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"F-M Trans Top Surgery

by Gregory Albert

The Help You Need to Live Your Truth

Female to male (F-M) top surgery is a gender-affirming plastic surgery procedure that masculinizes the chest of a trans male patient to achieve life-altering body confidence, psychological relief, and better quality of life. Transmasculine surgery or subcutaneous mastectomy, referred to as “top surgery,” removes breast tissue and creates a more masculine chest contour. It is a common procedure for trans male individuals to feel more self-assured in their body, and further aligned with their gender identity, leading to marked improvements in self-esteem and patient happiness.

Though unfamiliar to many people, the personal hardships of trans male life are very real. To begin with, binders are an undeniably uncomfortable reality of the pre-top surgery chest. And, for many trans males, the constant physical reminders of their body shape underneath are difficult to endure. In addition, trans men may choose to take masculinizing hormones to reduce breast tissue, however, the effects are usually minimal. (1) That's why surgical ablation (removal) of breast tissue is considered by professionals and patients alike to be the best medical option for faithful gender actualization for trans men

The decision to undergo top surgery is a deeply personal choice, and for many it is a vital step in a transition journey. In the 2020s, it is the duty of medical professionals to afford transgender patients the care they need and deserve to live a healthy, fulfiling life in a body tht reflects who they really are. That's why board-certified plastic surgeon Dr. Gregory Albert provides gender-affirming surgery to assist F-M patients who are transitioning.

Reveal a physical appearance that matches your truest self at The Optimization Centre. Call our friendly staff at (561) 495-2700 or complete a confidential inquiry form on our website for further information.

Transgender Health Concerns

Gender Dysphoria

Gender dysphoria is described in medical literature as “a marked incongruence between [a person's] experienced or expressed gender and the one they were assigned at birth.” (2) The psychological effects of feeling like you're “in the wrong body” should not be understated or overlooked. Unfortunately for many individuals, complications from gender dysphoria can include:

  • Emotional distress
  • Negative body image
  • Depression
  • Self-consciousness
  • Social Anxiety
  • Self-Harm
  • Eating Disorders
  • Substance Abuse (3)

Everybody deserves the right to their gender identity and gender expression. This statement may ring especially true for trans people, who often experience some very specific difficulties and psychological obstacles, particularly in the realm of healthcare. 

Healthcare Equality for Transgender People

Studies have shown that transgender people suffer significant health disparities, prejudice, discrimination, financial barriers to treatment, and a lack of cultural understanding from healthcare providers. (4) That's why it is essential to create safe medical spaces for people who are transitioning with education, compassion, and care. Let us provide for your surgical needs during your transition in an accepting, welcoming environment. Contact us now at (561) 495-2700 to book a private consultation with Dr. Albert.

Benefits of Top Surgery

Top surgeries for trans men can improve a wealth of social and psychological symptoms. An F-M gender affirmation surgery can:

  • Improve gender dysphoria
  • Alleviate symptoms of depression and anxiety
  • Improve body shape satisfaction
  • Improve quality of life
  • Increase social acceptance

Candidates for Top Surgery

Your medical choices as a trans individual are valid and important<. We want you to make them with the knowledge and foresight of your long-term health and wellbeing in mind. Candidates for gender affirming top surgery are consenting adults who are making this significant life decision for themselves, and nobody else! 

Having persistent gender dysphoria, people who have been living and/or presenting as male, and patients who have a recommendation of gender affirming surgery from a licensed medical professional are all suitable candidates for F-M top surgery.

Personal Consultation with Dr. Albert

At The Optimization Centre, we believe your input is vital to our success. That's why we offer one-on-one consultations with Dr. Albert to discuss gender-affirming surgeries, their impact, and their results with our transgender patients. We are sensitive to many patients' past negative healthcare experiences and open our doors to you as a safe space to discuss your personal needs. Please call our professional staff at (561) 495-2700 to arrange your session with Dr. Albert, or use our convenient contact form to reach out to us today.

Preparation for Your Top Surgery

Dr. Albert will use his best judgment to decide the method used in your top surgery procedure, and the anesthesia used. In the vast majority of cases, patients receive general anesthesia for gender affirming surgery. To prepare for your treatment, you may be asked to do the following:

  • Get a medical evaluation and any required lab testing.
  • Provide a letter of recommendation from a medical professional.
  • Stop smoking (nicotine impedes healing and can increase bruising).
  • Avoid taking anti-inflammatory drugs, aspirin, and herbal supplements as they can increase bleeding.
  • Take certain recommended medications or adjust your current medications.

The Masculinization Procedure

There is a selection of surgical routes for F-M top surgery. We will work with you in the period before your procedure to ensure the chosen method is the one that suits you best. 

Double Incision (Bilateral Mastectomy)

The double incision is probably the most common choice for F-M chest masculinization. It can be adapted to suit most breast sizes. After tissue removal, the areola can be resized. Dr. Albert can graft the nipple back on, reconstruct the nipple, or omit it entirely. Usually nipple sensation is low.  Although there may be more scarring, chest contour aesthetics are often excellent.

Periareolar (Circumareolar)

Dr. Albert places incisions either partway or all the way around the areola, sometimes referred to as a “doughnut” shape. He removes tissue through this incision. Because the nipple remains unmoved, sensation remains high. This is a good choice for trans men with very little breast tissue and less skin available. Compared to the double incision method, scarring is minimal.

Inverted T (T-Anchor) & Buttonhole

Incisions are made at the bottom of the areola to the skin of the chest wall. There can be higher nipple sensitivity but not as much comparative flatness. This incision type may not be recommended because of the vertical scarring, however, you are free to discuss this option with Dr. Albert.


Incisions run horizontally on either side of the areola. This style may limit nipple placement, though comparative flatness and nipple sensitivity is higher.

Personal Transformations: Recovery & Results of Top Surgery

Gender affirming surgery is major surgery. As a result, it's important you take the necessary post-operative steps to heal well with as little unnecessary discomfort as possible. Please allow yourself plenty of time to recover afterwards, and ensure those closest to you are on hand to help you out with daily tasks. This process will involve arranging time off from work with your employer, and preparing your home for convalescence. Immediately after your surgery, you may still feel the effects of the anesthetic. Please arrange your pre- and post-operative transportation with a trusted carer as you will not be able to drive yourself home after your procedure.

The First Few Days

After your top surgery, Dr. Albert will apply a compression bandage to your chest. It is important to leave this in place until directed. If you have nipple grafts, you must make sure you change the dressings regularly as directed by Dr. Albert. You will experience the most swelling and bruising in the first few days after your top surgery. You can take oral pain relief as necessary to improve these symptoms. Designate a comfortable area for rest and ensure you do not perform any strenuous activities.

The First Few Weeks

After around a week, the swelling and bruising will start to subside. After a couple of weeks, you will be able to resume very light daily duties. Though it is advisable to not push yourself too much. In six weeks, you will be able to perform more active activities and start light exercise and swimming.

The First Few Months

At around the two-month mark, your swelling will almost be gone, and should dissipate about 60 percent after three months.

Please stay in tune with the way you feel during your recovery. Our staff is available to provide aftercare advice and support when you need it.

Cost of Top Surgery

Your individual top surgery procedure is personal to you. Therefore, its cost will reflect your circumstances and requirements. Please schedule a personal consultation with Dr. Albert for further information about pricing. More and more health insurers are covering top surgeries, and the numbers keep going up every year. Please find out the necessary requirements and information from your insurance provider.

We know that you are more than a label, and your cosmetic desires are the same as everyone else's, and sometimes that means treating ourselves to the treatments we deserve! If you're interested in the wider range of procedures that we offer our patients and beyond, please visit our blog to discover more. Be sure to follow us on Facebook, Instagram, and YouTube for more information about the professional medical services at Plastic Surgery Optimization Centre.


Is top surgery a mastectomy?

Yes, and no. A top surgery can involve a mastectomy, but not all mastectomies are top surgeries. People who receive a mastectomy due to breast cancer may utilize the same or similar techniques as top surgery, but “top surgery” is a specific term given to gender affirming procedures for trans men, which include additional measures to contour the chest in a more masculine way.

What are the other names for Trans Top Surgery?

Top surgery can go by various other names, including “transmasculine surgery,” “chest masculinization,” and “gender affirming surgery.” Some surgeons may still refer to top surgery as “gender mastectomy”, but many trans individuals prefer the term “top surgery” to refer to their treatment. Please discuss your preferences openly with your healthcare providers.

Is Trans Top Surgery Covered By Insurance?

Most health insurance policies cover top surgery under specific circumstances. The best course of action is to check with your health insurance provider to ensure you are covered before booking a top surgery procedure.

  1. Garg, G., & Marwaha, R. (2020). Gender Dysphoria (Sexual Identity Disorders). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532313/ 
  2. McEvenue, G., Xu, F. Z., Cai, R., & McLean, H. (2017). Female-to-Male Gender Affirming Top Surgery: A Single Surgeon's 15-Year Retrospective Review and Treatment Algorithm. Aesthetic Surgery Journal, 38(1), 49–57. https://doi.org/10.1093/asj/sjx116 
  3. Gender dysphoria – Symptoms and causes. (2019, December 6). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/symptoms-causes/syc-20475255 
  4. Transmasculine Top Surgery Preparation. (n.d.). American Society of Plastic Surgeons. Retrieved January 6, 2022, from https://www.plasticsurgery.org/reconstructive-procedures/transmasculine-top-surgery/preparation 

Schedule Your Boca Raton Plastic Surgery Consultation Today

First impressions are important whether you're Zooming into a presentation or flying to a special event. The Optimization CentreTM in Boca Raton is where you can get information about the life-changing improvements of plastic surgery and aesthetic treatments. As a pioneering plastic surgeon and highly sought-after educator, patients from all over the world seek out Dr. Gregory Albert, and you can join them in benefiting from his experience and talent. Plan your consultation with Dr. Albert today.

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