Top Surgery includes a variety of procedures which alter the physical characteristics of the chest wall in order to contour a chest that appears less like the gender identity that the patient was assigned at birth. For transmasculine individuals who were born with bodies that formed breasts, this means a significant reduction or removal of breast tissue, which results in the chest appearing more masculine. For transfeminine individuals, this means a breast augmentation and/or mastopexy procedure to provide volume and shape to a chest that formed a male appearance to achieve the appearance and proportions of well-developed female breasts.

The definitions above are self-evident for most trans individuals. Exploring the challenges and experiences of being transgender is beyond the scope of this website, but there is a wealth of resources available online, especially through the WPATH website. These resources have been in valuable to family members and friends who are not trans themselves but are expressing support by educating themselves about gender affirming issues.

https://www.wpath.org/resources/seniors-youth-schools-families

The purpose of this website is to explain the surgical procedures involved in the physical transformation of the chest to alleviate discomfort and distress for those who feel out of sync with their gender identity. This feeling of discomfort that the physical body and gender identify are out of sync is called Gender Dysphoria.

“FTM” is an acronym for “Female to Male” and refers to individuals who personally identify as being male, but were born with female characteristics, and whose bodies continued to develop with female characteristics through puberty. “Transmasculine” is a similar term and is perhaps more accurate because it takes into consideration the “grey zone” that many individuals find

themselves falling within. While some individuals identify 100% as male, others may identify somewhere along the masculine spectrum or as gender neutral. The endpoint and end goal may not be definitively male for some individuals on this spectrum.

In general, most individuals who seek out FTM/N top surgery share a feeling of being uncomfortable with the presence of breast tissue that developed during puberty. Individuals often perform “binding” which involves compressing the breast tissue against the chest wall in order to both hide the appearance of the tissue and to provide some physical relief. While binding can relieve the feeling of discomfort for some individuals, others feel that surgery is necessary to

alleviate their gender dysphoria and help them feel more at ease without clothes on.

For someone thinking about FTM Top Surgery, there are several considerations. First, different procedures are available and deciding between the many different options can be overwhelming. Our FTM Top Surgery Procedures  Summary provides a nice overview of these procedures and Choosing an FTM Top Surgery Incision provides a description of how to choose a procedure based on your unique anatomy. Once you have narrowed down your choices, it is a good idea to have a consultation  with Dr. Chandler to go over your options and discuss your surgical plan. As you get closer to surgery, you can read our resources on How to Prepare for FTM Top Surgery and FTM Top Surgery Recovery and Postoperative Instructions.

Nonbinary/Gender Neutral

Nonbinary or Gender Neutral refers to individuals who personally identify as separate from the female or male gender. Nonbinary/gender neutral individuals do not identify as either male or female, and feel uncomfortable being put into a gender category that they feel doesn’t belong to them. These individuals fall outside the traditional gender binary classification, and may fall into a broad spectrum between binary male and binary female.

FTN Top Surgery

“FTN” is an acronym for “Female to Nonbinary or Gender Neutral”. While the anatomical considerations when choosing procedures may be similar to those interested in FTM Top Surgery, there are other considerations as well. There are different ways of shaping the incisions and changing the scar location and nipple location and shape that are more in line with a gender-neutral chest wall in FTN Top Surgery.

MTF and Transfeminine

“MTF” is an acronym for “Male to Female” and refers to individuals who personally identify as being female, but who were born with male characteristics, and whose bodies continued to develop with male characteristics through puberty. “Transfeminine” is a similar term, and perhaps more accurately describes individuals who fall more on a spectrum or individuals who are in transition toward a more feminine identity. In general, most individuals seeking out MTF/N breast augmentation share that the absence of breast tissue is incongruent with their sense of self and feel uncomfortable that the breasts feel as if they are missing.

MTF Top Surgery

Individuals who seek out MTF top surgery who have been on feminizing hormone therapy often present with a variable degree of breast tissue present preoperatively, which helps to maximize breast growth and can improve aesthetic results of surgery.

There are a few considerations for someone thinking about MTF Top Surgery, regarding choice of implant type and volume, incision location and tissue plane. MTF Top Surgery Procedure are discussed here. You can read our resources on How to Prepare for MTF Top Surgery  and MTF Top Surgery Recovery and Postoperative Instructions.

MTN Top Surgery

“MTN” is an acronym for “Male to Nonbinary or Gender Neutral”. Individuals who identify as non binary or gender neutral may choose to augment their breast volume to achieve a physical characteristic that is more in line with individual gender identity. Similar considerations are made regarding choice of implant type and volume, incision location and tissue plane. MTN Top Surgery Procedures are discussed in more detail here.