The Guide To Being Transgender

Types of Top Surgery (FtM)

- Double Incision
Basically, the doctor cuts a long incision under each of the breasts and removes the nipples, scoops out everything inside, and sews it all back into place. This is the most common form of top surgery, and does tend to leave some pretty noticeable scars. A serious loss of nipple sensation is also prevalent. This surgery is usually used for medium-to-large chested men.

- Keyhole
In this, the surgeon will cut an incision around the bottom part of the areola and use liposuction to take it all out. It leaves minimal scarring and usually doesn't reduce sensation in the nipple since nerve ending are left intact. This procedure is for smaller-chested men.

- Peri-areolar
This procedure is done with two concentric circles cut around the areola. Breast tissue is removed through liposuction and nipple sensation remains. This procedure is for smaller-chested men and often requires revisions, unfortunately. It doesn't use grafts, though, so that's good.

- T-Anchor/Inverted-T
In this procedure, an incision is made under the breasts, just like double incision, and then another is made intersecting the first incision and going up to the areola. That allows the surgeon to resize and position the nipple-areola complex (NAC) without severing the nerve. Thus, this surgery leaves much more sensation. It also lacks the nipple grafts that double incision often has, so it has less room for complications. This is also typically for medium-to-large chested men.

- Buttonhole
Two incisions are made, just like DI, and a circle is cut around the areola. No nipple grafts are involved, and sensation often remains. This procedure was popularized by Dr. Sherie, who charges 7500$ for it.

- Minimal Scar
This procedure is only recommended for small-chested men who have excellent skin elasticity. It includes a very small incision on either side of the chest, close to the underarms, and another small incision under the areola. This procedure leaves nearly no scars and nipple sensation usually remains. Revisions are often recommended, but not mandatory. As far as I know, Dr. Elliot Jacobs is the only surgeon who offers this, and with him it costs 7500$.

Choosing a procedure:
- Smaller-chested men with good skin elasticity can often do peri-areolar or keyhole and get the best results.
- Moderately sized chests (about a B cup), can often expect the best results from almost any procedure.
- Medium-to-large sized chests can expect the best results from buttonhole, DI, or inverted-T.
- Very large chests and those with poor elasticity may be limited to DI and/or buttonhole.

Top surgery can range from 3500$-9000$ depending on the procedure and the surgeon. Some insurance companies will cover the surgery, and some won't. It's all stuff to look into, and taking close looks at your state policies plus the affordable care act can help you make sure you get the help you deserve.

I hope this was informative enough. If you have any questions, please contact me via kik @ kellabellawuzhere

My main source for this update was www.topsurgery.net