Top Surgery (Transmasculine)

Transmasculine top surgery, also known as Female-to-Male (FTM) top surgery, is a gender-affirming procedure designed to remove breast tissue and contour the chest as a way to create a more masculine appearance for transgender men or individuals who’ve been assigned female at birth. Ultimately, the goal is to remove breast tissues and flatten the chest. The technique that is best suited for you depends on the amount of breast tissue that you have and the condition of your skin.

When the chest fullness is minimal and there is also minimal stretching of the skin, liposuction can be used to flatten the chest. Dr. Li also sometimes advises Renuvion to help tighten the skin post-liposuction. However, liposuction by itself is rarely the best treatment option because most patients do not meet the above criteria, and there is sometimes glandular breast tissue underneath the nipple-areolar complex that cannot be liposuctioned and needs to be surgically removed. If tissue needs to be removed to flatten the chest, then a peri-areolar or keyhole incision tissue can be made at the bottom of your areola. The scar associated with this incision hides very well once healed.

For most patients, there will either be moderate to significant fullness involving their chest with excess or stretched-out skin. As such, the double incision technique is most suitable to flatten the chest. This technique is by far the most common technique among surgeons who performed transgender top surgery. In the standard technique, a crescent pattern is designed at the bottom of the breast to remove a large segment of skin and tissue (see diagram). The nipple-areolar complex is also removed completely from your chest and can be placed back as a graft based on the choice of the patient. The result after surgery is horizontal scars that span across the lower chest and circular scars where the nipple-areolar complexes were grafted back.

By in large, the double incision technique provides the greatest ability to flatten and tighten the chest and re-position and resize the nipple-areolar complexes.

Dr. Eric Li at CA Aesthetics in Los Gatos, CA is a highly experienced and double board-certified plastic surgeon with affiliations to prestigious organizations like the American Board of Plastic Surgery (ABPS), the Royal College of Physicians and Surgeons of Canada (RCPSC), and American Society of Plastic Surgeons (ASPS). With his extensive training and expertise, Dr. Li specializes in chest contouring procedures, offering personalized treatment plans tailored to each patient’s unique goals and anatomy. Patients choose Dr. Eric Li for his commitment to safety, attention to detail, and dedication to achieving natural-looking and beautiful results.