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Why consider top surgery?

For transgender clients, top surgery can be completely life-changing as a bold reflection of how they feel inside. Self-confidence and well-being thrive once the appearance of the chest aligns with their gender identity.

For male to female clients, breast augmentation with implants or fat transfer is the most common choice. For female to male clients, top surgery often means removal of the breast tissue to create a flatter, traditionally masculine chest with repositioned nipples. Choosing a highly-experienced, compassionate and board-certified plastic surgeon such as Dr. Lee is critical for success in either procedure.

What is male chest contouring surgery?

Top surgery can be one of the most important steps on the journey of gender affirmation. FTM top surgery is designed to transform the bustier appearance of a female chest to appear flatter and more masculine. It is common for transgender males to bind their breasts to hide them, and this procedure can provide much relief for such clients. 

There are two methods of achieving a male chest surgically:

Double incision with free nipple graft

This procedure is designed for trans men with medium to large breasts. An incision is made along the lower breast fold, and the excess skin and breast tissue is removed. The nipple is then grafted onto the new chest contour. This is often performed with liposuction of the axillary and lateral chest as well.

Periareolar incision

This procedure is designed for men with small breasts. To minimize the scarring, Dr. Lee designs the incision along the outer border of the areola and removes the breast tissue through the small incision. The nipple is not moved with the periareolar incision.

Other chest contouring methods include…

Chest contouring with liposuction

During this procedure, liposuction is used to suction out unwanted fat, to create a toned and chiseled chest aesthetic. The incision is small and very well hidden.

Nipple and areolar reduction

Due to the fact that the female areola is often larger than the male areola, transgender men often require surgical correction during their transition. Nipples that are too large, droopy, puffy or long can all be tailored to achieve your unique aesthetic goals for your chest. 

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What are the benefits of male chest contouring?

  • Gender affirming
  • Long-lasting outcome
  • More masculine-appearing chest
  • Increased confidence in one’s image and gender

Male to female chest contouring

MTF patients typically desire a more feminine-appearing chest and want to create the appearance of breasts through the use of implants, or forming breast mounds with body tissue. The procedure can greatly improve self-confidence and comfort in social situations. Either saline or silicone implants can be used, and are placed either above or below the pectoral muscles.

In some cases, Dr. Lee can perform a fat transfer procedure in addition to the placement of implants, to create softer transitions between the implant and the chest wall.

The fat is often harvested from areas such as the belly, back, hips or thighs.

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Who is a good candidate for top surgery?

PERK Plastic Surgery follows the WPATH guidelines for top surgery. Clients should adhere to the following guidelines:

  • Living as the chosen gender for 1 year
  • Letter of clearance from a mental health professional
  • Stable weight
  • Non-smoker
  • Realistic expectations

What is recovery like?

Top surgery is outpatient and takes about 2-3 hours to perform. For FTM top surgery, you will have drainage tubes. Depending on the surgical technique used, your customized recovery plan will be tailored to your needs. Most of the bruising, swelling and discomfort subsides after 2 weeks.

A compression garment is worn for at least one month to optimize the contour of the male chest. In the MTF top surgery, the recovery is similar to a traditional breast augmentation. No drainage tubes are necessary. A light compression bra will be given to you for your recovery. Most patients are without limitations at 1 month.

Why choose PERK Plastic Surgery in Beverly Hills?

  • Award-winning, Board-Certified Plastic Surgeon
  • Unfaltering commitment to artistry, innovation and safety
  • Modern, compassionate and inclusive practice environment
  • Friendly, knowledgeable support staff
  • Nuanced, natural-looking results
  • Customized approach with each client
  • State-of-the-art technology and world-class equipment
  • Convenient Los Angeles location and concierge amenities

Frequently Asked Questions

How is the best top surgery technique selected?

Technique selection depends on chest size, skin elasticity, anatomy, and aesthetic goals.

Can nipple size and position be adjusted during top surgery?

Yes. Nipple and areola reshaping or repositioning is commonly performed during chest contouring procedures.

Will there be visible scars after top surgery?

Scarring depends on the surgical technique used, though incisions are planned carefully to heal as discreetly as possible.

How long is recovery after transgender chest contouring?

Most swelling and discomfort improve within the first few weeks, though healing timelines vary by procedure.

Will I need to wear compression garments after surgery?

Compression garments are commonly recommended to help reduce swelling and support healing.

Can fat grafting be combined with MTF breast augmentation?

Yes. Fat transfer may be used alongside implants to soften transitions and enhance contour.

Are top surgery results long-lasting?

Results are generally long-lasting, especially when patients maintain a stable weight and healthy lifestyle.

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Watch Beverly Hills Plastic Surgeon Dr. Michelle Lee on the Dr. 90210 TV Show on Hulu

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