What Is FTM Top Surgery?
Female to Male (FTM) top surgery is a surgical procedure for transgender patients to masculinise the chest. This is achieved by removing the breast tissue (bilateral mastectomy) as well as any excess skin and fat around the chest. FTM top surgery offers a permanent alternative to chest binding, which can often be uncomfortable due to skin irritation.
Dr. Omar Tillo of the CREO Clinic is a body contouring surgeon and a member of the World Professional Association for Transgender Health (WPATH). Having successfully performed FTM top surgeries for numerous patients, he has the niche skills and experience to carry out this masculinising chest surgery.
Contact the CREO Clinic today to book a confidential consultation with Dr. Tillo and design a bespoke treatment plan right for your transition journey.
Overview of FTM Top Surgery
Surgery time2-3 Hours
Full recovery6 Weeks
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Who is a Candidate for FTM Top Surgery?
Dr. Tillo will thoroughly assess your suitability for FTM top surgery during your initial consultation. In general, transgender patients are considered a good candidate for FTM chest surgery if:
- You are a trans man who has been diagnosed with gender dysphoria
- You have been living in your preferred gender for at least one year and have undergone psychological assessment
- You are over 18
- You are in overall good mental and physical health, with a BMI below 30. Use our handy BMI calculator to check your eligibility.
- You wish to flatten and tone your chest to achieve a more masculine aesthetic
- You have realistic expectations for what FTM top surgery can achieve
FTM Top Surgery Cost In London
At the CREO Clinic, the cost of FTM top surgery starts from £10,500.
However, prices for FTM top surgery can vary depending on the surgical complexity of the procedure in accordance with your bespoke needs. For this reason, a full cost breakdown will only be available following a 1-to-1 consultation with Dr. Tillo.
If you would prefer to spread the cost of the surgery over multiple installments, we provide financing options via our partner Chrysalis Finance. Chrysalis offers 0% APR over 12 months, and longer payment periods are available.
Female to Male Top Surgery Procedure
Female to Male top surgery is a gender affirmation surgery that involves the removal of your breasts completely (bilateral mastectomy) so as to flatten the chest, resulting in a natural looking male chest. This can be achieved through one of three surgical procedures:
Double-Incision Top Surgery
Double-incision top surgery is the most common method for masculinising the chest. The nipples and areolas are first removed and are made smaller. Long incisions are then made to remove the unwanted breast tissue and skin. Liposuction is then used to remove excess fat around the chest, if required. After this, the nipples and areolas are reattached for a natural-looking finish.
Periareolar Top Surgery
The periareolar top surgical method is best suited to patients with a smaller chest and involves one circular (donut-shaped) incision around the border of the areola, as well as one larger incision around the first one. The unwanted breast tissue, skin and fat is then removed. Finally, the edges of the outer incision are pulled in together to resize the areola.
Keyhole Top Surgery
Keyhole top surgery is suitable for patients with a very small chest and tight, elastic skin. It is a less invasive procedure requiring a small incision along the bottom half of the areola. The breast tissue is then removed and liposuction can be used. Finally, the nipples are resized, if required.
For female to male top surgery, drains may be used in the first few days after surgery before being removed. The healing process usually takes 1-2 weeks for non-physical activities, and 4-6 weeks for full physical activity.
You will also be required to wear a compression vest for at least 6 weeks to manage swelling in the aftermath of surgery.
Following FTM top surgery, your chest will immediately appear flatter and more contoured, now that the breast tissue and excess skin and fat have been removed.
The final results of your surgery will be apparent six months after your procedure when any post-surgical swelling has subsided. After this, you will be able to enjoy the full effect of your newly masculinised, toned chest.
What Are the Potential Risks of FTM Top Surgery?
Although the chance of complications from FTM surgery arising are low, like any surgical procedure, there are risks you should be aware of:
- Nipple necrosis and loss
- Loss of nipple sensation
- Visible or lumpy scarring
- Bleeding or infection at incision sites
- Wound breakdown or delayed healing
What to Expect Before and After the Procedure
During your initial consultation with Dr. Tillo, you will be asked about your medical history, including any allergies you may have and any medications you currently take, to determine your suitability for surgery.
You will be given an opportunity to discuss the results you wish to achieve with FTM top surgery, and ask any questions you may have about what the procedure involves. Dr. Tillo will then assess your body to determine the best surgical techniques to use and will explain the realistic results this surgery can achieve.
Leading Up to the Procedure
In the run up to FTM top surgery, you will need to make several preparations:
- BMI – Your BMI (body mass index) will need to remain under 30 to reduce the risk of complications.
- Oestrogen Contraceptives/HRT – If you take oral contraceptive pills or HRT (hormone therapy), you will be required to stop taking oral contraceptive pills or HRT, these need to be stopped four weeks prior to surgery.
- Testosterone – There is no need to stop taking the testosterone.
- Smoking – You will need to stop consuming nicotine products (including cigarettes, vaping, patches) four weeks prior to surgery as this can also substantially increase the risk of complications.
- Alcohol – You should aim to reduce your alcohol consumption to help recovering from surgery and anaesthetic.
- Prepare your home for recovery – Make your home as comfortable as possible for your recovery, ensuring that you have support in place for any required child and pet care during the initial stages.
Day of the Surgery
You will be required to arrive at the hospital at your allocated admission time to give our nurse an opportunity to perform all necessary pre-surgical checks and to complete any required paperwork for this male surgery. FTM top surgery is performed under general anaesthetic, and you will speak to our anaesthetist to make sure you are suitable for it to be administered accordingly.
Dr. Tillo will also speak to you prior to surgery to ensure you are happy to go ahead with the procedure and confirm your consent. He will then make markings on your skin where incisions are required and will take a series of ‘before’ photos.
Treatment and Recovery
FTM top surgery is done under general anaesthetic and typically takes 2-3 hours to complete, depending on the surgical techniques used.
After the anaesthetic is administered, Dr. Tillo makes the required incisions and removes unwanted breast tissue, as well as any excess skin and fat. The nipples and areolas will be repositioned and may be smaller in size, depending on your treatment plan. The incisions are then closed using dissolvable sutures.
After surgery, you will be taken to the recovery room where you will wake up from the anaesthetic. You will need to eat or drink something and be able to pass urine prior to leaving the hospital, and will be shown how to manage any drains at home during the initial stages of your recovery.
Finally, you will need to be taken home from hospital by a responsible adult who must stay with you for the first 24 hours of your recovery.
Additional Physique Adjustments
Male Brazilian Butt Lift (BBL)
A male Brazilian Butt Lift, or BBL, is a fat transfer surgical procedure performed to add volume and reshape the buttocks. Unlike the traditional BBL for women, a male BBL is designed to create a more masculine physique, with flatter hips and an enhanced buttocks.
FTM Top Surgery FAQs
Is Top Surgery Painful?
FTM top surgery is performed under general anaesthetic, meaning you won’t be awake during the procedure or feel any pain. You may experience some discomfort and soreness after the anaesthetic wears off, but our clinical team are experts in pain management and will provide you with any needed pain relief to ensure a smooth recovery.
Can you Reverse FTM Top Surgery?
FTM top surgery is a permanent procedure, as your breasts won’t grow back after surgery. Therefore, it’s extremely important to ensure that you are completely certain about undergoing top surgery before pursuing treatment.
What Scars Can I Expect After FTM Top Surgery?
The scarring you have after FTM top surgery will depend on the surgical techniques used, with periareolar and keyhole incisions producing less scarring than the double-incision method. Scars will gradually fade over time, and Dr. Tillo will work to hide any scarring with the natural contours of your chest where possible. At the CREO Clinic, we offer laser scar treatment to manage scarring after surgery.
Can you Get FTM Top Surgery Without Hormones?
Hormone therapy is not essential for undergoing FTM top surgery. Patients may choose to undergo hormone therapy after top surgery, or may choose to avoid hormonal treatment entirely.
Can you Breastfeed After Top Surgery?
The ability to breastfeed after FTM top surgery will depend on whether the milk ducts and some of the breast tissue was preserved (not fully removed) during surgery. If they are not removed, it may still be possible to breastfeed. However, this is extremely unlikely as this surgery most often involves the removal of all breast tissue and ducts. In addition, taking testosterone may affect the ability to produce milk.
How do you Shower After Top Surgery?
You will be shown how to clean the incision sites prior to leaving hospital. In general, you should avoid soaking the sutures until the wounds have fully healed to avoid wound breakdown and delayed healing.