FTM top surgery is a gender confirmation 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 affirmation 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 in Beverly Hills, 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 confirmation procedure for FTM clients. 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.

Who is a good candidate for FTM top surgery in Los Angeles?

The World Professional Association for Transgender Health (WPATH) has created a list of criteria for undergoing top surgery to ensure that clients are psychologically supported in their gender affirmation journey. Below are the requirements:

  • Clients have persistent, well-documented gender dysphoria
  • Clients are able to fully consent to treatment
  • Clients are at least 18 years old, or they have written consent from their parents/guardians
  • Clients’ medical and/or mental health issues are reasonable under control at the time of surgery

A letter from the patient’s therapist is also called for. This letter should state that the client is fully prepared and ready for FTM top surgery, and must include the following information:

  • Patient’s legal name as well as preferred name
  • Date of birth
  • Date that therapy began and frequency of appointments
  • Statement confirming that the patient exhibits the following:
    1. A desire to live as a member of the opposite sex, accompanied by a determination to undergo surgery and hormone treatment
    2. The gender dysphoria has been consistent for at least a period of 2 years
    3. The client is not under the influence of any mental disorders
    4. The client is suffering from acute distress and compromised functioning

What can I expect from my recovery?

After surgery, you will be fitted with drainage tubes to help escort excess fluids and blood out of the blood. These will be removed about 7 days post-op. You will also be fitted with a compression garment that will help mitigate swelling and will help keep your new, improved chest contours intact.

Most clients return to work after 2 or 3 weeks, provided they continue to abstain from vigorous exercise until at least 6-8 weeks post-op.

FTM Top Surgery Procedures

There are several different surgical options when FTM top surgery in Los Angeles 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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Practice Policy Update Regarding COVID-19 View Update Virtual Consultation


Coronavirus (Covid-19) Update

Updated - June 26th 2020

The COVID-19 epidemic has created unprecedented circumstances for our community. Our practice has been paying close attention to the guidelines put in place by the government and

With this in mind, we are offering virtual consultations to patients via face time, however, face-to-face in-office consultation are still available. We are still seeing post-operative patients and patients requiring ongoing treatments. To schedule, a virtual consultation or in-office consultation call our office.

Please know that we are constantly updating our services and staffing according to the local and national recommendations and doing our part to make sure that you are protected

  • We continue to exercise all the latest recommendations that are handed down by the CDC. Our preventative measures include:
  • Fully training all staff members to understand the disease process and its modes of transmission.
  • Appointments will be staggered to avoid congestion in the waiting room.
  • Checking temperatures of every patient that comes into the office.
  • Asking all staff, vendors and ancillary personnel to refrain from coming to the office if they have any signs or symptoms of a cold or an upper respiratory tract infection.
  • Asking every patient to refrain from coming to the office if they have any symptoms and inquiring about any pertinent travel history.
  • Hand-washing, as this continues to be the most important mode of prevention.
  • Although it is something that we have always constantly done, we are now doing so with heightened vigilance and attention.
  • Constantly sanitizing all surfaces (which we have always done as an accredited facility).

However, we have now increased this routine and are wiping down all surfaces, desks, door handles, keyboards and restroom facilities multiple times each day.

Although Covid-19 is a serious issue, we strongly believe that it will pass and hopefully make our infrastructure and our ability to deal with pandemics in this country even better than it currently is. We are closely monitoring this situation on a real-time basis and will update our practice’s guidelines as needed to protect our patients.

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