Female to Male (FTM) & Female to Non-Binary (FTN) Top Surgery
Feeling that the body you were born with does not match the innate sense of your true gender can be stressful, anxiety provoking and depressing. For those who are transgender or gender non-binary, your appearance as opposed to your gender identity do not align. Even if you think, behave, dress and interact with others in a way that feels authentic to you, certain gendered physical characteristics may continue to represent a source of discomfort or distress—resulting in a condition known as gender dysphoria.
For many individuals, gender dysphoria can lead to negative, destructive manifestations such as anxiety, depression, eating disorders, self-harm, substance abuse, anti-social behavior and even suicide. Counseling, psychological and psychiatric sessions can be very effective in helping people constructively address and deal with both gender identity issues and the associated negative behaviors. It can also help facilitate medical transition including gender affirming surgery where a person can ultimately bring their physical characteristics into better alignment with their gender identity.
Advancements in the field of gender affirming plastic surgery and the greater availability of these services have made it far easier for interested individuals to undergo these procedures, leading to results that can be extremely positive and life-changing. Here at the Arizona Center for Aesthetic Plastic Surgery, board-certified plastic surgeon Dr. Steven H. Turkeltaub specializes in transgender breast (top) surgery, including female to male (FTM) and female to non-binary (FTN) top surgery, helping his patients obtain tremendously desirable outcomes.*
Dr. Turkeltaub has been providing care to members of the transgender community for many years, and he strives to ensure that every interaction you have with him and his staff is professional, caring, helpful and supportive.
During your consultation with Dr. Turkeltaub, he will seek to understand your unique goals and desires. Then, based on your anatomy, he will customize a treatment plan to help you achieve your life-changing transformation.
Before you can undergo the selected breast procedure, however, we do require written documentation by a qualified mental health professional diagnosing your gender dysphoria, stating that you have met all criteria necessary to be considered an appropriate candidate for the surgery and supporting your desire to proceed with it.
We do follow the guidelines from the World Professional Association for Transgender Health (WPATH) Standards of Care. WPATH seeks to promote the highest possible quality of care for transgender and gender diverse individuals, championing respect, compassion and inclusivity, Dr. Turkeltaub has been a member of the organization for several years and he seeks to uphold these values throughout every facet of his practice.
*Genital reconstruction procedures are not offered.
What Is Female-to-Male (FTM) Transgender Breast Surgery?
Female to male (FTM) transgender breast surgery—also called FTM top surgery—is a gender affirming reconstructive procedure that transforms an anatomically female presenting chest into a more masculine appearing one that aligns with the individual’s actual gender identity. FTM top surgery is generally the first and, oftentimes, the only surgical treatment that transmen pursue as a part of their medical transition due to its efficacy in addressing chest-based gender dysphoria.
Changing a feminine chest anatomy to a masculinized form involves the removal of the breast tissue (mastectomy) along with any excess skin, possible nipple and areola modifications including size and position, and contouring of the chest wall. This is most often accomplished with the keyhole technique, the concentric circle (periareolar) approach or with the double incision free nipple graft technique (see below for more). Liposuction can also be used to further enhance the outcome. Other ancillary procedures may be desired in order to better align with one’s affirmed gender.
As with any surgical procedure, there are attendant risks that will be discussed during your consultation. With his extensive experience and meticulous techniques, Dr. Turkeltaub will do whatever he can in order to help you obtain the best possible results while also trying to prevent or minimize the chance of these untoward issues occurring.
Female to Male (FTM) and Female to Non-Binary (FTN) Top Surgery Techniques
There are several different procedures and variations that can be considered in FTM or FTN top surgery. Ultimately, a variety of factors such as the initial breast size, presence and degree of drooping and skin laxity, size and location of the areola and chest wall contour will determine the best surgical course of action. All of these are typically performed under general anesthesia as an outpatient procedure.
Keyhole mastectomy – With this technique, a mastectomy (removal of the breast tissue) is performed through an incision involving the lower half of the areola, making the ultimate scar fairly inconspicuous. This is a good choice when the breasts are small and have good skin tone. If the areolas are large, they can be reduced in size at the same time by extending the incision around the whole areola and removing a “donut” of skin (see B).
Concentric circle (periareolar) mastectomy – This is a variation of the Keyhole technique (see A) and is used when there is some excess skin present and/or a large areola that needs to be reduced in size. This approach involves the excision of a “donut” of skin of an appropriate width extending around the entire areola, either at its margin or within it (to reduce its size).
Double incision free nipple graft mastectomy – This technique is excellent for moderately sized or larger breasts and those with substantial skin excess, often characterized by drooping. This technique entails undergoing the mastectomy in combination with the removal of a large ellipse of skin. It employs an incision in or near the crease at the bottom of the breast. The nipple-areola complexes are removed as full thickness skin grafts, reduced in size and then placed back at an appropriate location on the chest.
In some cases, a patient may prefer to not have their nipples reattached. You should discuss this option with Dr. Turkeltaub ahead of time.
Inverted “T” mastectomy – This is the same configuration as that performed for most breast reduction procedures and involves an incision extending from around the areola then down to and along the crease at the lower part of the breast. With this technique, the nipple-areola complexes can either remain attached to underlying tissues or be removed and repositioned back as full thickness skin grafts.
Nowadays with the available options, there is essentially no reason to use this approach.
At the time of your consultation with Dr. Turkeltaub, the most realistic option(s) for your particular situation will be thoroughly discussed.
Female to Male (FTM) and Female to Non-Binary (FTN) Top Surgery Recovery
Following surgery, you will have a circumferential dressing on for a few days before being placed in an elastic, form-fitting garment for several weeks. Drains, which are placed at the time of surgery, are usually removed in the office after ten days to two weeks.
You can expect discomfort to be mild to moderate and it is usually well controlled with oral analgesics (painkillers) like Tylenol. Most patients can return to school or a non-strenuous job within several days to a week. Very vigorous activities, heavy lifting, certain sports and straining need to be avoided for around four weeks after surgery, and upper extremity activities should be minimized for a total of eight weeks. There will be some variation in these guidelines based on the specific technique employed as well as individual circumstances.
“How was your recovery time?” – Transgender Patient
The transformational results of your FTM or FTN breast surgery is apparent immediately. However, it can take up to a year for you to see what the final results will be as the swelling abates and the scars fade.
Female to Male (FTM) and Female to Non-Binary (FTN) Top Surgery Patient Testimonials*
*Individual Results May Vary
Are You Interested in FTM or FTN Breast Surgery?
If you are seriously considering Female to Male or Female to Non-Binary breast surgery, Dr. Turkeltaub would be very happy to assist you in making your goals a reality. To schedule your consultation, you can contact our practice either by phone at (480) 451-3000 or online.