What is Female to Male FTM top Surgery for Trans Men?

As mentioned above, this surgery is offered to transgender men. The procedure involves taking out the breast tissue and rearranging the surrounding tissue. The skin around the nipple is rearranged as the male chest is usually wider than the female chest. The surgery is similar to a bilateral mastectomy but involves more chest contouring. The surgery is much more than just removing the breast tissue. The new chest should look more masculine, so, there needs to be a careful reconstruction of the entire chest.

Several techniques are used for transgender FTM top surgery. The technique to be applied In your particular case is determined by the size of the breasts before surgery.

People with larger breast tissue need a total bilateral mastectomy. It is also often called Double-incision top surgery with or without nipple grafts. As there is much more tissue to remove, Dr Maryam will need to create a larger incision; the whole nipple may be removed in this approach. Through the incision line, the breast or mammary tissues are removed. The nipple and areola are also worked on to reduce their size. The extra fat in the chest area is removed and then the altered nipple and areola are repositioned or reattached. Dr Maryam will take special care in making sure there are no wrinkles in the skin surrounding the nipples or in the chest. To make a smooth, tight masculine chest, removing excess skin is often necessary. This is one of the most common methods.

For people with smaller breasts, a periareolar approach also works. As the name suggests, the incision in the periareolar approach is done on the sides of the areola; or to be specific, in a circular motion surrounding the areola. After the breast tissue is removed, the incisions are sutured, effectively creating a smaller chest with smooth skin. If you already have a small chest, only a slight modification will be needed. In this case, only a small incision is made along the lower border of the areola. Through that small opening, Dr Maryam removes breast tissues and performs liposuction, if necessary. Thus, the chest is flattened. However, this approach only works if you already have a flat chest, so no excess skin removal is necessary.

Are you a Suitable Candidate for FTM Top Surgery?

Before scheduling your procedure, make sure you are ready to get the procedure done and your body is in good health condition. To be a good candidate to get Female To Male top surgery you will need to:

• Have been cleared by a psychologist. Usually a psychologist needs to clear you as fit for the surgery and you will need a WPATH certificate. Getting top surgery is a life changing decision. Although most patients are ready and eager to go through the procedure, you still need a psychologist’s approval. They will just assess your mental health to ensure you are taking this decision after understanding all that it entails.
• Have a normal weight. You need to be in the healthy weight range to be able to undergo the surgical procedure under General Anaesthesia.
• No systemic disorder. Any disorder that prevents you from getting the surgery.
• Realistic expectations. This may sound counterintuitive, but people who have realistic expectations are good candidates. Gender affirmation surgery is a complex process. While this surgery will make your chest area flatter, it is healthy to have realistic expectations.
• You don’t smoke. If you do smoke, you will need to abstain from it for at least a few weeks before and after the surgery.
• Older than 18 and able to consent. This is important as you need to understand the risks and can take informed decisions.
• You may have to have taken hormone therapy. Usually a 10/12 month hormone therapy is required.

Recovery after FTM Top Surgery

Recovery is an essential part of the process. As the results of the surgery partly depend on uneventful recovery, you need to take extra precautions during this time. Do not put stress on your body. Immediately after surgery you will notice lots of swelling and redness. That’s completely normal. The swelling will go down soon enough. You will be prescribed some analgesic medication that also help with the swelling. Avoid applying ice packs directly on the wound as it could cause skin damage.

You should not lift your arms for a week, or you may pull on the stitches. You should also refrain from showering for 48 hours. In the meantime, take sponge baths to prevent getting the surgery site wet. Also, you will feel stiffness in your arms and upper body in the initial four/ five days following the surgery. During this time, stay home and rest. You can go back to work or school after 2- 4 weeks. During these first few weeks, you will also need to sleep on your back to prevent unnecessary pressure at the level of the incisions. You probably will be able to do some light exercises from the 4th week. However, intense exercises and heavy lifting needs to be held off until the 8th week.