Sometimes our outer appearance simply does not match our perception of who we are on the inside. We may be born one way, but identify with another group anatomically and wish to fit better among your peers with the help of surgical change. For those who are transgendered and find themselves looking for a surgical solution, Dr. McLean may have just that! Here is some information for those born with female anatomy, looking to masculinize their look with FTM top surgery.
What is FTM Top Surgery?
FTM Chest recontouring is a more complex version of a breast reduction aimed at patients who wish to undergo gender reassignment. The procedure is designed to remove the breast tissue and create a more masculine appearing chest to help your image on the inside, match that on the outside. This procedure best suits those who identify as male, gender neutral, or simply wish to relieve themselves of the feminine appearance of breasts.
It is important to note that the procedure is not synonymous with a mastectomy as 10-20% of the breast tissue remains in place to uphold structure, thus breast cancer can still be a concern and routine breast exams and mammograms should still be conducted.
How is it performed?
There are a variety of methods used to remove the breasts depending on the size and structure. Here are a few different methods used by Dr. McLean when performing Top Surgery.
Double Incision:
This procedure is designed for those with medium to large breasts. The skin of the chest is opened using 2 horizontal incisions below and above the pectoral muscle. This skin is retracted and the breast tissue (not the muscle) is removed. Additional liposuction may be performed to help contour and shape the chest. The nipples may be removed, resized, and then grafted to the newly shaped chest in a location that suits a pec rather than a breast appearance.
Please note, sensation may be decreased in the nipple area if they are removed from original structure. Please discuss your preference of incision location and shape (curved, straight) with your surgeon.
Keyhole:
This procedure is designed for those with smaller breasts. An incision is created below the areola and the breast tissue can be removed using liposuction. The benefit of keyhole surgery is that the areola and nipple are generally maintained as is, keeping nerve sensation intact. Nipple reshaping should be further discussed with your surgeon to address any concerns you may have.
Periareolar:
This procedure best suits those with good skin elasticity or smaller breasts. It is performed with an incision created around the whole circular border of the areola. A second, larger ring is created and a ring the shape of a donut is removed. Next, a drawstring approach is taken bringing the remaining skin in towards the nipple region. Like with keyhole surgery, additional liposuction may be used to remove excess tissue while attempting to maintain nipple sensation. If nipple resizing is desired, please speak further with your surgeon.
How long is the hospital stay?
These three surgeries are generally day surgeries lasting between 2-4 hours. General anesthesia is used, but not all patients required going completely “under”. Drainage tubes will be left in place (for about a week) to collect any excess blood or lymphatic fluid and will have to be emptied regularly, but this can be done form the comfort of your own home. Compression bandages will be required to help reduce swelling, fluid build-up, and help maintain shape. Most patients will fulfil their recovery at home barring complication.
When can I return to work?
Most patients can return to work after 2 weeks. Remember to avoid repetitive lifting of the arms above the head, along with heavy lifting and vigorous exercise including weight training. All of this should be avoided for approximately 8 weeks. Light activity, such as walking, is recommended to improve blood flow and avoid clotting.
How can I reduce scarring?
It is imperative to note that there will be come scarring, how visible they will be depends on how well you care for your kin post-op. Leave any stitches, taping, or bandages in place as per doctors’ orders and make sure to wear the compression wrap/vest which will help reducing scarring long term. Avoid excessive stretching and exercise to the area allowing for the tissue to heal without repetitive stressors.
Avoid direct sunlight for the first year, using sunscreen after to keep the colour of the scar as close to your natural skin colour as possible. There are many creams and solutions such as Bio-Oil to help prevent the marks from worsening over time.
Is Top Surgery right for me?
This is a decision that should not be made without careful thought and planning. Seeking guidance from both a counsellor and your physician from any cosmetic surgery clinic should be considered before booking any surgeries.
Featured images:
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EmmaWilliam is a consultant plastic surgeon in Canada whose private practice is largely dedicated to cosmetic surgical procedures like breast reconstruction and tummy tuck. Now on researching in other areas of plastic surgery, I feel that each surgery must be individualized to each person’s unique situation. I love to make people feel more confident about themselves and their bodies. Besides work, I love to swim, bike and dance in my spare time,and also spend a lot of quality time with my kitty Lovy!