Real chest masculinisation results from patients treated at our Baker Street day surgery facility, grouped by technique. Jump to Double Incision, Keyhole or Periareolar.
Results vary from patient to patient. All photos are published with written patient consent and are examples of outcomes achieved at Centre for Surgery, not guaranteed results. After photos were taken at least six months after surgery unless the caption says otherwise. No photograph has been retouched or filtered; some are cropped or masked only to protect patient privacy. Full disclaimer below, and how to read these photos — including why the technique used matters more than the result shown.
Double Incision Top Surgery — Before & After
11 photographs
Double incision mastectomy is the most commonly performed top surgery technique. Two horizontal incisions are made across the chest, breast tissue and excess skin are removed, and the nipples are replaced as free grafts. It suits a larger chest, or a chest with limited skin elasticity, because it is the only technique that removes a significant amount of skin.
The scars run horizontally across the chest, usually along or just above the pectoral border, and they are permanent. This is the trade the technique makes: the most skin removed, the flattest contour, the longest scars, and nipples that must survive as grafts.
Keyhole Top Surgery — Before & After
1 photograph
Keyhole top surgery removes breast tissue through a small incision at the lower border of the areola. No skin is removed and the nipple is never detached, which is why sensation is more often preserved. It is only possible for a small chest with good skin elasticity — the skin has to shrink onto the new contour by itself.
Periareolar Top Surgery — Before & After
1 photograph
Periareolar top surgery — sometimes called circumareolar — removes a ring of skin from around the areola and closes the gap concentrically, drawing the chest skin inward. The nipple stays attached to its blood supply and is often resized. It sits between the other two techniques: more skin removed than keyhole, far less than double incision, and the scar is confined to the circle around the areola.
About These Top Surgery Photos
The top surgery photos above are presented for educational purposes only and should be interpreted subjectively. They do not represent the opinion or view of any patient regarding their result, and they are not intended to suggest the result that any other patient may achieve. No two patients are alike, and no two results are necessarily alike. Only a personal consultation with your surgeon can provide you with a reasonable expectation of the results you may achieve from any specific procedure. We only publish photographs of patients who have given full written consent for their images to be used.
How to Read Top Surgery Before and After Photos
Top surgery galleries are read differently from every other gallery on this site, because the technique is not a preference. It is determined by your chest, and it determines your scars. An outcome achieved by one technique tells you almost nothing about an outcome achieved by another.
Find the before photograph, not the after
Chest size and skin elasticity decide which operations are available to you. A keyhole result — a small scar, a preserved nipple, no line across the chest — is the outcome most people want, and it is not on offer to most people. If the before photograph shows a chest much smaller than yours, the after photograph is not a preview of your result. It is a preview of somebody else’s anatomy.
Testosterone changes the picture independently of surgery
Where months or years separate the two frames, the person in the after photograph may have gained muscle, redistributed fat, and grown chest and abdominal hair. All of that changes how a chest photographs, and none of it is the surgery. Body hair in particular obscures scars very effectively. This is not deception — it is simply what happens — but it means the after image is showing you the combined effect of two things.
Grafted nipples do not photograph like attached ones
In double incision surgery the nipples are removed entirely and replaced as free grafts. Grafts commonly lose pigment, change texture, flatten, and occasionally fail in part. Fresh grafts look different from settled ones. Position, size and symmetry are chosen by the surgeon and are among the most visible markers of the work.
Scars, and where the camera is standing
Double incision scars are long, horizontal and permanent. They photograph faintly under even, front-on lighting and become obvious under side lighting or from below. Ask any surgeon to show you their own patients’ chests photographed from an angle where the scars are clearly visible, at six months and at two years.
What Stage of Healing You’re Looking At
Three things settle at different speeds, and a single photograph freezes all three at one moment.
Contour settles first. Swelling and fluid are present for weeks. A compression vest is usually worn for the first month or so, and the chest continues to flatten and soften as swelling resolves over the following months.
Nipple grafts settle next. They are dressed for the first week, scab, and then go through a long period of colour change before the final pigment is apparent. A graft photographed at eight weeks is not the graft you will have at a year.
Scars settle last. They are firm and pink or red for many months. In many patients they fade substantially over roughly twelve to eighteen months, though this varies considerably with skin type, tension and individual healing, and thickened or raised scars are a recognised outcome.
Revision — for a scar, or for a small fold of skin at the outer end of an incision, sometimes called a dog ear — is a recognised and unremarkable part of the process for some patients. A gallery that never states the interval is asking you to assume the flattering end of all three clocks.
The after photographs in this gallery were taken at least six months after surgery, unless the caption says otherwise. For what to expect at each stage before then, see our top surgery recovery guide.
What These Photographs Cannot Show You
There is a limit to what any gallery can tell you, and a clinic that pretends otherwise is selling rather than informing.
- Sensation. After free nipple grafting, erotic and tactile nipple sensation is commonly reduced and may not return. Keyhole and periareolar techniques leave the nipple attached and are more likely to preserve it. No photograph distinguishes a chest that can feel from one that cannot.
- Which technique you are eligible for. That is decided by chest volume and skin elasticity at examination — not by which photograph in this gallery you prefer.
- How the scars will look on your skin. Scarring behaviour varies with skin type and tension, and thickened or keloid scars occur.
- Whether the result was revised. Many good results in many good galleries followed a second, smaller operation. The photograph does not say so.
- What it looks like clothed, and what it feels like to live in. Which is, for most people who have this surgery, the entire point — and it is the one thing a photograph of a bare chest is structurally incapable of showing.
None of this is a reason to distrust before and after photographs. It is a reason to treat them as the beginning of a conversation with a surgeon rather than the end of one.
Top Surgery Results: Common Questions
What are the downsides of top surgery?
The main trade-offs are scarring, which is long and horizontal in double incision surgery, and changes in nipple sensation. Other risks include bleeding, fluid collection, contour irregularities, problems with nipple grafts and the need for a small revision. Your surgeon will explain which technique suits your chest.
Do your nipples still have feeling after top surgery?
It depends on the technique. With keyhole and periareolar surgery the nipple stays attached to its nerve supply, so some sensation is often kept, although it may be reduced. With double incision and free nipple grafts, sensation is usually lost or much reduced, and the nipples generally no longer become erect.
Can breast tissue grow back after top surgery?
Tissue that has been removed does not grow back. A small amount is deliberately left to keep a natural chest contour, and weight gain can add fullness to the chest, but that is fat rather than regrowth. Contour irregularities can sometimes be refined with liposuction or a minor revision.
FTM Top Surgery at Centre for Surgery
Centre for Surgery is a private hospital for plastic and cosmetic surgery on Baker Street in Marylebone, London, registered with and independently inspected by the Care Quality Commission. Our plastic surgeons perform FTM top surgery for transgender men and non-binary people, including double incision, keyhole and periareolar mastectomy, at our Baker Street day surgery facility.
Choosing a Technique
Your chest size and the elasticity of your skin determine which techniques are available to you. At consultation your surgeon will examine your chest, explain which options are realistic, and describe the scars and the nipple outcome that each one carries. Every plastic surgeon on our team is GMC-registered and independently verifiable on the General Medical Council register.
Aftercare and Follow-Up
Surgery is performed at our Baker Street day surgery facility. You have your surgeon’s direct number for the first 24 hours after surgery, your surgeon will review you at regular follow-up appointments, and a full scar management programme is included as standard.
Verified Patient Reviews
We invite you to read what our top surgery patients say on independent, verified review platforms. Every review is publicly verifiable, dated, and linked to a real named patient.
- Google Reviews: Read our Google reviews — rated 4.6 stars based on hundreds of verified patient reviews.
- Patient reviews page: Read patient reviews by procedure — Google and Trustpilot reviews brought together on our own site.
As a CQC-regulated provider, every surgeon on our team is GMC-registered and independently verifiable. View our CQC rating.
Related Reading
- Can Top Surgery Be Reversed?
- What Are My Options for FTM Top Surgery?
- How to Prepare for Top Surgery: What to Know Before Your FTM Mastectomy
Explore More Before and After Galleries
View our full collection of plastic surgery before and after photos, or browse related procedure galleries: Labiaplasty Before and After Photos | Mummy Makeover Before and After Photos | Breast Reduction Before and After Photos
Learn more about us: About Centre for Surgery. Subject to status, we also offer finance options with Chrysalis Finance. For a full price breakdown, see our FTM top surgery cost guide. Browse our Plastic Surgery Blog or find answers in our Clinic FAQs.
Call us on 020 7993 4849, email contact@centreforsurgery.com, or visit us at 95–97 Baker Street, London W1U 6RN.
