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Home|Blog | What Surgical Options Are Available for Female-to-Male (FTM) or Female-to-Nonbinary (FTN) Top Surgery?

What Surgical Options Are Available for Female-to-Male (FTM) or Female-to-Nonbinary (FTN) Top Surgery?

June 2, 2026

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If you’re considering female-to-male (FTM) or female-to-nonbinary (FTN) top surgery, it can be helpful to understand your surgical treatment options. Top surgery is an umbrella term for a wide variety of procedures that can be selected to address your chest dysphoria. The one that is best for you would depend on your individual anatomy and personal needs.

At the Arizona Center for Breast Surgery, understanding your surgical option(s) can help you make more confident decisions about your body and gender affirming care. This blog will discuss the various FTM/FTN top surgical options and what to expect from each one.

Table of Contents

FTM and FTN Top Surgery: What’s the Difference?

Gender affirming top surgeries are procedures designed to reshape the chest to fit a patient’s gender identity. However, both the techniques employed and the results vary based on each patient’s goals, their present anatomy and other factors.

Female-to-male transgender breast surgery, or FTM top surgery, transforms a female-presenting chest into a more masculine-appearing one. Many individuals seeking female-to-nonbinary breast surgery, or FTN top surgery, also want a masculinized chest so it is only the gender identity that is different — the procedures are identical.

However, there are also patients wanting FTN top surgery who do not want a masculinized chest. There are different procedures which can accomplish their goals.

Both FTM and FTN top surgery are highly customizable and can be designed to better align with a patient’s desired results.

Types of FTM/FTN Top Surgeries

The following are the most common surgical options for gender affirming top surgery.

Keyhole Mastectomy

During a keyhole mastectomy, breast tissue is removed through an incision along the lower half of the areola. This approach involves the most minimal incision and usually leads to an inconspicuous scar.

The ideal candidate for this has very small breasts, typically an “A” cup, along with good skin tone without any skin excess or drooping. The areola should also be of desirable size.

Concentric Circle (Periareolar) Mastectomy

The concentric circle (periareolar or circumareolar) technique involves an incision placed around the entire areola with a donut-like removal of skin and/or areola. With this approach, some skin tightening will be accomplished and there can be a reduction in the overall size of the areola.

Ideal patients for this are around a “B” cup size with relatively good skin elasticity and no drooping. Only a relatively small amount of skin can be removed with this approach without causing substantial contour deformities and areola irregularities.

Double Incision Free Nipple Graft Mastectomy

This is the most common type of incision pattern. It involves curvilinear or linear removal of a pseudo-ellipse of skin along with breast tissue and fat. The nipple-areola complexes are removed, reduced in size and placed back on the chest in the desired location as full-thickness skin grafts. This allows for maximum contouring and precision and generally provides the most consistent results.

Ideal candidates have a medium to large chest size, with or without drooping. The incisions used for this approach are, by nature, more extensive. Because the nipple-areola complexes are completely removed from their nerve supply, there will be no sensuality and little to no sensation long term.

Double Incision Mastectomy Without Nipple-Areola Complexes

This procedure follows the same steps as standard double incision mastectomies except that the nipple-areola complexes are permanently removed. Many gender nonbinary and non-conforming patients as well as some trans men choose this option.

Inverted “T” Mastectomy

This involves an incision around the areola, then vertically downward across the lower breast, resembling an anchor or an inverted “T”. It is virtually never indicated for a routine mastectomy since the double incision will accomplish the flat chest without the extra scar. It is used, however, in gender affirming breast reductions (see below).

Inverted “T” Gender Affirming Breast Reduction

This is used for those gender nonbinary, gender fluid and androgynous individuals who want to retain a small breast — typically an “A” or “B” cup – rather than being totally flat. This involves inverted “T” shaped incisions (as above) and can be performed either with or without the nipple-areola complexes.

Combining FTM/FTN Top Surgery With Other Procedures

Some patients choose to combine their FTM/FTN top surgery with additional body contouring procedures to achieve more or their desired long-term results. This could be related to the gender aesthetic or just to weight issues. One common consideration would be for liposuction in order to create a more masculinized body contour or a less feminine-appearing one. This may involve liposuction of the abdomen, hips, thighs, chest and arms.

Those individuals with large skin and fat rolls of their chest may benefit from a lateral chest wall lipectomy. This allows for a more harmonious, dynamic improvement of body contour. Some other procedures to consider are a tummy tuck and arm lift.

Which Top Surgery Is Right for Me?

The most appropriate approach for you will depend on:

Determining the best surgical option for you starts with a personalized consultation with a reputable plastic surgeon specializing in gender affirming top surgery and who is board certified by the American Board of Plastic Surgery.

Does FTM/FTN Top Surgery Leave Visible Scarring?

Top surgery leaves varying degrees of scarring with the major determinant being the surgical approach employed. The very limited incisions associated with the keyhole and concentric circle (periareolar) techniques are far more inconspicuous, in general, as compared to the much more extensive incisions associated with the double incision mastectomies and gender affirming breast reductions.

Individual factors also can significantly impact the final scar appearance. Some of these include:

Scar maturation can take six to twelve months or more for full maturation. However, even over a period of several years, they can become even more inconspicuous.

Choosing the Right Surgeon for Your FTM/FTN Top Surgery

It’s important to learn about your surgical options from a reputable and experienced plastic surgeon who’s dedicated to quality, patient-oriented care and detailed surgical planning that caters to you. At the Arizona Center for Breast Surgery, Dr. Steven H. Turkeltaub will ensure that you’re well-informed about and prepared for your treatment.

Dr. Turkeltaub is certified by the American Board of Plastic Surgery and has extensive experience in gender affirming top surgery, cosmetic breast procedures and breast reconstructive surgery. He relentlessly seeks to provide you with the best comprehensive care and surgical results that can have a lasting and strongly positive impact on your life.

Schedule Your Top Surgery Consultation

Whether you live in Phoenix, Scottsdale or anywhere else in Arizona or elsewhere and are seeking FTM/FTN top surgery, you are invited to schedule a personal consultation with Dr. Turkeltaub. You can do so either by calling the Arizona Center for Breast Surgery at (480) 451-3000 or by filling out our online contact form.