FTM top surgery

Three different techniques can be used to perform the mastectomy, primarily depending on the size of the breasts:

• The periareolar technique is usually chosen when the chest is small. It involves making an incision around the areola, through which the glandular tissue is removed. This technique results in minimal scarring.
  
• The extended periareolar technique is used when the breasts are large. It involves making the periareolar incision plus another extending towards the armpit through which the glandular tissue is removed. In this case, the scars are more visible than with the periareolar technique, although they can be concealed over time by body hair.
  
• The free nipple graft technique is used when the breasts are very large or when the patient is considered a “heavy” smoker. The surgeon opts for areola grafts during the surgery.

All these techniques can include reducing the size of the areola and nipple, which can improve the final result in some cases. Prior liposuction can also be used to reduce scar size and improve chest contour.

Pre-surgery consultation

Before the surgery, it is important to have a consultation with the surgeon to discuss your goals, medical history and any concerns. A comprehensive medical evaluation, including blood tests, a chest X-ray and an ECG, may be required to ensure you are in good health for the surgery.

Medication and diet

Inform your surgeon about any medications or supplements you are taking, as some may need to be discontinued before the surgery. Maintaining a healthy diet and staying well-hydrated is important, along with following any specific dietary instructions provided by your surgeon.

Day before surgery

Follow your surgeon’s instructions regarding fasting, typically avoiding food and drink after midnight. On the day of the surgery, wear loose, comfortable clothing that is easy to put on and take off.

What is the recovery like after female to male top surgery?

During the surgery, a drain is placed in each breast to facilitate the removal of retained fluids and prevent hematoma. These drains are removed after 48 hours. After that, you will need to wear a compression garment, band, or shirt for one or two weeks, as recommended by the medical team. This compression band prevents hematoma formation and helps shape and adapt the skin.

You can return to your usual life 24 hours after the surgical procedure, but you should avoid strenuous activities and lifting heavy objects.

When can I return to sports after a trans mastectomy?

Consult your doctor about when it is appropriate to resume your sports routine and what type of physical activity is most suitable until you have fully recovered. Remember that during the first few days, you should not lift heavy objects or exert yourself with the upper body.

How should I sleep during the recovery?

It is highly recommended to sleep on your back for at least the first month after the trans mastectomy. However, this always depends on each patient’s recovery.

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.

Once the drains are removed, the patient’s recovery is much faster. After 10 days of FTM top surgery, the decrease in inflammation begins to be noticed.

Generally, you will lose erotic sensation, but after this FTM surgery you can expect your nipples to be sensitive to pressure sensation or temperature. Also, this surgery includes some tingling that will normally go away within a few weeks or months.

Who can undergo this surgery?

All those trans men who want to achieve a smooth, flat and symmetrical chest, resulting in a masculinisation of the chest.

How long does the surgery take?

This gender affirmation surgery is performed under general anaesthesia and usually lasts 2–3 hours.

How painful is FTM top surgery?

You may feel some pain for the first couple of days, but don’t worry! Your plastic surgeon will prescribe medication to lessen the pain.

How much is top surgery?

The price of a FTM top surgery can be different depending on the case of the person. It must also be taken into account if the chest operation is decided to be combined with other treatments. A first visit is recommended to assess the patient’s case to make a personalised budget.