FTM/N Top Surgery

Embrace your true self and feel confident in your own body with FTM top surgery – a transformative procedure tailored to your individual needs and goals

Female-to-male top surgery, or FTM Surgery, is aimed at transgender men who want to achieve a more masculine-looking chest that appears flatter and contoured. FTM top surgery is also known as female-to-male chest reconstruction surgery or masculinising chest surgery. Other terms that may be used to refer to this surgery include gender-affirming chest surgery, chest masculinisation surgery, and gender-confirming chest surgery. There are several types of FTM top surgery. The most common gender affirmation procedure involves surgically removing breast tissue, also known as a mastectomy, and eliminating excess skin and fat. The nipple and areola complex is often repositioned to achieve a more natural look. Many trans men prefer smaller areola dimensions, which can be surgically reduced as part of an areola reduction procedure. The most appropriate type of female-to-male top surgery will depend on the existing breast size, skin elasticity, and soft tissue surrounding the breasts.

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Previous treatments for achieving a flatter chest often involved chest binding. This method of flattening the chest often causes injury to the skin and is linked with difficulty in breathing due to the tightness of the binder. FTM top surgery is considered the most effective cosmetic surgery procedure for trans men wanting to achieve a flat-looking chest.

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Female to Male (FTM) top surgery is a surgical option available for transgender men who wish to achieve a more masculine chest. The procedure involves removing the breast tissue and reconstructing the surrounding tissue to create a more masculine appearance.

There are several techniques used in FTM/N top surgery, and the technique used in a particular case depends on the size of the breasts before surgery. For individuals with larger breast tissue, a total bilateral mastectomy is performed, often referred to as double-incision top surgery with or without nipple grafts. This approach involves creating a larger incision, removing the breast or mammary tissues, and altering the size of the nipple and areola. The surgeon may also remove excess fat and skin to create a smooth and tight masculine chest.

For those with smaller breasts, a periareolar approach may be used. This approach involves making an incision around the sides of the areola, removing the breast tissue, and suturing the incision to create a smaller chest with smooth skin. In cases where the individual already has a small chest, a small incision may be made along the lower border of the areola, through which the surgeon removes breast tissue and performs liposuction if necessary.

FTM top surgery is much more than just removing the breast tissue. The surgery involves a careful reconstruction of the entire chest to create a more masculine appearance. The size of the breasts will determine the technique used before surgery. Make sure to discuss the options with a qualified surgeon to determine which technique is best for achieving the desired results.

Dr Spiros Vlachos is a highly experienced specialist in FTM top surgery, offering all types of masculinising chest surgery to help individuals achieve their desired results with natural, aesthetic outcomes. His expertise includes double incision mastectomy with free nipple grafting, nipple-sparing techniques, periareolar mastectomy, and inverted-T top surgery, allowing for tailored procedures based on each patient’s unique needs and anatomy.

With a meticulous approach and a deep understanding of gender-affirming surgery, Dr Vlachos ensures that every procedure prioritises safety, precision, and patient satisfaction. His commitment to excellence has made him a trusted name in the field, providing compassionate care throughout the surgical journey.

Double Incision Mastectomy

Keyhole Top Surgery

Female-to-male top surgery is increasingly requested by trans men who want to achieve a masculine-looking chest with natural contours. FTM surgery is one of the best ways to treat symptoms of gender dysphoria. Gender dysphoria is linked with feelings of significant distress and is most often due to a mismatch between a person’s gender identity and biological sex.

Female-to-male gender surgery is highly effective for treating gender dysphoria. Anxiety and depression are frequently associated with this condition. FTM top surgery has been proven to lead to a significant boost in confidence and emotional well-being. This helps many trans men have an improved quality of life and a better ability to form more robust personal and professional relationships.

FTM top surgery is ideal for trans men diagnosed with gender dysphoria, affecting their quality of life. Current guidelines recommend that trans men live in their chosen gender for at least 12 months and have completed an in-depth psychological assessment before being considered for the female-to-male top surgery. All patients should be aged over 18 before they can be considered for FTM top surgery. There are certain preoperative steps which patients should take to ensure they are optimally prepared for surgery. Smokers should stop at least four weeks before surgery. Any significant medical conditions, including hypertension and diabetes, should be well controlled. Being significantly overweight increases the risks of surgery, and we advise your body mass index should be 25 or below. Your surgeon must also be fully assured that you are in the best possible mental condition before FTM surgery. As with any type of surgical procedure, it is essential to have realistic expectations of what female-to-male gender surgery can achieve.

FTM top surgery involves several different surgical techniques to create a more masculine and flatter-looking chest. The most appropriate surgical method used will vary based on the existing size of the breasts, the size of the nipples and areola, and the amount of skin laxity present. Those who have lost significant weight may have significantly more skin laxity, requiring a more invasive procedure. Female-to-male top surgery is most commonly performed under general anaesthetic, and the procedure takes approximately three hours to carry out. FTM top surgery is an outpatient procedure, which means you can go home later the same day once you have recovered from the anaesthetic effects.

Double incision top surgery with free nipple grafting

Double incision top surgery is the most commonly performed type of FTM top surgery. The procedure involves surgical removal of the nipples and areola and reducing their size if required. Incisions will then be made to remove breast tissue as part of a mastectomy procedure. Liposuction is then used to remove excess fat. Excess skin over the breasts is also removed to tighten and flatten the chest. Your surgeon will reconstruct the chest and minimise the appearance of indentations or puckering with the meticulous surgical technique. The detached nipple and areola complex are then fixed back in the new position on the flat chest. A nipple-sparing double incision mastectomy could be a suitable option for selected candidates.

Periareolar top surgery

Periareolar top surgery is ideal for trans men with smaller chests. The procedure involves a circumferential incision around the margins of the areola. A second incision is then made around the first incision. Any breast tissue is surgically removed, with liposuction performed to remove excess fat. The two edges of the skin are then stitched back together, which helps to create smaller-looking areolas.

In some cases, your surgeon may recommend inverted T-top surgery, especially if you have a larger chest with extra skin. The incision for this procedure involves making an anchor-shaped incision, and the nipple and areola are not affected. This procedure preserves nipple sensitivity, although an extra vertical incision will be required as part of the technique. This technique is often preferred by trans men who want to preserve nipple sensation, and the risk of nipple loss is minimised. A drawback of the procedure is that some residual tissue must be preserved to ensure adequate blood supply to the nipple. This means the surgeon may be unable to completely flatten the chest compared with double incision periareolar top surgery.

Keyhole top surgery

Keyhole top surgery is ideal for trans men with smaller chests and tighter skin. The procedure involves making a small incision at the lower margin of the areola. The areola remains attached to the underlying breast tissue. Breast tissue is then carefully removed. Liposuction may be performed to remove excess fat. As with other types of FTM surgery, the areola size can be surgically reduced if necessary. This procedure helps to preserve nipple sensitivity with the added benefit of achieving a good level of chest flatness.

After surgery, it is normal to feel mild to moderate discomfort and stiffness. Any discomfort is most commonly felt during the first few days after FTM surgery. You will be prescribed painkillers by your surgeon to help keep you comfortable throughout your recovery.

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Most patients can return to work approximately two weeks after surgery, although this depends on the type of surgical technique used as well as your overall state of health. Strenuous activity must be avoided for six weeks after surgery. Most pain and swelling will resolve over the first few weeks after surgery. We would advise sleeping on your back for at least two weeks to avoid putting any pressure on your chest. Your surgeon will provide customised recommendations for minimising scarring after FTM top surgery. If you fail to follow your surgeon’s instructions in full, you may increase the risk of developing unsightly scarring after surgery. As part of the surgery, your surgeon may insert wound drains to prevent seroma or haematoma formation. These will be removed approximately 3 to 4 weeks after your procedure.

Aftercare for FTM Top Surgery

Recovery after FTM top surgery takes time and patience, and proper aftercare is essential to ensure a smooth healing process. Here are some aftercare tips to follow:

Use Compression Bandages

Compression bandages are essential to prevent fluid accumulation and support the chest area during healing. It’s crucial to wear them as the surgeon instructs to ensure optimal results.

Take Medications on Time

To manage pain and reduce swelling and bruising, it’s essential to take pain medication as prescribed by the surgeon. Missing doses can affect the healing process, so following the medication schedule closely is important.

Avoid Pressure on the Chest

During the healing process, it’s essential to avoid putting any pressure on the chest area. Wearing loose clothes and avoiding strenuous activities, such as yoga or exercises, can help reduce discomfort and ensure proper healing.

Sleep on Your Back

It’s essential to sleep on your back during the healing process to avoid putting pressure on the chest area. Elevating the upper body with pillows can help reduce swelling and promote proper healing.

Stay Hydrated and Rest

Staying hydrated and resting is crucial to ensure proper healing after FTM top surgery. Drinking fluids and avoiding alcohol and smoking can help speed up the healing process.

Attend Follow-Up Appointments

Attending all follow-up appointments with the surgeon is crucial for monitoring the healing process and promptly addressing any concerns or complications.

As with any type of surgery, there are certain risks involved with FTM top surgery. When performed by an experienced plastic surgeon, the risks of surgery are considered minimal. Your surgeon will discuss the potential risks and complications associated with FTM surgery at your consultation, which may include:

• Bleeding and haematoma formation – a blood collection beneath the skin at the surgery site.
• Seroma – straw-coloured fluid collecting at the site of surgery.
• Wound infection.
• Nipple necrosis or death of nipple
• Loss of nipple grafts.
• Altered skin sensation.
• Altered nipple sensitivity.
• Anaesthetic risks, including anaphylaxis
• Deep vein thrombosis and pulmonary embolism

Every patient is different, and the cost of FTM top surgery in London will vary depending on the surgical technique used. Double incision top surgery with free nipple grafting will cost more than keyhole top surgery. Once you have consulted with your surgeon, you will receive a comprehensive quotation from your dedicated patient coordinator. FTM top surgery cost includes your surgeon’s fee, anaesthetist fee and facility fee. Postoperative checkups are included as part of the surgical package.

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If you’re seeking FTM top surgery, choosing a reputable and experienced provider is crucial. At Centre for Surgery, you can trust that you’re in good hands. With over 40 years of combined experience and thousands of satisfied patients, our team of plastic surgeons are considered some of the leading gender surgery experts in the UK. We specialize in FTM top surgery, and our surgeons have performed numerous successful procedures, delivering high-quality results.

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In addition to our experience and expertise, we are committed to providing personalised treatment plans tailored to your unique needs and goals. Our state-of-the-art facilities are equipped with the latest technology and equipment, allowing us to perform procedures with the highest level of precision and accuracy. We also offer comprehensive care throughout the entire treatment process, from the initial consultation to post-operative follow-up care, to ensure that you have a positive and successful experience. With a patient-centred approach to care and a track record of positive patient reviews, Centre for Surgery is a trusted and reputable provider of FTM top surgery.