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FTM top surgery is a term frequently applied to the surgical procedure of altering a genetic female's chest to create a masculine appearance. This female-to-male (FTM) procedure is often one of the first gender reassignment surgeries. Dr. Javad Sajan performs a three-dimensional high definition chest reconstruction to remove breast tissue and adjunct liposuction to reshape and give a masculine appearance to the patient's chest.

Understanding FTM Top Surgery

FTM Top Surgery Patients

Breast removal, like the surgery done in a cancer-related mastectomy, removes skin, nipples, fat, and muscles in the breasts. It usually results in a flat or somewhat concave appearance. This is true for either men or women mastectomy patients.

However, Dr. Sajan performs a 3D high definition chest reconstruction by removing excess skin and some, but not all of the mammary gland and mammary fat. If the nipples are removed, they are sutured to a new location on the chest for a more natural masculine appearance. Adjunct liposuction is performed to remove unwanted genetic feminine fat deposits from the chest, sternum, and armpits.

Are you a candidate for FTM top surgery?

The World Professional Association for Transgender Health (WPATH) has established guidelines that plastic surgeons like Dr. Sajan can use to identify whether or not a patient is an ideal candidate for FTM surgery. In general, you'll qualify for the procedure if you are able to consent to treatment and make an informed decision.

In addition, any medical or mental health concerns should be well-controlled at the time of the procedure.

What to expect during your procedure

Revisional FTM Top Patient

You can expect your FTM surgery to be performed at our state-licensed surgical center. It will typically be done under general (deep sleep) anesthesia, and should not require an overnight hospital stay.

The surgical approach used will have been decided during your initial consultation and will depend, in part, on the size of your breasts. The first option available is the "keyhole" procedure, which is often used for people who would wear a size "A" or a small size "B" bra cup. With this approach, Dr. Sajan will make an incision along the border of your areola, removing breast tissue through that opening. He will not remove extra skin or resize/reposition your nipple and areola, and your nipple sensation will usually be preserved.

A "double incision" top surgery is the approach that is most often used for large chested patients. It involves creating an incision along the lower border of the pectoralis muscle and around the nipple. Through those openings, excess breast tissue is removed and the nipple-areola complex is reshaped and repositioned. In addition, liposuction may be performed as needed. This is a terrific approach because it delivers an excellent masculine contour. However, the primary disadvantage is the fact that nipple sensation is usually lost.

The final approach is the "periareolar" technique, which is recommended for patients with small to medium breasts, large areolas and minimal excess skin. To perform this procedure, Dr. Sajan will make an incision around the areola. Through that opening, he will remove the excess breast and fatty tissue, along with the remaining skin. He will then suture the area to tighten your skin around your newly positioned areolas.

FTM Top Surgery Gallery >>

Your recovery

Top Surgery Patient

Once Dr. Sajan has completed the procedure, your incisions will be closed and dressings will be wrapped around the surgical wounds. He will then place drainage tubes in the area, which will need to remain for about one week. You will also be instructed to wear a compression garment for a period of time to minimize swelling and ensure that the tissues adhere to their new position against your chest wall.

You will be encouraged to begin walking as soon as possible after surgery, but it's important to avoid strenuous activity and lifting your arms over your head until you're fully healed. In about one week, Dr. Sajan will have you return to his Seattle office where he will evaluate your progress. Even if you're healing as planned, you will likely need to continue to wear your compression garment for several more weeks to ensure optimal results.

Throughout the initial recovery period, some discomfort in the treatment area is to be expected. However, Dr. Sajan will provide you with prescription pain medication to keep you comfortable as you heal. The results of your surgery will be evident immediately and should continue to refine over the next several months as post-surgical swelling resolves. During your post-operative appointments, Dr. Sajan will provide you with detailed steps that you can take throughout your individual healing process to optimize your recovery.

Aligning your outer appearance with your gender identity

Top surgery chest reconstruction is a courageous step toward physically matching your upper body's shape with your gender identity. The results can be exciting and will likely contribute considerably to your greater self-esteem. Contact Dr. Sajan for a consultation to learn more about what FTM top surgery can do for you.

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Allure Esthetic Plastic Surgery

(206) 209-0988
Seattle Plastic Surgeon Location

1455 NW Leary Way Suite 449 Seattle, WA 98107