Typically, the procedure itself is done by an experienced plastic surgeon who has specialized in gender-affirming surgeries. The entire process or operation can take anywhere from 1.5 to 4 hours. Furthermore, depending on your surgeon’s preferred method and your pre-opt breast size, a masculine chest look will most likely be achieved using any one of three common surgical techniques—periareolar, double incision, or keyhole. Generally, the periareolar and keyhole methods are used for smaller chest sizes. On the other hand, double incision top surgery is usually reserved for larger chest sizes and bodies. All three methods are outpatient procedures.

The Cost

In terms of expense, FTM top surgery can cost anywhere from $3,000 to $10,000. The overall price varies due to insurance coverage, the surgeon, and where you live. Obviously, if you live in a small town or an area that doesn't have plastic surgeons trained in gender-affirming surgeries, you may have to add the cost of travel and out-of-network healthcare expenses to your overall budget. Note that there may also be hospital/facility fees to factor in as well.

Discussing Expectations and Goals

If you're like most people, you probably conducted extensive research about your upcoming procedure, which is a good thing. It's always better to be informed and have a clear understanding of your pending surgical procedure. That said, you and your surgeon should still go over the best course of action and technique for your specific procedure. Doing so will ensure that you both are clear on your expectations and goals.

Techniques to Reduce Scarring

Along those same lines, one of the most unpleasant parts of plastic surgery is the potential for visible scarring. As briefly mentioned, depending on the optimal technique for your chest size and desired outcome, there may be some visible scarring. In fact, you can expect some scarring with any of the three common surgical techniques used for this procedure. However, the keyhole method tends to cause minimal scarring, and the double incision method often has more. If you and your surgeon have determined another technique would work best, make sure you go over any aftercare that can reduce scarring post-surgery.

Having Family History Handy

In addition to discussing your goals and receiving aftercare recommendations, you and your provider should go over your family history, especially regarding breast cancer. This may seem a little counterintuitive, given the fact that you're having a significant amount of breast tissue removed. However, the reality is that cancer-causing genetic mutations can still cause a problem for you post-surgery. In the event that genetic testing does show that you're at an increased risk, your surgeon and an oncologist may recommend that all breast tissues be removed.

Prep for FTM Top Surgery and Recovery

Before your FTM top surgery, you can start prepping for your recovery process. Since this surgery is an outpatient procedure, you need to get your home ready. If all goes well, you can expect to be at home for at least two weeks. Do yourself a favor, and stock up on groceries and fluids, and set up your recovery area. Other items you should have handy to make a recovery a little easier include cleansing wipes, OTC scar treatment, back scratchers, ice packs, reusable straws, a cushioned lap desk, a compression garment and extra pillows. Note that many people prefer to spend this time on the couch as it's more user-friendly. It’s best to spend all immediate time after surgery on a comfortable bed or couch, having an easy to remove and comfortable compression garment is of utmost priority. You can find a long list of good compression garments online, or simply by asking what compressor garment your doctor recommends. Alternatively, preparation for your FTM top surgery will be similar to any other outpatient procedure. Normally, your surgeon/provider will give you a list of all the things you can and can't do before surgery. For instance, you should avoid alcohol and stop smoking, preferably days before the actual operation. You should also make sure to discuss any current medications you're taking and set up transportation as you won't be allowed to drive yourself. Finally, the night before surgery, lay out comfortable, loose clothing that's easy to get in/out of before and after surgery.

FTM Top Surgery Post-Op

Post-surgery, you can expect to be sore and slightly uncomfortable for several days while your body starts to heal. Roughly a week after your procedure, you should have a follow-up appointment schedule to remove any dressing and to get an overall sense of how you're healing. Usually, any swelling will decrease after several weeks, especially with the use of a compression garment. It’s proven that with the use of a body compression suit, swelling can decrease quicker than without the use of a compression garment. Prior to this follow-up appointment, your provider/surgeon will go over permitted post-surgery activities. This basically means no heavy lifting (6 weeks post-op), exercising (8 weeks post-op), or lifting your hands above your head for at least two weeks.

Possible Complications of FTM Top Surgery

Much like with any surgery, FTM Top Surgery does have some associated risks and potential complications that can occur. As a result, there's always a possibility that you'll have a bad reaction to the anesthesia or suffer other complications like blood clots and infection. You may also experience post-op depression. Therefore, if you have a history of depression, don't forget to discuss this with your doctor. That said, FTM top surgery specific complications include a failed nipple graft, reduced sensation, scarring, and additional reconstructive surgery. Ultimately, these are just a few things you need to know before your FTM top surgery. Take some time resting both mentally and physically. Invest in a good compression garment and ensure you have friends or family to help you along. If you'd like more information or have general questions about this surgery, contact your local healthcare provider or a gender-affirming surgeon.