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FTM top surgery, is usually classed as an elective surgery. However, after having performed hundreds of top surgeries on diverse patients, Dr. Sajan understands that FTM top surgery—and many other gender affirming procedures—can be lifesaving and significantly improve a person’s quality of life. Thus, with legislation in multiple states banning any gender affirming care for people under 18, Dr. Sajan is one of the top providers in the United States able to and still offering top surgery for minors. Allure Esthetic Plastic Surgery provides the best FTM top surgery for minors Texas patients have access to.

Top Surgery For Minors: When & Why?

Female-to-male top surgery—or FTM top surgery—is a gender affirming procedure that involves removing the breasts and sculpting a more male-presenting physique. The same procedure can also be performed for non-binary patients looking for a flat chest. The majority of patients who undergo this procedure are adults. However, there are some cases where it is appropriate for patients under 18 to have top surgery.

The primary reason patients undergo top surgery is to help alleviate and treat a condition known as gender dysphoria. This diagnosis usually involves a feeling of intense discontent or dislike of one’s body, primarily focused on gender-identifying areas such as the genitals, breasts, and certain facial features. Gender dysphoria can also involve several other symptoms that hinder a patient’s life.

One of the first areas a transgender male may seek surgical treatment for is the chest. Additionally, it is important to note that not all transgender or gender non-conforming people experience gender dysphoria or seek surgical treatment. When evaluating whether a minor is suitable for undergoing the procedure, several factors are considered and more paperwork is required than that of an adult patient.

Candidates For Minor FTM Top Surgery

A minor who qualifies for FTM top surgery will likely meet qualifications such as:

  • A long and well-documented history of gender dysphoria
  • Full understanding of the procedure, what it entails, and the possible risks and ramifications
  • In a good mental state and able to provide informed consent
  • Has parental consent
  • May have already begun a chemical transition with hormones (Dr. Sajan does not require this, but some insurance companies do)
  • Other health issues stemming from gender dysphoria such as anxiety, depression, or physical injury from binding
  • The patient has lived in their gender identity for at least one year before surgery
  • Is otherwise healthy and can safely undergo elective surgery

Benefits & Risks

All surgical procedures come with inherent benefits and risks. For most who undergo minor FTM top surgery, there are few risks or complications that can or do occur. Dr. Sajan will review the benefits and risks with the patient and their parental figure during the consultation and before surgery to ensure full understanding and consent.

The benefits of FTM top surgery for minors may include:

  • Alleviation and treatment of gender dysphoria
  • Chest contour that better matches the patient’s identity
  • Ability to be seen as a male outwardly
  • May help reduce certain mental health issues
  • Reduce instances of misgendering
  • Improve overall quality of life
  • Allows patients to stop binding
  • Live visibly in their gender identity
  • Minimal risk
  • Short surgery time
  • Easy recovery with minimal pain for most patients
  • Performed to the World Professional Association for Transgender Health’s standards for gender affirming care
  • Performed by a surgeon with extensive experience in top surgery and many other gender affirming procedures

Like all surgeries, FTM top surgery comes with some risk of complications. For minors, the risks remain roughly the same as adult patients; though, their age, medical history, and history of gender dysphoria all need to be thoroughly evaluated. As it stands now, the minor and adult rates of top surgery remain about the same at one percent. This is one of the lowest regret rates of all elective surgeries.

The risks of minor FTM top surgery may include:

  • Infection
  • Scarring
  • Complications associated with general anesthesia
  • Asymmetry
  • Skin or nipple death
  • Temporary or long term loss of nipple sensation

Major complications following FTM top surgery are exceptionally rare.

From Start To Finish FTM Top Surgery For Minors Texas


For patients traveling from Texas, Dr. Sajan offers both in-person and virtual consultations. The virtual consultations are held via FaceTime or Skype. Patients will receive the same standard of care as they would in the office. Dr. Sajan will first discuss the patient’s goals, medical history, preferences, and other aspects of the surgery with the patient and their guardian.

Dr. Sajan will also conduct a physical exam. This allows him to determine the top surgery techniques the patient qualifies for. Then, depending on the patient’s desires and anatomy, Dr. Sajan will make a recommendation for the surgical technique. After discussing the options, the patient can then inquire more about insurance and financing, if necessary.

Traveling To Seattle

Patients—depending on the specifics of their surgery—may have their pre-operative appointment virtually about three weeks before surgery, or in person a day or two before surgery. Allure Esthetic works to accommodate patients flying in from Texas for care. We offer discounts with a few local hotels. When requested, the Allure Esthetic team can also provide concierge services that could include transportation, caregiving, and local recommendations.

Dr. Sajan normally likes patients to fly in at least the day before their surgery. Patients should factor in potential flight delays and the time of year when determining the dates of their flights. Before traveling, patients will also need to work out logistics such as childcare, time off work and school, and other necessary arrangements.

Top Surgery Procedure

On the day of surgery, the patient and their parent will come to an Allure Esthetic surgical center. Upon checking in, patients can expect to have their vitals and basic tests performed. They will then meet with Dr. Sajan who will mark the patient for surgery and confirm the surgery plan. Patients are then taken to the operating room and placed under general anesthesia.

The most frequently performed type of FTM top surgery uses a surgical technique called the double incision chest reconstruction. Making an incision on either side of the chest—just below the breast—Dr. Sajan removes the tissue and nipples. If patients want nipples on their new chest, Dr. Sajan resizes them and places the nipples back on the chest.

Another type of top surgery that patients under 18 may qualify for is keyhole top surgery. This uses only a small incision in the areola area and removes breast and glandular tissue. The keyhole technique is only utilized when there is very little breast tissue and the nipples do not need repositioning.


Patients tend to bounce back well after FTM top surgery. Some patients do not use prescription pain medications at all during their recovery. Patients will go home in a compression garment that they will need to wear constantly until otherwise told. They should avoid heavy lifting and strenuous activities for at least two weeks.

Out-of-town patients are advised to stay in the Seattle area for at least one week after surgery. This is generally when patients have nipple bolsters removed and are healed enough to fly back to Texas. The exact time Dr. Sajan recommends staying after recovery can fluctuate given various circumstances.

Frequently Asked Questions

Does Insurance Cover FTM Top Surgery For Minors?

In many cases, yes. However, this will vary between companies and plans. Some may have more stringent requirements for minor patients while others may not cover it at all. It is recommended that patients inquire about their insurance plan’s coverage before their consultation.

Allure Esthetic’s insurance coordinators can also help patients at all steps of the process. Often, patients reach out to the insurance team at some point before or after their consultation.

Can You Get Top Surgery Without Having Dysphoria?

Yes, but not usually as a minor. For a person under 18 to get top surgery, there usually needs to be a larger medical diagnosis such as gender dysphoria. Once a patient is 18 though, not all companies or surgeons require that the patient has received a diagnosis of gender dysphoria.

Do The Nipples Shrink After Top Surgery?

The nipples do not shrink on their own after top surgery. For patients who want a chest with nipples, Dr. Sajan uses a specially designed stencil to resize and reposition the nipples.

How Long Do You Need To Have Your Nipples Covered After FTM Top Surgery?

Usually one week.

Is Top Surgery Reversible?

Top surgery is not fully reversible. However, if in the future a patient decides they want to reverse their results, there are options. But, the patient should understand that the scarring from FTM top surgery does not go away. The skin may also be tighter which can make reversal more difficult. Therefore, it is important that patients have a good understanding of the procedure and a documented history of gender dysphoria if undergoing the surgery as a minor.

The Best FTM Top Surgery For Minors Texas

Allure Esthetic Plastic Surgery is a plastic surgery practice in Seattle, WA. Along with traditional cosmetic plastic surgery, Dr. Javad Sajan also performs gender affirming procedures such as top surgery, facial feminization, and body contouring. His expertise allows him to customize top surgery for each patient by allowing them to choose their incision shape and whether or not they want nipples.

To learn more and schedule a consultation with Dr. Sajan, call us at 206-209-0988. Patients can also reach out online via chat, contact form, or Price Simulator.

Allure Esthetic Plastic Surgery

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