What Is Top Surgery: Everything You Need to Know

Many transgender men and non-binary individuals decide to undergo top surgery to make their outer appearance match their true gender identity. Top surgery can be an essential part of your affirmation journey. There are various choices when it comes to top surgery. The right one for you hinges on what you hope to achieve, your body type, and the size of your chest. Consult with a surgeon who specializes in gender-affirming care. If you are transitioning your gender identity and considering cosmetic procedures to masculinize your body, learn more about what to expect with top surgery.

Gender-Affirming Top Surgery 

Gender-affirming top surgery is also known as chest surgery or breast surgery. It is typically performed on people who wish to make their physical appearance match their gender identity and minimize feminine body features. This may be male, non-binary, or another gender.

The surgery involves the removal of breast tissue and reshaping of the chest. This creates a masculine or gender-neutral chest contour. Techniques used can vary depending on the individual’s goals and body characteristics. Some people may choose to have nipple and areola reconstruction as well.

Top surgery can be an important step in gender-affirmation. Consult with specialists experienced in transgender healthcare. They can assist you in developing a personalized plan and discuss the potential risks and benefits of the procedure.

Am I a Good Candidate for Top Surgery?

Good candidates for top surgery are transgender men seeking a more masculine chest appearance, non-binary people who want a gender-neutral chest, and gender-diverse individuals who want a more harmonious physical appearance. This surgery can alleviate stress from disconnection between gender identity and physical characteristics.

Candidates for top surgery are usually adults who have lived in their gender identity for a while. The decision to undergo top surgery is deeply personal. If you are considering top surgery, consult with healthcare professionals with expertise in transgender healthcare to understand your options. You can learn about the potential risks and benefits of top surgery. From there, you can make a choice that best aligns with your gender identity and well-being.

Types of Top Procedures

Specific techniques for top surgery vary depending on your goals and chest characteristics. The basic steps often involve making incisions to remove breast tissue and excess skin. The nipple and areola may be resized and repositioned. This creates a masculine or gender-neutral chest contour. Common top surgery options include double incision mastectomy, periareolar mastectomy and keyhole mastectomy.

A double incision mastectomy involves making two horizontal incisions across the chest, removing breast tissue and extra skin, and repositioning the nipples. This method is suitable for those with larger breasts looking for a significant transformation.

A periareolar mastectomy involves making a circular incision around the nipple area to remove breast tissue and extra skin. It typically leaves a less noticeable scar. It's a good choice for people with smaller to medium-sized breasts.

A keyhole mastectomy uses small incisions and liposuction to remove breast tissue. It's a good choice for people with minimal breast tissue and skin. It results in minimal scarring for a natural appearance.

Top Surgery Before And After

The entire top surgery process requires attention to detail. Find a compassionate healthcare team who can guide you through the initial preoperative conversations, the delicate operative procedures, and the critical post-operative recovery.

How to Prepare for Top Surgery

Start the process by scheduling a personalized consultation with a gender-affirming surgeon. During this discussion, share your goals and expectations. Your surgeon will select the most appropriate technique based on this feedback.

Some surgeons may require a letter from a mental health doctor to confirm your readiness. A physical evaluation also ensures your overall physical health.

Adjust medications or habits that may impact the surgery and recovery. You should also take into account financial planning, insurance coverage, and budgeting for related expenses. Pre-operative care also includes planning for your recovery. Arrange for a support system to assist you, as you may have limited mobility.

Top surgery can bring significant physical and emotional changes. Seek emotional support from friends, family, or support groups as needed. Plan for at-home care. Have a family member or loved one accompany you to the surgery and assist you during recovery. Following all instructions will lead to a safe and successful top surgery experience.

What Happens During Top Surgery

The surgery typically begins with anesthesia. This ensures that you are pain-free and asleep throughout the procedure. Next, the surgeon makes incisions based on the chosen surgical technique. This includes removing breast tissue and excess skin to create a flatter chest. Nipple and areola reconstruction may also be performed. The procedure ends with the careful closure of incisions with sutures.

After surgery, you will be monitored in a recovery area while you emerge from anesthesia. When you are ready to be discharged, your family member or loved one will provide transportation back home. Pain medication will ease discomfort. You are often required to wear compression garments to reduce swelling and support the chest during healing.

Top Surgery Recovery

Individuals typically experience soreness, swelling, and limited mobility in the days after surgery. Changes in chest sensation and feeling are also common. Pain medication is prescribed to manage discomfort. You can return to light daily activities and work within one to two weeks. Strenuous activities and heavy lifting should be avoided.

Individuals may go through a range of emotions during recovery. It is important to have emotional support during this period.

Following your surgeon’s care instructions and attending follow-up appointments will guide your successful recovery. It can take several months to a year for the final results to show and for scars to continue fading. Healing rates may vary, so be gentle on yourself during this process.


What are the Risks of Top Surgery?

Top surgery, like any surgical procedure, comes with its own risks and rewards. Risks include potential surgical complications. These can be infection, bleeding, and anesthesia-related issues. Scarring is a normal outcome, and changes in nipple and chest feeling can occur.

On the other hand, the rewards of top surgery can be profound. It can provide gender affirmation and reduce gender dysphoria. This leads to improved mental and emotional well-being. Enhanced self-confidence and improved quality of life are common outcomes. The surgery allows you to shape your chest appearance according to your preferences. Many report long-term satisfaction with the procedure, sharing its positive impact on their lives.

Choosing the Right Top Surgery Surgeon For You

To understand your options for top surgery, schedule a consultation with an experienced surgeon. Seek a surgeon who is experienced in cosmetic procedures and gender-affirming care. Your surgeon should listen to your goals and then develop a personalized plan.

ART Surgical was established by Dr. Angela Rodriguez with the goal of delivering empathetic and tailored gender-affirming healthcare. Identifying a gap in surgical services for transgender, non-binary, and gender-diverse individuals, Dr. Rodriguez recognized the importance of offering care that is centered on the distinctive goals of each person.

Click below to schedule your consultation and discuss your options for top surgery with Dr. Rodriguez.

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