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How Transgender Breast Surgery Is Performed
Dr. Turkeltaub, a member of the World Professional Association for Transgender Health (WPATH), follows the WPATH Standards of Care v7, which means that certain requirements need to be met before you are eligible to undergo top surgery. These issues will be discussed in detail during your consultation. Most importantly, you will need to be of proper age to consent to surgery and have documentation from a mental health professional supporting the appropriateness of your desire to proceed with top surgery.
FTM Surgery Techniques
Several different techniques can be used for FTM (female-to-male) top surgery. The specific technique will depend on various factors such as the amount of skin and breast tissue that needs to be removed, level of skin elasticity, presence of drooping and surgeon preference. The two most common approaches are:
- “Keyhole” Mastectomy: Breast tissue is removed using an incision made along the border of the lower half of the areola. This means that the resulting scar will be quite small and generally inconspicuous. There is no removal of breast skin.
This approach is most appropriate for smaller breasts that have good skin elasticity, no drooping and little to no excess skin. A variant of this is the concentric circle technique where a doughnut of skin is circumferentially removed from around the areola. It can be employed in the presence of large areolas or increased skin laxity.
- “Double Incision” Mastectomy: This technique is best used for larger breasts as well as those with significant skin laxity and sagging. Breast tissue is removed along with an ellipse of skin near the crease where the breast meets the chest wall. The nipple-areola complex is also removed, reduced in size and repositioned in a more appropriate location on the breast.
MTF Surgery Techniques
MTF (male-to-female) top surgery is the gender affirmation version of a breast augmentation with some variations and additional issues that need to be addressed in consideration for surgery. Typically, an inframammary incision is preferred for implant placement. Furthermore, in contrast to the submuscular placement of implants for a standard breast augmentation that is employed most all of the time, a submammary pocket (in front of the muscle) is quite often far more advantageous and recommended. Special considerations also needs to be given with regard to implant profile (height to width ratio) and cohesiveness (firmness and ability to resist deforming forces). Saline implants are just not an appropriate choice with this procedure.
After your surgery, you will be placed in a supportive surgical dressing for a few days. Patients who have had breast implants will be required to wear a surgical bra for two weeks, day and night. Those who have had a mastectomy will wear a compression garment for several weeks and will have surgical drains in place for around one to two weeks.
Returning to work, school or other activities will be determined on an individual basis that will obviously be affected by the specific procedure performed and one’s personal characteristics. In general, most patients can return to work or school within a week or two and are able to resume more strenuous activities after about four weeks.
Make sure to follow Dr. Turkeltaub’s postoperative instructions carefully as this will increase the likelihood that you will heal correctly and will minimize the risk of complications.
Contact our office at (480) 451-3000 today to schedule a consultation.