FTM top surgery is a gender reassignment procedure – female to male – designed to give patients a flattened, more masculine chest. Dr. Alexander Sinclair of Beverly Hills Transgender Surgery performs FTM top surgery as part of a comprehensive gender reassignment plan, custom-tailored to meet each individual patient’s needs. Dr. Sinclair is a general plastic surgeon with extensive experience, who focuses his practice upon transgender surgery, and who served the greater Los Angeles area and beyond for more than three decades.

His compassionate bedside manner and commitment to surgical excellence have benefitted thousands of satisfied patients, many of whom return for subsequent transgender and plastic surgery procedures. If you are considering FTM top surgery, contact our office to arrange for a free consultation with Dr. Sinclair. He will listen to what you hope to achieve, evaluate your unique physical characteristics, and design a treatment plan specifically for you.

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What Is FTM Top Surgery?

Top surgery is the single most popular gender reassignment procedure for FTM transsexuals. It involves breast removal and contouring to create a chest with a more masculine appearance. It may also include nipple and areola resizing and positioning or free nipple grafts – a procedure in which the nipple-areola complex is removed completely and grafted into place after the breast is reconstructed.

FTM top surgery alone may improve social and psychological functioning and make it possible for a trans man to live more comfortably. For some patients, it may be the only surgical step taken in the FTM gender reassignment process.

FTM Top Surgery Procedures

There are several different surgical options when FTM top surgery is performed. Every issue and concern you have will be discussed in a private consultation to determine how to best move forward in your case.

The top surgical procedures for FTM include:

Keyhole Technique:

This surgical method is best suited for smaller A or small B cup breasts with little or no extra skin. In this procedure, an incision is made around the nipple-areola complex (NAC) and the tissue underneath it is removed. The incision is closed with sutures, after which the patient will wear a compression garment. The keyhole procedure is typically an out-patient surgery that takes 1.5 to 3 hours to perform.

Buttonhole Technique:

This procedure may be an option for trans men who prioritize nipple-areola size, positioning, pigmentation, and sensation. It enables removal of larger amounts of breast tissue and skin than is possible with the keyhole technique, which makes it a good choice for reducing medium to large breasts. The surgeon makes two horizontal incisions at the top and bottom of the pectoral muscle, through which excess breast tissue and skin are removed. The nipple-areola complex is resized but left attached to nerves and blood supply, preserving sensation. To reposition the NAC, the surgeon makes a circular incision at the appropriate location for a male nipple. The NAC is brought from under the skin through this incision – similar to a button through a buttonhole – and sutured into place.

Double-incision Technique:

Double-incision top surgery is a good option for medium to large chested trans men. Two horizontal incisions are made at the top and bottom of the pectoral muscle to open the skin – not the muscle. The skin in the area is pulled back and breast tissue is removed. Liposuction may be performed to adjust the contours of the chest. The nipple is typically removed, resized, and grafted onto the chest in this procedure (resulting in a loss of sensation). Double-incision surgery is typically performed as an out-patient procedure that takes approximately 3 to 4 hours.

Liposuction and Body Sculpting:

Liposuction can be performed in conjunction with top surgery procedures to further enhance your results. It can be used to remove fat deposits from under the armpits, the abdomen, and flanks to give the upper body a more sculpted, masculine appearance.

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We invite you to schedule a consultation with Dr. Sinclair to discuss how he can assist you with your transition. Consultations for elective cosmetic procedures are complimentary.

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