue and excess skin, while also resizing and placing the areolas in a more masculine position.
If you have larger breasts, you may need to have your nipples and areolas removed, resized, and grafted back onto your chest to finish your surgery. The double incision method, while highly effective, often results in more scarring and loss of sensation in the nipples.
Further reading – Medical References
- Gender Confirmation
- ASAPS Transgender Chest Surgery
- Transmasculine Top Surgery
- Mayo Clinic – Trans Surgery Article
- Hopkins Medical – Top Surgery
- FTM Surgery