What is FTM top surgery?

FTM top surgery, or FTM (female to male) top surgery - also known as masculinising chest surgery or, solely, top surgery - is a surgical procedure called subcutaneous mastectomy.

What's involved in FTM top surgery?

FTM top surgery removes breast tissue to create a more masculine-appearing chest. 

There are different types of subcutaneous mastectomy procedures:

• double incision mastectomy;
• subcutaneous mastectomy with nipple preservation;
• periareolar mastectomy.

Double incision mastectomy

This surgery is recommended for people with more breast tissue. Cuts are made under and on top of each breast, and breast tissue and some chest skin is removed. 

It may be required to change the shape and location of the nipples. In order to achieve this, the surgeon removes the nipples, makes them smaller and more oval shaped. They are then reattached to the chest wall. There is no feeling in the nipples and areolas after this procedure.    

Subcutaneous mastectomy with nipple preservation

For those with smaller breasts, subcutaneous mastectomy with nipple preservation is a type of FTM top surgery that people may be recommended.

Periareolar mastectomy

It's advised that a smaller to medium-amount of breast tissue is suitable for this operation. It involves a small cut made around the areola of each breast and the breast tissue is removed. It's rare than any skin is removed, and nipples and areolas remain attached which helps to preserve sensation in the area.

Is FTM top surgery painful?

After FTM top surgery, discomfort may be present for a few days. However, after four to five days, pain will ease. It can be managed with over-the-counter pain medication such as ibuprofen. 

What's involved in recovery from FTM top surgery?

Recovery from FTM top surgery involves:

• Dressings; you should continue to wear dressings until you see your doctor for a follow up appointment, and they confirm it's okay to remove them. You may also have drains in place, and you'll be given instructions on how to empty them.
• Compression garments; A compression vest is placed on your body in the operating room after the procedure. It's important to ensure you wear this vest at all times in order to prevent post-operative bleeding and fluid collection. 

Again, discomfort and pain may be present after the procedure but it should last up to four to five days. It can be managed with pain medication. 

What are the complications of FTM top surgery?

Possible complications of FTM top surgery include:

• bleeding;
• infection:
• problems with healing;
• loss of nipple sensation;
• nipple and areola loss;
• anaesthetic complications. 

Which specialist undertakes FTM top surgery?

Plastic surgeons and oncoplastic surgeons are the expert specialists who do FTM top surgery.