From Woman to Man: The Untold Story of Ftmç Transitioning

Introduction to Ftmç Top Surgery

Ftmç top surgery refers to a variety of procedures that surgically change the appearance and function of the chest for transgender men and nonbinary individuals who were assigned female at birth but identify as male, masculine, or nonbinary. The purpose of ftmç top surgery is to create a more masculine chest appearance and remove breast tissue.

The main goal of top surgery is to help align someone’s external physical characteristics with their internal gender identity, in order to reduce gender dysphoria and improve mental health and self-image. Though not all transgender people desire medical interventions as part of their transition, top surgery can greatly improve quality of life for those who need the procedure.

There are two main types of ftmç top surgery – double incision with nipple grafts and periareolar surgery. Both procedures remove breast tissue and reshape the chest to appear flatter, firmer and more masculine in form. The procedures differ in the size of the incisions and placement of incisions around the areola. Along with masculinizing the chest, top surgery can also enable individuals to feel more comfortable going shirtless.

Overall, ftmç top surgery is a transformative procedure that allows transgender men and nonbinary people to bring their outer appearance into closer alignment with their gender identity. The surgery produces significant physical changes while also improving self-confidence, self-image, and mental health.

Types of Ftmç Top Surgery

There are three main types of top surgery for transgender men:

Keyhole Surgery

Keyhole surgery, also known as periareolar surgery, involves an incision made around the areola. The surgeon removes breast tissue through this incision and reshapes the chest. Keyhole surgery results in minimal scarring since the incision is only around the areola. It preserves nipple sensation and the ability to breastfeed in some cases.

Keyhole surgery is only an option for trans men who have smaller breasts. The surgeon must be able to remove enough breast tissue through the areola incision alone. Those with larger breasts or who want a flatter chest often need a different technique.

Double Incision

The double incision technique, sometimes called DI top surgery, is the most common. The surgeon makes an incision under each breast, removes tissue and excess skin, and resizes the areola and nipples. This technique allows the surgeon to contour the chest and place the nipples in a more masculine position. It results in two horizontal scars along the crease under the breasts.

Double incision works well for larger-chested individuals who want a flatter, more sculpted masculine chest. It does involve more extensive scarring than keyhole surgery but allows the surgeon more flexibility in shaping the chest.

Periareolar or “Doughnut”

In periareolar top surgery, the surgeon makes a doughnut-shaped incision around the areola border. They remove tissue through this incision and reposition the areola and nipple. This technique involves more scarring than keyhole surgery but less than double incision.

Periareolar top surgery allows some contouring while minimizing scarring. It can work for medium-sized breasts where a keyhole incision would not remove enough tissue. The horizontal scars are avoided, but the circular periareolar scar may widen over time.

Choosing a Surgeon

Choosing the right surgeon is one of the most important decisions in getting top surgery. Here are some key factors to consider when researching surgeons:

  • Experience. Look for a surgeon who has significant experience performing ftmç top surgery specifically. Ask how many procedures they have done and how many years they have been performing them. An experienced surgeon will have refined techniques and can handle any complications that arise.
  • Results. Evaluate before and after photos of previous patients to get a sense of a surgeon’s aesthetic results. Look for consistently good outcomes in nipple placement, symmetry, contour, and scarring. Photos should represent the surgeon’s average results, not just their best outcomes.
  • Reviews. Read online reviews from former patients to learn about others’ experiences with a surgeon. Look at satisfaction with results, staff interactions, and the overall process. Beware of reviews that seem overly glowing or analytical. Focus on patterns in multiple honest, detailed reviews.
  • Location. Geographic proximity to a surgeon can be a factor, as you may need to travel for consultations and follow-ups. Consider location in terms of getting adequate local aftercare as well. Some patients opt to travel long distances for surgeons with exceptional expertise or results.
  • Insurance coverage. If using insurance, make sure the surgeon accepts your specific plan. Be aware that many surgeons require out-of-pocket payment upfront and provide reimbursement paperwork to submit yourself. Know billing procedures and costs ahead of time.
  • Personality fit. Since you’ll interact closely, make sure you feel comfortable with the surgeon’s bedside manner and communication style. They should answer all questions thoroughly and describe your options clearly.

Taking the time to carefully choose your surgeon is vital for having the best and safest top surgery experience. Identify clear priorities going into your search process.

Preparing for Surgery

Before undergoing top surgery, there are several things you’ll need to do to prepare your body and mind. This preparation is crucial for minimizing complications and optimizing your recovery.

Medical Checks

Your surgeon will require you to undergo certain medical tests and exams prior to surgery. These usually include blood work, a pregnancy test, an EKG, and a chest x-ray. The tests allow your surgeon to assess your overall health and identify any issues to address beforehand. Inform your surgeon of all medications and supplements you take, as some may need to be stopped weeks before surgery.


If you smoke, you’ll be required to stop for a certain period before and after surgery, usually at least 6 weeks. Smoking impairs circulation and wound healing, leading to higher risk of complications. Speak to your surgeon about when you need to quit and how long you must remain smoke-free. Consider using patches, gum, apps, or support groups.


It’s important to be in good physical shape before surgery. Exercise improves circulation and lung function, speeding up recovery. Focus on cardio and upper body strength training in the months beforehand. Avoid overexerting yourself or lifting heavy weights for at least 2 weeks pre-surgery.


Eat a nutritious diet high in protein, vitamins, and minerals. Protein aids tissue repair, while vitamins and minerals support healing and immune function. Avoid crash or fad diets. Hydrate well by drinking lots of water. Stop taking supplements that can increase bleeding risk 2 weeks before surgery.

The Surgery

On the day of surgery, you will arrive at the hospital or surgical center and get checked in. You’ll likely have some pre-op testing done, including bloodwork and possibly an EKG to make sure you’re healthy for surgery.

You’ll meet with your surgeon to go over the details of your procedure one last time and answer any final questions. They’ll draw lines on your chest to mark the areas for incisions.

When it’s time for your surgery, you’ll be brought into the operating room and given anesthesia so you’ll be asleep and pain-free during the procedure. The anesthesiologist will monitor your vital signs closely. The two most common forms of anesthesia used for top surgery are:

  • General anesthesia – Given through an IV, this puts you into a deep sleep throughout the operation. You will not feel any pain or be aware of anything during surgery.
  • Local anesthesia with sedation – You are given sedation medications through an IV to relax you and local anesthesia injections to numb the chest area. You will be asleep but able to wake up if needed. Some surgeons prefer this option because you can wake up and cough to expand your lungs and prevent pneumonia.

The surgery itself usually takes 2-4 hours depending on the technique. Your surgeon will make incisions and remove breast tissue, then reshape the chest into a more masculine contour. They will also reposition and resize the nipples and areolas. Drains may be placed to remove fluid buildup after surgery and the incisions will be stitched up and bandaged.

There are risks associated with any surgery that your surgeon should discuss with you beforehand. Potential risks of top surgery include:

  • Bleeding, blood clots, fluid buildup
  • Adverse reactions to anesthesia
  • Infection of incision sites
  • Loss of nipple sensation or necrosis
  • Asymmetry or unsatisfactory cosmetic results

Your surgeon will take measures to minimize risks and complications. Following your surgeon’s pre- and post-op instructions is crucial for optimal safety and outcomes.


After surgery, you will be monitored in a recovery area for a few hours before being released to go home. You will likely feel groggy from the anesthesia and may experience nausea or dizziness. Most patients can go home the same day as their surgery.

The chest area will be wrapped in bandages and you may have one or more drains to collect fluid and prevent fluid buildup. The drains are removed after 1-2 weeks, once drainage has decreased. Dressings need to be kept clean and dry. Your surgeon will provide instructions on caring for incisions and changing dressings.

Medication is prescribed for pain management. Many patients report the pain as uncomfortable but manageable, usually about a 5/10 pain level. The worst pain is within the first few days but starts improving after about 3-5 days. Complete pain relief can take several weeks.

You will need to limit arm mobility and avoid lifting anything heavy in the first few weeks after surgery. Most normal activities can be resumed after 4-6 weeks. Athletic activities may require 2-3 months for full recovery.

Some common complications include:

  • Bleeding under the skin flap (hematoma)
  • Fluid buildup (seroma)
  • Poor wound healing
  • Loss of nipple sensation
  • Asymmetry in the chest area

Notify your surgeon if you experience signs of infection, excessive swelling/bruising, fluid leakage, or other issues. Most patients are able to heal well from surgery without major complications through proper aftercare.


The results of ftmç top surgery can vary greatly depending on the specific procedures performed. However, most patients report high satisfaction with both their appearance and sensation after healing is complete.


The chest appearance after top surgery is flatter, more masculine, and matches most patients’ male gender identity. Any remaining breast tissue or excess skin is removed, creating a male-contoured chest. The size and placement of the nipples and areolas are resized and repositioned to a more natural male alignment. While scarring is inevitable, a skilled surgeon creates incisions strategically placed for minimal visibility. With proper scar care, the chest will look natural and proportional when healed.


All top surgery techniques result in permanent scarring to some degree. The type of procedure impacts the number and placement of incisions. Keyhole and peri-areolar surgeries offer minimal scarring, but may not be ideal options for all patients. Double incision methods leave two main horizontal scars along the lower chest, but skilled surgeons minimize scar visibility by placing them near the natural creases below pectoral muscles. While scars fade over time, they do not disappear completely. Proper scar care during healing can help reduce long-term visibility.


Most patients retain erotic and tactile nipple sensation after top surgery, though it may be decreased or heightened compared to pre-surgery. Nerves are often stretched or injured during tissue removal and grafting techniques. Regaining full sensation can take several months or longer following surgery. In some cases, loss of sensation may be permanent. Discuss realistic expectations for nipple sensation with your surgeon prior to the procedure. With a skilled surgeon, most trans men are pleased with their erotic sensation after complete healing.


The costs associated with top surgery can seem daunting, but being prepared and understanding all the expenses ahead of time can make the process more manageable. Here’s a breakdown of the typical costs for ftmç top surgery:

Surgery Fees

This is usually the biggest expense. Surgeon’s fees typically range from $5,000 to $10,000 or more. The exact cost depends on the surgeon, their experience and credentials, the type of procedure, and the city/state where it’s performed. Be sure to ask potential surgeons for a complete cost estimate ahead of time.

Anesthesia and Facility Fees

These fees are often separate from the surgeon’s fee. Anesthesia may range from $1,000 to $3,000. The surgical facility/hospital fee can also be $1,000 to $3,000 or more.

Travel Expenses

Since qualified surgeons are still limited, you may need to travel for surgery. Factor in costs for transportation, lodging, and food in the city where you’ll have surgery, which could total $1,000 or more.

Time Off Work

You’ll need about 1-2 weeks off work for recovery. If taking unpaid leave, account for this lost income. Alternately, consider using vacation time or short-term disability if available through your employer.

Prescriptions and Post-Op Care

Antibiotics, pain medication, surgical garments, and follow up appointments will incur some costs as well. Budget several hundred dollars for co-pays and out-of-pocket expenses.

Preparing for these costs takes time and financial planning, but many find creative ways to afford top surgery through insurance claims, payment plans, crowdfunding campaigns, and loans. The rewards of getting this often life-changing procedure make the investment worthwhile for most.

Emotional Aspects

Top surgery can have a profound impact on mental health and emotional wellbeing for transgender men. Beyond the physical changes, undergoing this procedure can improve body image, self-esteem, and contribute to an overall sense of authenticity.

Body Image

Many transgender men experience body dysphoria – a disconnect between their assigned female body and male gender identity. They may feel uncomfortable with or distressed by their chest. Top surgery can help align the body with their inner sense of self, allowing transgender men to see their body as it should be. This can greatly improve body image and self-confidence.

Dating and Relationships

Having surgery can affect dating and relationships in positive ways. Some transgender men avoid intimacy prior to surgery due to dysphoria. After top surgery, they may feel more comfortable being shirtless or intimate. Their self-assurance can make them more open to dating and meeting partners. For those already in relationships, surgery can remove a source of anxiety and deepen connections.

Coming Out

While not every transgender man chooses to come out publicly, having top surgery may impact decisions around disclosing gender identity. With a flatter, more masculine chest, some opt to come out after surgery because they feel ready to live openly as male. The surgery facilitates coming out for those who wish to share this part of themselves. However, there are no requirements around coming out before or after surgery. The choice to disclose one’s transgender status remains highly personal.

Undergoing top surgery can instill a sense of wholeness and authenticity. While the emotional benefits vary for each person, many transgender men report profound improvements to body image, confidence, and comfort after taking this step.

Life After Top Surgery

For many ftmç,s one of the most exciting aspects of top surgery is finally being able to live life with a chest that matches their gender identity. After surgery, most men report a profound sense of alignment and wholeness. Here are some of the ways life may change after top surgery:

Being Shirtless

Going shirtless is often one of the first joyful experiences after top surgery. For those who felt dysphoria around their chest, they may have avoided swimming, certain shirts or being shirtless. After surgery, the freedom of taking off your shirt can feel liberating. Many ftmçs enjoy spending time shirtless in private or even in public settings like swimming pools or beaches.


Swimming shirtless is a common goal after top surgery. Binding while swimming can be uncomfortable and difficult. Following surgery and recovery, swimming can be more enjoyable and comfortable without a binder or shirt. This allows ftmçs to fully participate in pool parties, beach trips and water activities.


With the removal of breast tissue, exercise can become more comfortable without the movement and bouncing that binding can cause. Working out shirtless may also feel more liberating and aligning with your gender. Pools, gyms and sports may take on new meaning after surgery.

New Wardrobe

One of the fun parts of recovery is shopping for a new wardrobe that fits your post-op chest. With the freedom to go shirtless or wear slimmer fitting tops, ftmçs can reinvent their personal style. Tank tops, lower cut shirts, and tighter tees are all options. Having a wardrobe that reflects your gender can boost confidence.

After surgery, ftmçs can fully live as their authentic selves, participating in activities like swimming shirtless, exercising freely, wearing desired clothes and enjoying life without chest dysphoria. Top surgery can open up new possibilities and be life changing.