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Mastectomy for Gender Confirmation

A mastectomy for transgender or non-binary individuals is a surgical procedure to remove breast tissue, resulting in a flatter, more masculine chest contour. The mastectomy, commonly referred to as “top surgery” when performed on transgender patients, is one of the most popular and often the initial masculinization procedure requested by transgender men.

Unlike the standard total mastectomy which removes the entire breast, procedures for transgender individuals often retain and reposition the nipple and areola complex. Through a number of specialized techniques perfected at the Crane Center, surgeons are able to make incisions around the nipple and below the pectoral areas of the chest to remove breast tissue as well as any excess skin and position the nipples in a way to enhance the masculine appearance of the chest.

Mastectomy Surgery Techniques

There are two common techniques for transgender patients seeking chest masculinization top surgery. The technique that is right for you will depend on the size and shape of your existing chest.

Double incision is the primary method and is used in 90% of cases as it offers the greatest flexibility in sculpting an ideal, masculine-presenting chest. With this procedure, the nipple and areola are removed completely and then regrafted onto the chest once the breast tissue has been removed. This gives the surgeon the greatest reconstructive freedom to reshape the areola and nipple into a smaller, more masculine size as well as to place them in the best possible position. Surgeons are also able to remove any excess skin and create a tighter result. Double incision is the best option for patients with larger body types or larger breast sizes. The surgery is performed under general anesthesia and there is typically a 4-week recovery period.

An alternative to double incision is the keyhole surgery technique. This procedure involves making a small incision at the edge of the areola and scooping out breast tissue. No additional incisions are made and no skin is removed. Furthermore, the nipple and areola aren’t repositioned. The key benefit of this technique is that the only scar leftover after surgery is mostly hidden by the line at the edge of the areola. Patients can also have faster recovery times. The reason that the keyhole technique is used in far fewer cases is that in order to qualify, patients must have very little breast tissue to remove. If the patient has breasts larger than an A cup or if they have nipples that point downward, the results will be less than ideal.

Learn More About Transgender Mastectomy Surgery

The goal of a mastectomy for chest masculinization is to create a natural-looking result that matches the patient’s body type. Surgeons at the Crane Center are experienced in performing mastectomies on all body types and will consult with you to determine the best procedures and techniques to optimize your results. Contact us for an appointment.

We acknowledge that terminology regarding transgender identities is evolving. We are committed to staying informed and using accurate terminology and inclusive language as determined by the individual themself.

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