Nipple-Sparing Double Incision Top Surgery

Double incision top surgery is a masculinising chest procedure designed to create a flatter, more defined contour by removing excess breast tissue. The operation involves making two carefully placed incisions along the lower edge of the pectoral muscles. These incisions allow for the precise removal of breast tissue while sculpting the chest to achieve a more traditionally masculine appearance.

A key aspect of this procedure is the handling of the nipple-areola complex. Rather than completely removing and grafting the nipples, the surgeon carefully detaches them from the underlying breast tissue while ensuring that their blood supply is maintained. This technique helps preserve a more natural look and, in some cases, retains some degree of sensation over time.

To enhance the final result, your surgeon may suggest incorporating liposuction to refine the chest contours further. Liposuction is particularly useful for addressing areas of excess fat along the sides of the chest, preventing the formation of “dog ears”—small folds of skin and fat that can appear at the outer edges of the incisions. This additional step helps create a smoother, more seamless transition between the chest and surrounding areas.

RELATED: How to Avoid Dog Ears After FTM Double Incision Mastectomy

The entire procedure is performed under general anaesthesia, ensuring a pain-free experience. It typically takes around two hours to complete and is carried out as an outpatient surgery at our Baker Street centre, meaning most patients can return home the same day to begin their recovery. With careful surgical planning and attention to detail, double incision top surgery offers a life-changing transformation for those seeking a masculine chest that aligns with their gender identity.

Dr Spiros Vlachos is a highly skilled specialist in masculinising chest surgery, offering a range of procedures tailored to individual needs. With expertise in double incision mastectomy with nipple preservation, periareolar mastectomy, and inverted T top surgery, Dr Vlachos ensures outstanding aesthetic results while prioritising patient safety and satisfaction.

Renowned for his meticulous technique and compassionate approach, Dr Vlachos helps individuals achieve a more masculine chest contour with natural-looking outcomes. His extensive experience in nipple-sparing double incision mastectomy allows for optimal preservation of nipple sensation and placement, enhancing post-surgical appearance.

Dedicated to delivering personalised care, Dr Vlachos works closely with each patient to understand their goals and provide the most suitable surgical approach. Whether seeking a traditional double incision mastectomy or a more refined nipple-sparing technique, patients can trust in his expertise for transformative, life-affirming results.

Before undergoing nipple-preserving double incision top surgery, a comprehensive clinical assessment is necessary to determine whether this procedure is the right fit for you. Our experienced gender-affirming surgeons will carefully evaluate several key factors, including breast size, skin elasticity, and overall health, to ensure that you can achieve the best possible results.

This surgical technique is most suitable for individuals with moderate breast tissue and good skin elasticity, as these factors help facilitate a smoother chest contour while preserving the nipple-areola complex. Those with larger breasts or significant sagging may not be ideal candidates for this procedure, as the ability to maintain nipple viability and achieve an optimal aesthetic outcome may be compromised. In such cases, alternative techniques, such as free nipple grafting, may be recommended to provide the desired masculine appearance.

During your in-person consultation, your surgeon will discuss all available options, guiding you towards the most effective approach based on your unique anatomy and surgical goals. The priority is always to create results that align with your identity while maintaining safety and long-term satisfaction. If you are considering top surgery and wish to explore whether the nipple-preserving technique is suitable for you, our expert and compassionate team is here to provide expert advice and support throughout your journey.

Undergoing gender-affirming surgery is a significant milestone that requires both physical and emotional preparation. Getting ready for nipple-preserving double incision mastectomy involves careful planning to ensure a smooth procedure and a comfortable recovery. Our team will provide personalised guidance during your pre-operative consultations to help you prepare effectively. Here are some key aspects to consider in the lead-up to your surgery.

Optimising Physical Health

Maintaining a healthy lifestyle before surgery can have a direct impact on your recovery. Regular exercise, a well-balanced diet, and proper hydration contribute to better healing and overall well-being. Your surgeon may provide specific recommendations regarding dietary changes, as well as instructions on medications and supplements to avoid before the procedure. Certain substances, such as blood thinners, should be discontinued in the weeks leading up to surgery to minimise risks.

Mental and Emotional Readiness

It’s natural to experience a mix of excitement and anxiety before surgery, especially when it marks such an important step in your gender-affirming journey. Speaking with a clinical psychologist who specialises in gender-affirming care can be beneficial in managing any pre-surgery stress. Additionally, leaning on supportive friends, family, or community networks can help you feel more confident and emotionally prepared for the changes ahead. Your surgeon will also be available to answer any questions or concerns you may have about the procedure, post-surgical care, and recovery expectations.

Planning for Time Off Work

Recovery times vary from person to person, but it’s important to plan ahead for time away from work. Most patients can resume desk-based jobs within a week, while those with physically demanding roles may need additional time off. During your consultation, your surgeon can provide guidance on the best recovery timeline based on your specific needs and lifestyle.

Pre-Surgical Blood Tests

As part of your pre-operative assessment, your surgeon may request blood tests to ensure you are in good health before undergoing surgery. These results should be submitted to the clinic at least one week in advance to avoid any last-minute delays.

Setting Up a Comfortable Recovery Space

Preparing your home in advance will make the post-surgery period much easier. Before your procedure, stock up on any prescribed pain medication and antibiotics and keep them within easy reach near your bed. Since movement will be restricted in the initial days, placing essential toiletries and everyday items on lower shelves can help avoid unnecessary strain. It’s also advisable to arrange for a trusted friend or family member to assist you during the first 48 hours following surgery, as you may need extra support with basic tasks.

Nipple-preserving double incision top surgery is an outpatient procedure, meaning that you will be able to return home just a few hours after waking up from anaesthesia. However, the recovery process is just as important as the surgery itself in achieving optimal results. Following your surgeon’s post-operative care instructions carefully will ensure a smoother healing process and a more comfortable recovery experience.

No Need for Surgical Drains

Unlike some other surgical providers who routinely use drains to remove excess blood and fluid after top surgery, we utilise advanced surgical techniques that eliminate the need for post-operative drains or tubes. Traditional surgical drains can be restrictive and uncomfortable for patients, making at-home recovery more challenging. By avoiding the use of drains, we ensure that your healing process is more comfortable, with fewer maintenance requirements and a lower risk of complications.

Wearing a Compression Binder

To promote proper healing and minimise complications, you must wear the required compression binder for up to six weeks following your surgery. This medical garment plays a crucial role in reducing swelling, preventing fluid buildup, and ensuring that the healing skin remains in place. It also helps to minimise scarring and provides additional support to reduce post-operative discomfort. Wearing the binder as instructed is essential for achieving the best possible surgical outcome.

Rest and Support at Home

Since you will not be able to drive yourself home after the procedure, it is essential to arrange for a trusted friend, family member, or caregiver to pick you up from the clinic. In the first few days of recovery, your mobility will be limited, and simple tasks such as cooking, cleaning, and laundry may be difficult to manage on your own. If you live alone or are travelling from abroad for your surgery in the UK, speak with our team in advance so that we can assist you in arranging post-operative care or caregiver support.

Returning to Work and Daily Activities

Recovery timelines vary from person to person, and there is no universal answer for when you will feel ready to return to work or normal activities. If you have a desk-based job, you may feel well enough to resume work after about a week of rest. By this time, light walking may also be possible. However, listening to your body and avoiding pushing yourself too soon is crucial. Engaging in heavy lifting or strenuous activities within the first six weeks can increase the risk of complications, such as bleeding or delayed healing. Your surgeon will provide personalised advice on when it is safe to reintroduce more physical activities gradually.

Like any surgical procedure, nipple-preserving double incision mastectomy carries certain risks and potential complications. While modern surgical techniques and careful planning significantly reduce the likelihood of complications, it is essential to be aware of the possible risks involved. Your surgeon will discuss these in detail during your consultation and outline the precautions taken to minimise them.

Infection and Bleeding

As with any surgery, there is a small risk of infection or excessive bleeding following the procedure. Infection can usually be prevented with proper wound care and prescribed antibiotics. Signs of infection may include increased redness, swelling, warmth, or pus-like discharge from the incision site. If excessive bleeding occurs, it is important to seek medical attention promptly.

Changes in Nipple Sensation

Since this procedure involves the careful detachment and repositioning of the nipple-areola complex, some patients may experience changes in nipple sensation. This can include increased sensitivity, numbness, or a loss of sensation. In many cases, sensation partially or fully returns over time, but results vary from person to person.

Asymmetry and Uneven Healing

Although surgeons take great care to create a balanced and symmetrical chest appearance, slight variations in nipple positioning or overall contour may occur during the healing process. Swelling and scar tissue formation can sometimes cause temporary asymmetry, which often resolves as the body heals. In rare cases, revision surgery may be considered if significant asymmetry remains after full recovery.

Scarring

Scarring is a natural part of any surgical procedure, and while the incisions are strategically placed along the lower border of the pectoral muscles, they will leave some visible marks. The extent of scarring varies depending on individual healing factors, skin type, and adherence to post-operative care instructions. Over time, scars typically fade, and treatments such as silicone sheets or laser therapy may help improve their appearance.

Minimising Risks and Ensuring a Smooth Recovery

To reduce the likelihood of complications, following all post-operative care instructions provided by your surgeon is essential. This includes taking prescribed medications, attending follow-up appointments, avoiding strenuous activities, and wearing your compression binder as directed. You can optimise your healing process and achieve the best possible results by prioritising rest, proper wound care, and a gradual return to normal activities.

Undergoing a Nipple-Preserving Double Incision Mastectomy is a deeply personal and transformative step for many transgender and non-binary individuals. At Centre for Surgery, we recognise the significance of this journey and are committed to providing the highest standards of care in a safe, inclusive, and welcoming environment. With extensive experience in gender-affirming procedures, our expert surgical team has helped thousands of patients achieve a more comfortable and confident sense of self.

We understand that each individual’s needs are unique, which is why we offer personalised treatment plans tailored to your goals. From your initial consultation to post-operative care, our dedicated team will be with you every step of the way, ensuring a smooth and supportive experience.

What Sets Us Apart?

• Specialists in Gender-Affirming Surgery – Our surgeons are highly experienced in masculinising chest surgery, offering cutting-edge techniques that preserve the nipple-areola complex for a more natural result.
• No Post-Surgical Drains – Unlike many clinics, we use advanced surgical methods that eliminate the need for drains, reducing discomfort and making recovery easier.
• Personalised Care – We tailor each procedure to match the patient’s anatomy and personal goals, ensuring an optimal outcome.
• State-of-the-Art Facilities – Our Baker Street clinic in London is equipped with the latest medical technology, providing a safe and comfortable environment.
• Flexible Finance Options – We offer a range of financing plans to help make gender-affirming surgery more accessible.

What Our Patients Say

💬 Alex, London
“From start to finish, the team at Centre for Surgery made me feel seen and respected. The surgery was seamless, and the results are everything I hoped for. I finally feel comfortable in my own skin.”

💬 Jordan, Manchester
“I was really anxious about surgery, but the staff were so reassuring and supportive. My surgeon took the time to answer all my questions, and my recovery was smooth. I couldn’t have asked for a better experience.”

💬 Sam, Bristol
“The best decision I ever made! The care I received was outstanding, and the results exceeded my expectations. I felt safe and in good hands throughout the entire process.”

Book Your Consultation

If you’re considering Nipple-Preserving Double Incision Mastectomy, we invite you to book a consultation with our expert team. We will provide a detailed assessment, discuss your goals, and guide you through the next steps with clarity and care.

📍 Visit us at our Baker Street clinic in London
📞 Call us: +44 (0)20 7993 4849
📧 Email us: info@centreforsurgery.com
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At Centre for Surgery, we are dedicated to providing world-class gender-affirming surgical care. Let us help you take the next step towards a body that aligns with your identity, with compassionate support at every stage.