Bilateral subcutaneous mastectomy

Bilateral subcutaneous mastectomy is one of the first surgeries that some trans men request. Removing the breasts is often one of the first steps in matching their body contours to their gender.



Bilateral subcutaneous mastectomy is the surgery that allows removal of the glandular breast tissue while preserving the areola and nipple, and adapting the size of these if necessary. There are three techniques for mastectomy, and the choice depends mainly on the size of the breasts. In addition, your surgeon may advise prior liposuction of the area to minimise scarring.

The aim of this procedure is to achieve a smooth, symmetrical chest, resulting in masculinisation of the thorax.

Resultados de Mastectomía subcutánea

Para ti puede ser importante conocer el antes y después de mastectomía bilateral subcutánea realizadas por el equipo de IM GENDER. De esta manera podrás ver casos parecidos al tuyo y hacerte una idea del resultado final que puedes conseguir.



If you have decided to undergo a bilateral mastectomy, you will be admitted to IM CLINIC on the day of the operation. During this time, you will undergo all necessary monitoring and be prepared for surgery.

To achieve a smooth, masculine chest, IM GENDER’s team of surgeons will perform a subcutaneous mastectomy to preserve the mammary areolas (adapting their size to a more masculine standard) and the nipples. This procedure is performed under general anaesthesia and usually lasts 2–3 hours.

Three different techniques can be used for mastectomy, depending mainly on the size of the breasts:

  • Periareolar technique. When the breast is small, this surgical technique is usually chosen. It consists of making an incision around the areola, through which the glandular tissue is removed. This technique allows scarring to be kept to a minimum.
  • Extended periareolar technique. This technique is usually used when the breasts are voluminous. Basically, it consists of making the periareolar incision plus another incision that is extended towards the armpit area through which the glandular tissue is removed. In this case, the scars are more evident than in the periareolar technique, although over time they may be concealed by body hair.
  • Free graft technique. When the breasts are really voluminous or when the patient is considered a “heavy” smoker, the surgeon usually opts for areola grafts during surgery.

All these techniques can be combined with a reduction in the size of the areola and nipple, which will improve the final result in some cases. Prior liposuction can also be used to reduce the size of the scars and improve the pectoral contour.



During the operation, a drain is placed in each breast to facilitate drainage of retained liquids from the operated area and thus avoid haematoma. These drains are removed after 48 hours. Afterwards, you will have to wear a compression garment, band or T-shirt for one or two weeks, depending on the medical team’s assessment. This compressive band prevents the formation of haematomas and facilitates the modelling and adaptation of the skin.

24 hours after the operation, you will be able to return to your normal life, with the express limitation of exertion and weight bearing.


The results

The results are excellent and can be seen immediately, although you must wait for the swelling to go down before checking the final shape. Your breasts are smoother, while your areolas and nipples are in harmony with your chest’s new masculine appearance, which is aesthetically similar to that of a cis man.



Debes llevar una prenda compresiva (como una faja, banda o camiseta compresiva) puesta las 24 horas del día, incluso para dormir durante la primera semana o días, según te aconseje el equipo médico. Solo te la puedes quitar para ducharte.


Llevarás drenajes durante las primeras 48 horas para mejora la eliminación de líquidos. Estos drenajes serán retirados por un miembro del equipo de IM GENDER.

Volver a hacer deporte

Antes de reiniciar tu rutina deportiva consulta con tu médico cuándo es adecuado empezar y que tipo de actividad física es la más adecuada hasta tu completa recuperación. Recuerda que durante los primeros días no deberás coger peso ni hacer esfuerzos con la parte superior del cuerpo.


At IM GENDER we have been specialising in the care of transgender people for more than 20 years. Two decades of experience, professionalism, research and training endorse our medical team.

Do you need more information about IM GENDER’s Gender Unit? Do you want to know the price of a mastectomy?