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FTM Top Surgery

Female-to-male Top Surgery is Not Just Removal of the Breasts!

FTM top surgery transforms a feminine chest with breasts into a flatter, more masculine-appearing chest.  But it is so much more than breast removal surgery.  Our goal isn’t just a flat chest but rather an overall masculine shape.  This usually includes:

  • Removal of most breast tissue and excess skin
  • Removal of the inframammary fold (fold under the breast)
  • Nipple/areolar reduction and repositioning

FTM Top Surgery 101

What procedure is right for me?

The procedures available for FTM top surgery are:

  1. Keyhole Procedure
  2. Periareolar (Concentric Circle) Procedure
  3. Double-incision Procedure

Which one is right for you depends on the amount of breast tissue, skin laxity/excess, amount of ptosis (droopiness), and positioning of the areola.

What is the Keyhole Procedure?

The Keyhole Procedure uses an incision along the lower aspect of the areola and simply removes breast tissue.  This procedure is only suitable for patients with very small breasts and no excess skin.

The above image shows the type of patient that would be a candidate for Keyhole Surgery.

It does not reposition the nipple/areola, so sensation should remain intact.  It offers the least amount of scar of all the procedures but is most likely to require liposuction.

What is the Periareolar Procedure?

The periareolar or concentric circle procedure uses an incision all the way around the areola.  A second circular incision is made outside of the areola.  The breast tissue is removed using the space between the incisions.  The larger incision is then narrowed and closed to the smaller incision resulting in a smaller areolar with a scar around its periphery.

This procedure works well in patients with small to B cup breasts, moderate excess of skin, larger areolar, and no ptosis (droopiness) to the breasts.

The above image shows the type of patient that would be a candidate for Periareolar Surgery.

It usually leaves nipple/areolar sensation intact.  It usually requires the use of a drain and is the procedure choice that is most likely to require a revision.

What is the Double Incision Procedure?

The Double Incision procedure uses an incision along the inframammary fold to release it and remove all of the breast tissue. The nipple/areola are completely removed & repositioned as a graft to the most masculine position.

This procedure is best in patients with medium to large breasts with excess skin, large areola or nipples, and ptosis (droopiness) of the breasts.

The above images show the type of patient that would be a candidate for Double Incision Surgery.

Nipple and areolar sensation will be altered and/or absent.  It usually does not require drains and is the least likely procedure to require revision.

Is Liposuction required?

Liposuction is frequently used as an adjunct with the excisional procedures to improve the masculine contours of the chest.  Dr. Reid (& Gordon) are the only Austin-area surgeons trained in both the SAFELipo and Vaser High Def Lipo techniques for body contouring.

What are the eligibility requirements prior to FTM Top Surgery?

Dr. Reid is a member of WPATH and does believe in their mission and recommendations.  However, each individual has a unique experience, and this is taken into account.  So ultimately, Dr. Reid subscribes to the “informed consent” model for his patients.  As such, a therapist’s letter is recommended but not an absolute requirement.  Testosterone therapy is not an absolute requirement but does offer the benefits of increased pectoralis muscle size.  Dr. Reid does follow the WPATH standards for patients under the age of 18.

FTM Top Surgery Q & A

What can I expect at Consultation?

At your consultation, you will meet with Dr. Reid, personally.  Your medical and transition history will be carefully reviewed.  Individual goals will be discussed, and a plan that meets your goals will be confirmed.  You should feel comfortable to ask as many questions as you like.

Where will surgery be performed?

Your FTM Top Surgery is performed as an outpatient procedure at INSPIRE Surgery Centre, our state-of-the-art surgical facility that is certified by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), which ensures the highest standard of surgical care. INSPIRE is conveniently located in the suite adjacent to Restora Austin and is staffed by a team of board-certified anesthesiologists and very experienced nurses and surgical techs, all of whom were hand-picked by Dr. Gordon and Dr. Reid. The facility is equipped with highly advanced monitors and the finest surgical equipment, and is fully equipped to handle any emergency situation if one should occur.

How long does the procedure take?

FTM Top surgery takes from 3 to 5 hours and is performed on an outpatient basis.

What type of anesthesia is used?

Your surgery will be performed under general anesthesia administered by a board-certified anesthesiologist from Capitol Anesthesiology Association, who will monitor you during the entire procedure, ensuring your safety and comfort, and will remain with you until you are fully awake. Dr. Reid prefer general anesthesia, so that you are asleep and your chest muscles are completely relaxed and your airway is protected. This leads to less pain after surgery because your pectoralis muscles won’t be in a constant state of flexion during your surgery. This leads to less tightness and swelling in your post-operative period. Safety, comfort and a fast recovery are paramount to Dr. Reid.

How can I prepare for surgery?

Will I need to stop any of my medications before surgery?

You will be advised to stop taking certain medications and vitamins or herbal supplements that can contribute to excess bleeding 2 weeks prior to surgery. You will be given a full list of medications to discontinue, but the most common ones are Advil, Aleve, Ibuprofen, Vitamin E and Aspirin. Please be sure to include all vitamins and supplements you are taking on your health history form.

Does smoking affect the healing process, and if so, how far in advance of surgery should I quit?

You MUST discontinue the use of ALL nicotine products, including the patch and the gum, for 4 weeks before and 4 weeks after surgery. Smoking decreases blood flow to the nipple and can lead to delayed wound healing, infection and nipple loss.

Will I need a mammogram prior to my surgery?

If you are under the age of 40 and do not have a family history of breast cancer, you do not need a mammogram prior to surgery. If you are close to 40, we may recommend that you have a baseline mammogram prior to surgery. If you are 40 or older, you will need a mammogram performed within the last year prior to surgery.

Will I need any other tests or blood work done?

Lab work will be performed prior to surgery to ensure that you are not anemic, do not have an infection, and are not pregnant. Based on your medical history, you may be asked to have additional laboratory studies or other diagnostic tests to ensure your overall health and breast health.

What can I expect after surgery?

You should plan to take 7-10 days off of work.  Pain is usually mild with FTM Top Surgery, and we take pain control very seriously.  Drains are typically not used.  Sutures are usually dissolvable.  Bolster dressing over areolar grafts are removed at 5-7 days.  A gentle compression garment is used for 3 weeks after surgery.  This will aid in healing & decreases swelling.  Dr. Reid will see you at your first postoperative appointment, then typically at 6 weeks, 6 months, and 1 year after.

What revisions may be required after FTM Top surgery?

Need for revision surgery is uncommon but may include removal of “dog ears” (little flaps of skin sticking out from the side of the chest, often in the armpits), touch-up liposuction, nipple reduction, etc.  Usually, these revisions are simple and can be performed in-office without downtime and at no cost to you.  These little “tweaks” help us to achieve your ideal chest appearance.

Why should I choose Dr. Reid and Restora Austin for my FTM Top Surgery?

We believe there are many reasons, but our name, RESTORA, explains it all.

Results. The masculine-appearing chest that fits who you are!
Experience. Dr. Reid has the most experience in this surgery in Austin.
Safety. It is a privilege when you choose us, and we don’t take that responsibility lightly. Your well-being and comfort are our primary concerns, so your procedure will be performed in a fully accredited operating room with a board-certified anesthesiologist.
Team. Our team is a group of overachievers focused on delivering the best plastic surgery experience possible. Over half of us started out as patients of Dr. Gordon or Reid, so we have an intimate understanding of the anxiety and excitement that come with this decision.
On the Cutting Edge. Dr. Reid never rests on his past and present achievements. Dr. Gordon and his practice is a constant evolution in the “how” and “why” of aesthetic surgery, always perfecting techniques that minimize scarring, discomfort, and downtime but give maximal results. Dr. Reid is actively involved with the Trans community, and as a gay man and doctor has special insight into the challenges that this patient population faces.
Respect. Our practice is built on word-of-mouth referrals from happy patients and our medical colleagues. Dr. Reid was named a Texas Super Doctor in 2013, 2014, 2015, 2016, & 2017. Super Doctors identifies top doctors as selected by their peers and only 5% of physicians are named to Super Doctors.
Artistic Approach. We don’t believe in “one operation fits all” cookie cutter approach to aesthetic surgery. Dr. Reid will create an individualized plan to exceed your expectations and bring out the best version of yourself.

Well, now you know everything you need to know about FTM Top Surgery! We hope you found our information helpful. Please let us know if we omitted anything. At your consultation, Dr. Reid will discuss your goals and will offer you an individualized surgical plan to achieve your desired look. We want you to look and feel confident in and out of your clothes. Shopping will be fun because you won’t be trying to hide or minimize your breasts. Get the body you were meant to have.  Call 512.371.8817 today to set up your consultation. We can’t wait to meet you!

Our Videos

Restora Austin is largely based on word of mouth referrals from happy patients. Although we are one of the busiest plastic surgery practices in Austin, we will always remain a boutique practice, where quality time spent with patients and building long-term relationships are our top priorities. Watch these patient testimonial videos to learn what you can expect when you visit our practice.

Testimonials

Kelly

My name is Kelly and Dr. Ashley Gordon did my procedures.

I went to many other doctors, did extensive research, did a lot of consultations… I just never had that feeling that everything was a complete package. So I was researching on the internet and I went from the Houston market to the Austin market, and Restora came up. It did not matter if there was one review, or 120 reviews, it was always five stars.

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