FTM Top Surgery: Overview

Written by Dr. Jacobs

Are you planning a female to male transition?  If so, you’re probably excited about taking this step.  It’s a good bet you have many questions too.  How do you prepare for top surgery?  What is recovery like?  How different will you look?  To move forward in understanding the procedure, making decisions and getting ready, schedule a consultation with Dr. Elliot Jacobs, a board certified plastic surgeon in New York who welcomes transgender patients.

You will be glad to discover that with more than three decades of experience, Dr. Jacobs is a great partner for people considering woman to man surgery.  Not only does he routinely perform breast procedures of all kinds for female patients, over the years he has become known across the country as a male breast reduction specialist.  He has performed man boob surgery for thousands of men and teens—perhaps more than any other plastic surgeon—and he’s adept at creating masculine chest contours.

FTM Transformation

Our FTM Surgery Philosophy

When working with any patient, our approach is to listen carefully to understand goals, concerns and lifestyle factors.  Then, we share complete information to help educate each man or woman and support them to make sound decisions.  We answer all questions and ensure patients do not feel rushed.  The process is especially important in the case of transsexual surgery.  We want to know that our female to male patients are ready for this big step and are choosing to move forward with the full awareness that this is a life-changing procedure.

We enjoy our relationships with transgender patients thoroughly.  We understand that transitioning involves much more than simple physical changes, and we all feel that it’s a privilege to be part of the journey.

Female to Male Surgery Overview

The top surgery plan Dr. Jacobs develops for you will depend primarily on how large your breasts are.  Other factors that play a role include your skin quality and your age.  The goal is to reduce the size of your breasts and give you a much more masculine appearance while minimizing scars.

Here’s some information to help you understand the strategy for breasts of different sizes. As you read through the options and think about what might work best for you, know that we are ready to help if your goal is an appearance somewhere in between male and female. We understand that not all transgender people fall at one end of the spectrum or the other. If you're considering a more "non-binary" look--we can certainly accomplish that for you as well.

• Small Breasts
  If you’re ready for FTM surgery, chances are you have been on hormone therapy for a while and your breasts may have become smaller than they once were.  If you do have small breasts and relatively good skin quality, we may use an approach very similar to the way we perform male breast reduction for men with gynecomastia.  This means small nicks on the side of the chest and an incision at the edge of the areola. These heal leaving tiny scars.
  
  We use instruments of our own design to suction much of the fat tissue as well as removing most of the breast gland.  We never remove all breast tissue—that would result in an unnatural, sunken appearance.  The idea is to sculpt remaining fat and breast gland so your chest has a masculine look.
   
• Large Breasts
  If your breasts are relatively large, the best strategy may be to make incisions in the inframammary fold beneath to allow us to remove fat, gland and excess skin.  We may also need to relocate nipples higher on your chest.  Disadvantages of this approach include larger scars as well as the possibility of sensation loss.  Dr. Jacobs will explain what you can expect and you can discuss the options with him.
   
• “In Between” Breasts
  Many FTM surgery patients have breasts that are somewhere in between small and large.  If this is the case for you, you and Dr. Jacobs may decide to choose the minimal scar technique and see how well your skin tightens during the months following surgery.
  
  Assuming your skin is fairly elastic, you may be quite satisfied with your results once the healing process is complete.  If you find you have a little too much redundant skin, we can perform a second procedure to remove it.  You will still benefit from waiting as surface tissues will have tightened to some extent and smaller incisions will be required the second time around.
   
• Nipple Surgery
  Some patients choosing female to male surgery also benefit from nipple and/or areola reduction.  The procedure is relatively simple and can be performed on an outpatient basis after the minimal scar breast reduction procedure.  If you elect surgery for larger breasts, it’s possible nipple/areola reduction can be done at the same time.

Taking the Next Step

If FTM top surgery has been on your mind for a while, or you're thinking of reducing the size of your breasts to achieve a less binary look, scheduling a consultation with us would be a good move.  Chances are excellent you will enjoy the experience and learn a great deal. Even if you should decide to wait, or choose not to have surgery at all, an appointment with Dr. Jacobs is a good investment for transgender individuals.

If you’re not certain it’s time to take this step, you may want to read some of our thoughts on surgical readiness. You can also take a look at our extensive gallery of before and after gynecomastia photos.  Even though these patients are men who are not transitioning, the images will show you why Dr. Jacobs is considered an expert in creating masculine contours.

Give us a call at 212-570-6080 when you’re ready.  You can also contact us online to ask questions or make an appointment.