Transgender Top Procedures

Male-To-Female Top Surgery In Michigan

Male-to-female (MTF) top surgery involves a breast augmentation procedure utilizing breast implants to create a feminine chest contour in transgender or gender-expansive patients. MTF patients typically experience some breast development from long-term hormone therapy. Those who desire a larger breast than hormones produce may explore breast augmentation surgery to further enhance the size and shape of the breasts.

Insider Tips For MTF Top Surgery

  • Ask your surgeon about his or her experience with the transgender population and WPATH standards of care.
  • Think carefully about the size of your desired breast implants and discuss your goals and expectations with your surgeon.

How Is MTF Top Surgery Performed?

The goal of MTF top surgery is to create a feminine chest contour. A breast augmentation is performed utilizing saline or silicone implants to enhance the size and shape of a patient’s breasts. The breast implants are inserted under the chest wall muscle through a small incision, typically located along the patient’s inframammary fold crease. The procedure is performed under general anesthesia and patients will typically go home the same day as an outpatient procedure.

Female-To-Male Top Surgery In Ann Arbor, MI

Female-to-male (FTM) top surgery, also called gender mastectomy, involves direct excision of breast tissue with or without liposuction to create a masculine chest contour and reveal the underlying pectoralis muscles in transgender or gender-expansive patients. These changes result in a flat and possibly concave chest, where the pectoral muscles are more prominent than before. The surgeon takes care to remove additional fatty deposits utilizing liposuction as needed based on each patient’s anatomy.

How Is FTM Top Surgery Performed?

The goal of FTM top surgery is to create a masculine chest contour. A variety of incision patterns and techniques may be utilized, including peri-areolar, circumareolar, and double incision with free nipple grafting.  The procedure is performed under general anesthesia and patients will typically go home the same day as an outpatient procedure.

The particular technique used is dependent on a patient’s scar preference as well as breast size and anatomy. The double incision surgery results in a horizontal scar below each pec and the nipples are excised from their original location and repositioned on the chest. The tissue of smaller breasts is often excised via an incision around the areola. Drains are placed to eliminate the buildup of fluid at and around the surgical site. A special compression garment may be worn for a period of time to protect the surgical site, aid in swelling, and promote optimal final results.

Schedule A Consultation

Our Michigan plastic surgery specialists understand that the difference is in the details when it comes to achieving your desired results. Visit Dr. Malhotra and Dr. Ballard at our Ann Arbor or Jackson locations to learn more.

Candidates For Top Surgery

The surgeons at Ann Arbor Plastic Surgery follow the World Professional Association for Transgender Health (WPATH) standards of care for transgender individuals seeking surgery. Individuals seeking top surgery must be 18 years of age and have one letter of readiness for surgery by a mental health provider. Patients younger than 18 may be surgical candidates if the patient, legal guardians, and mental health professional are in agreement that delaying surgery would induce patient harm.

Patients must be in good health with no major medical or physical issues that would preclude a life- and figure-altering surgery. Patients should refrain from smoking at least 4 weeks before and 4 weeks after surgery to reduce the risk of complications. Those accepted as patients must also have realistic expectations of what plastic surgery can accomplish and the resulting scars.

Photo of an actual patient

FAQs About Top Surgery

At Ann Arbor Plastic Surgery, transgender top surgery is considered a cosmetic surgical procedure and therefore no insurance claims are submitted.

Your surgeon will provide specific post-operative instructions depending on which procedure you are planning to undergo. In general, patients will need to avoid strenuous activities except for walking initially following surgery.

Patients undergoing MTF top surgery may experience temporary soreness, swelling, bruising, and changes in nipple sensation immediately following surgery. Patients will need to avoid strenuous activities except for walking initially following surgery and they may be advised to wear a surgical bra for several weeks after surgery. Generally, patients return to work within one week following surgery, depending on the nature of the job.

Patients undergoing FTM surgery may be advised to wear a compression binder over their chest to alleviate swelling for several weeks after surgery. If you undergo free nipple grafting as part of your procedure, you will have bolster dressings on your nipples for approximately five days after surgery, which will be removed in clinic. You may be discharged home with surgical drains in your chest, which will be removed when the output decreases in the first one to two weeks after surgery. Generally, patients return to work within three to four weeks after surgery.