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.
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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 erect when stimulated.
After surgery, it may be recommended to wear a brace, such as this, to support the chest and hold the chest area steady while recovering.
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.
Top Surgery FAQ
How much does top surgery cost?
The cost of top surgery can vary based on your specific needs and the details of the procedure. During your consultation, we'll talk about what you can expect in terms of cost. To make your journey more affordable, Riverside Plastic Surgery proudly accepts a variety of financing options, which we'll be happy to review with you.
Will I need to wear a compression garment after top surgery?
We usually recommend wearing a compression garment after top surgery to reduce swelling and support a smoother recovery. Dr. Childers will instruct you on how long to wear it so you can feel as comfortable as possible while you heal.
Does top surgery leave scars?
There will likely be some scarring after top surgery, which is normal and part of the healing process. Over time, these scars usually fade, and we'll provide you with aftercare tips to help them heal in a way that feels right for you.
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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.
