Top Surgery Overview
As a female-to-male transgender patient transitions, he will need to address his breasts to complete his physical journey. One of the most effective and common breast reconstruction procedures is called top surgery, or breast mastectomy free nipple graft surgery. This is where Inland Empire's board-certified plastic surgeon, Dr. Childers, removes the entire nipple/areolas during surgery to be replaced at the end. All of the breast tissue is removed (mastectomy), and the chest is shaped and sculpted for a masculine contour. Then, the removed nipple is grafted back into an appropriate location on the breast to restore form and function. It is important to note that the breast will not have full nipple sensation after the surgery.
"Had my lips done Saturday Amber was amazing she was gentle and very professional I definitely recommend her loving my new lips thanks Amber."- L.N. / Yelp / Oct 18, 2016
"I couldn't recommend Dr.Childers enough. I had a breast lift and implants in 2017 everything went great and I was super happy with the results. I had a reaction the the sutures after surgery and Dr.Childers was super helpful. I just has a "tummy tuck" with no muscle tightening as my abdominal muscles were back together. I had some lower abdominal loose skin after two kids so it wasn't your average tummy tuck, I didn't have enough skin to pull down and move the belly button so he was able to do it without moving it and I LOVE the results. Dr. Childers did an amazing job and was super helpful before and after surgery. I would say he gives an honest opinion which is nice when you're thinking about getting cosmetic surgery."- D.C. / Yelp / Feb 21, 2020
"I had my breast implants removed by Dr Childers, and I have to say, him and his staff made it a great experience. I had my saline implants in for 20 years and one had ruptured. Dr Childers office was able to get it covered by my insurance, which was AMAZING! I have had a lot of mysterious health issues and was not sure if my implants were the culprit and I didn't want to chance it, so I did not replace. Dr Childers was great about listening to my concerns and was confident he could help me. And he did!!:) I am VERY pleased with my results and would recommend to everyone! You will be in great hands!"- K.S. / Yelp / Jan 23, 2020
"I really want to make sure people looking for real people with real experiences get as much out of Yelp as I do. Dr. Childers is beyond fantastic. He completed my original breast augmentation in 2009 and put in 400cc silicone Mentor Mod-Plus profile implants and I loved them. In March, I found out I had a rupture and capsule constriction (I started noticing my right side changing 12 months before) which developed due to the rupture and leaking implant. I immediately went back to Childers. He was able to remove all of the capsule constriction that had developed around the implant and created a beautiful set of twins for me. I am very happy with my results. I switched to 400cc silicone High Profile Mentor implants. The staff is also great and the ladies go above and beyond with help on finances and insurance claims. Again, noticed changes in my breast and tightening for a year before I had the ultrasound. Please ladies, if you ever notice changes, don't let it go a year before you get it checked out like I did."- A.D. / Yelp / Jan 23, 2020
"I had breast reduction surgery and couldn't be happier. It has been over 3 years and my husband always says how great they look. They look great. Mammogram techs are really surprised how good they look too. Thank you so much Dr Childers."- M.J. / Yelp / Oct 20, 2019
Top Surgery During/After Surgery
This surgery can be performed in around 3 hours under general anesthesia. First, the nipple/areola area is quickly removed and placed on a moist sponge. The breast tissue is removed and the remaining skin is reshaped and contoured for a masculine appearance. Once the breast has been stitched up, the nipple/areola is grafted into the most appropriate place on the breast. Pressure is added to the nipple to increase the chances of the blood supply and certain nerves reconnecting for better results.
Depending on how the patient heals, recovery time can be anywhere between 4 to 6 weeks. A follow-up appointment will be made in around that same time to check on the patient’s progress to ensure the breasts are healing properly. While most patients can expect some form of reactivity in the nipple area, there’s a loss of sensual nipple sensation, where nipples may not become erected when stimulated.
Advantages and Disadvantages
The free nipple graft is advantageous for trans men because it can completely remove the breast tissue for a patient’s preferred, masculine look. This surgery is relatively quick where patients are not under anesthesia for extended periods of time. Another advantage is the fact that there’s minimal blood loss, which cuts down on complications.
The downside to this surgery is that it can lead to breasts with an unnatural shape and the nipples can look asymmetrical. In some cases, the nipple/areola don’t survive the grafting process. Further, the nipple/areola’s color can fade, leading to an uneven color, especially for darker-skinned patients. More than likely, the nipple will no longer become erected when stimulated since complete sensation can’t be restored after this surgery.
Plan Your Procedure
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Top Surgery Learn More
If you are a trans man looking to complete your transition, you should learn more about Breast Mastectomy Free Nipple Graft surgery, or Top surgery. In this procedure, the nipple/areola is removed and replaced following the mastectomy to achieve a masculine appearance. When you call our office, we would be more than happy to set up a time for you to come in and discuss the procedure with Dr. Childers. He will determine whether this procedure is right for you, as well as go over the surgical procedure, the pros and cons, pricing and more, so give us a call today.