Female to Male Surgery: FAQ

Written by Dr. Jacobs

If you’re considering FTM top surgery, you’ve probably already done plenty of research.  You may have found information that’s somewhat helpful, but most of what you’ll discover about breast reduction is targeted to women, not to transgender individuals.  The Internet—along with the rest of the world—has some catching up to do when it comes to understanding and addressing your specific needs.

We hope to be of help by offering the FAQ below.  The next step you might take is to request a consultation with Dr. Elliot Jacobs.  He’ll listen to you carefully and answer all your questions, giving you vital information to use in decision-making.  There’s never any pressure to schedule surgery.

Here’s a list of questions many female to male surgery patients have.

• Can I make my breasts smaller without removing them entirely?

  Yes, certainly, you and Dr. Jacobs can decide together how small you want to go.  In fact, no plastic surgeon should ever remove all breast tissue, even when operating on a guy with man boobs who wants an ultra masculine look.  Every person has some measure of fat and breast gland, even slender men—it’s a must in terms of looking normal.  When you have your consultation with Dr. Jacobs, be sure you spend time on size options.

• Will I be able to produce milk after surgery?

  Assuming you aim for a significant reduction in size, your breasts will not produce milk later on.  Though a few milk ducts will remain, there won’t be enough to make milk.  This is one in a long list of reasons to be sure FTM top surgery is right for you!

• What if I do change my mind; is top surgery reversible?

  While it is theoretically possible to reconstruct breasts after FTM surgery, you should consider the procedure to be permanent.  Recreating breasts with implants down the road would not provide a good-looking outcome, considering the loss of skin and other tissues, scarring and more.  If you are not 100% sure it’s the right time for you, we’ll suggest waiting.  We’ll be here when you are ready.

• Will my areolas and nipples shrink after breast reduction?

  The nipple/areola complex, as doctors call it, is normally not affected much by top surgery.  If you do want one or both reduced, we may be able to take care of it during your breast reduction procedure.  If not, minor outpatient surgery can be arranged later.  You may want to live with your new chest for a while and see what you think in any case.

• Will my risk of breast cancer be lower after top surgery?

  Since you will have less breast tissue after the procedure, your risk of breast cancer may be a bit lower than before.  Don’t be fooled into thinking you’ll have no risk at all, though.  Please talk with your primary care doctor about the right course of action for monitoring in the future.

• If I have been binding my breasts, will that affect FTM surgery?

  Most of the time, binding does not impact surgery or your results.  If you have been binding tightly for a long time, however, it is possible that your skin may have been affected.  Please bring this up during your physical exam with Dr. Jacobs and he’ll give you his input.

• I feel somewhat timid about the surgery itself; can you reassure me?

  One aspect of our practice patients really appreciate is the fact that we use intravenous (IV) sedation instead of general anesthesia for almost all procedures.  This means that while you’ll be completely asleep during surgery, you’ll only be lightly “under” and you’ll breathe on your own.  Our anesthesiologist is also a medical doctor, and he has worked alongside Dr. Jacobs for more than 25 years.  He will monitor you very closely during surgery.  If you are in good health and follow our instructions, it’s extremely unlikely a problem will arise.  Nevertheless, we have up-to-date technology at the ready in our modern surgical suite and hospital privileges at an accredited facility nearby just in case.

We hope some of your general questions have been answered here, but we’re sure there’s much more information you want to find out.  You can start by sending some additional questions via email, or call us at 212-570-6080 to make an appointment.  We hope to see you in the consultation room!