FTM Top Surgery Techniques
Before and After Female to Male Surgery
Medically Necessary for Gender Reassignment
For transgender men, TOP surgery is the most requested. FTM surgery is considered medically necessary for gender reassignment.
To achieve a masculine appearing chest, specific surgical techniques are required. The various methods all require incisions and removal of breast tissue and fat. The procedures may also remove excess skin and reduce or reposition the areola and the nipple. In some cases, a free nipple graft will be necessary.
Double Incision With Free Nipple Graft
For medium to large chested patients with poor skin elasticity, the “double incision with a free nipple graft” is considered the best procedure. The incisions are horizontal above and below the pectoral muscle, but not involving the muscle. The nipple and areola are removed. Breast tissue is excised, and liposuction may be used to sculpt the chest. The two incisions are sutured together with the resulting scar running under the pectoral muscle and following the natural contour of the chest. If needed, the areola and nipple can be made smaller and then grafted into the proper position.
The double incision procedure gives excellent results for a masculine chest. However, patients need to understand that they will lose all sensation in the areola and nipple as the nerves are cut when it is re-positioned.
Keyhole Procedure Retains Sensation
Dr. Miguel Delgado, M.D. states that the patient with small breasts and good skin elasticity, the “keyhole” procedure is ideal. For this procedure, a semi-circular incision is made at the bottom of the areola. Breast tissue and fat are removed through the incision; sensation is retained since the areolas and nipples are not removed. Scarring is minimal, blending in with the edge of the areola.
If you are considering TOP surgery, call Dr. Delgado (415) 898-4161 today and find out if you are a candidate for TOP surgery.
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