Breast tissue is a source of gender dysphoria for most trans-men, especially after commencement of testosterone replacement therapy. Many trans-men will notice several changes in their bodies after they start taking testosterone, including deepening of the voice, the growth of body hair, and an increase in muscle mass. However, despite all of these masculine changes in their bodies, the breast size does not change significantly. Most trans-men need to bind continuously in order to conceal their breast tissue. This process is not only uncomfortable, but it hinders trans-men who want to take their shirts off in appropriate public places, such as the pool or the beach.
What is top surgery?
Top surgery mastectomy, or chest masculinization surgery, is a procedure to remove the breast tissue in trans-men. It differs from mastectomies performed in women for breast cancer, in that the scars are positioned differently, and efforts are made to reshape the remaining skin and tissue to give the appearance of a more masculine chest. There are many techniques that are available to perform top surgery, with the amount of breast tissue, the presence of excess skin, the quality of the skin tone, the size of the nipple and areola, the desire for nipple sensation, and the patient’s preferences all contributing to the decision on which technique is used.
What to expect after top surgery
Top surgery is typically performed as an outpatient procedure. Most patients require between three to four weeks before they are cleared to return to work. There are some physical restrictions that are placed during this initial recovery period, but most trans-men are able to exercise without restrictions by eight weeks after their procedure.
Improved confidence and a sense of alignment with one’s gender identity
Most trans-men experience a significant improvement, if not resolution, of their gender dysphoria almost immediately after surgery. As the healing process transgresses over the first several months, trans-men grow accustomed to the new shape and appearance of their chest. Having a masculine appearing chest allows the patient to identify more closely with their gender identity. Although top surgery often leaves visible scars, most trans-men have improved self-esteem and confidence in their appearance. This newfound self-assurance allows trans-men to do activities they previously avoided, such as going to the pool or the beach.
Choosing your surgeon
Not all plastic surgeons have experience with performing top surgery. If you prioritize your safety, good results, and quality of care, it’s likely you won’t choose an inexperienced surgeon. Ask your plastic surgeon if they are a member of the World Professional Association for Transgender Health. Members of WPATH are committed to continuing education and advancement of knowledge in the field of transgender health. Since the appearance of the chest after surgery is of the utmost importance in helping to alleviate gender dysphoria, be sure to look at photographs of the plastic surgeon’s work. After all, one of the goals of top surgery is to allow you to take your shirt off and be beach body ready!