Transgender FTM Chest Reconstruction

"Top surgery" is typically one of the first procedures that FTM patients undergo. This involves the removal of breast tissue to create a male chest. There are two main surgical techniques that can be used to reconstruct the chest. Which technique is used depends on the amount of skin and breast tissue present.

For those with a lot of excess skin and breast tissue, the most common procedure is the bilateral simple mastectomy with nipple grafts, commonly known as the double incision (DI) surgery. This procedure does leave a scar on each side of the chest, but the scars are generally placed along the lower border of the pectoral muscle fold to help hide the scaring. While the scars are permanent, they should fade significantly with time. The area around the nipple (the areola) is reduced to an appropriate male size and is repositioned to an appropriate male location.

For those with minimal excess skin and breast tissue, another technique called a Subcutaneous Mastectomy is preferred as it removes breast tissue leaving only a small "key hole" incision. The clear advantage is that there is much less scarring.