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Is Gender-Affirming Breast Surgery Right for Me?

3 Minute Read: 

Gender-affirming top surgery refers to chest/breast procedures that help trans men, trans women, gender non-binary individuals and others in the LGBTQ+ community address their gender dysphoria and feel physically more aligned with their true gender identity. 

Man holding his hand over his chest.

This is a very personal decision, however. Not everyone with these gender identities feel the absolute need to undergo a top surgery procedure that may otherwise be appropriate for them. 

When Is the Best Time to Consider Gender-Affirming Breast Surgery?

If you are experiencing well-identifiable gender dysphoria related to your breasts, then that is an indication that it may be time to pursue surgery.  

However, it is not as simple and straightforward as showing up to a plastic surgeon’s office stating that you want to have top surgery and then proceeding with scheduling. 

What Are the Criteria to Be Approved for Top Surgery?

Anyone seeking gender-affirming surgery must have documented and persistent gender dysphoria (emotional discomfort caused when their assigned sex differs from their true gender identity). This requires a rigorous evaluation by a psychiatrist, psychologist, licensed social worker or counselor specializing in gender issues. Sometimes, this evaluation can take months or longer before the evaluator is comfortable in supporting (or not) a diagnosis of gender dysphoria. 

A professional letter can then be written affirming several necessary criteria including the diagnosis of gender dysphoria and support for the desire to undergo top surgery.

What Is Involved in Gender-Affirming Breast Surgery?

Female-to-Male (FTM) or Female to Non-Binary (FTN) Top Surgery

Female-to-male (FTM) or female-to-non-binary (FTNB) top surgery for trans men and gender non-binary involves the removal of the breasts via a mastectomy, typically creating a chest that is either masculinized or flat and neutral to the specifically requested degree.

There are a few different procedures that can be considered depending on anatomy, breast size and other factors. Some even request that this be performed without preserving the nipple-areola complexes. 

Surgery is performed under general anesthesia as an outpatient. Typical surgical times can range from around one a half hours to three hours. 

Male-to-Female (MTF) Top Surgery

Male-to-female (MTF) top surgery is the gender-affirming procedure designed to feminize the appearance of the chest. It is, in essence, a breast augmentation performed on non cis-females. 

There are several factors that must be addressed in order to obtain the best possible results. Because the natal male chest (born and genetically male) is significantly different than a cis-females, there usually will be some substantail limitations and compromises in order to obtain reasonable results. 

MTF breast surgery is performed under general anesthesia as an outpatient. The expected range of surgical times is between one and one and a half hours. 

What Is Recovery From Gender-Affirming Breast Surgery Like?

Initial postoperative discomfort following FTM/FTNB and MTF top surgery depends on several factors including procedure type, implant placement, surgical skill and “tolerance” to discomfort. That being said, the discomfort level is generally mild to moderate and may be present only for the first few days.

Resumption of working out depends on a variety of factors including the procedure, health, healing quality and physician preference. Typically, this may be around a month, though there often are limited restrictions for another month or so. 

Returning to work without restrictions depends on the specific procedure performed and the job requirements. For a job that is sedentary, time off may be one to two weeks. A very physically demanding job can require up to six to eight weeks off of work.

Learn More About Top Surgery

Want to know more about FTM, FTNB or MTF top surgery? 

You can either call us at (480) 451-3000 to schedule a consultation with me, Dr. Steven Turkeltaub, or contact us by email.