What you can expect

Top surgery for transgender men is typically done as an outpatient procedure. You'll be given general anesthesia.

During the procedure

Top surgery involves more than a mastectomy for the treatment of breast cancer. Special techniques are used to contour and reduce the chest wall, position the nipples and areola, and minimize scarring.

If your breast size is small, you might be able to have surgery that spares your skin, nipple and areola (subcutaneous nipple-sparing mastectomy). This procedure minimizes scarring, has a faster healing time and usually preserves sensation in the nipples. During this surgery, incisions are made around the borders of the areolae and the surrounding skin. Breast tissue is removed through the incisions and some skin also might be removed. Remaining skin is reattached at the border of the areola.

If you have larger breasts, you might need to have your nipples and areolas taken off, resized and grafted back into position to create the appearance of a male chest. This causes more scarring and loss of sensation to the nipple. Non-erotic sensation typically returns in months to years.

If you are a carrier of genetic mutations that increase your risk of breast cancer, you might also choose to have your nipples and areolas completely removed and subsequent surgery or tattooing to recreate their appearance.

After top surgery, you might need additional surgery to correct scarring, chest contour, or the placement of the nipples and areola.

After the procedure

After surgery, your chest will remain in a compression wrap for several weeks. You'll likely have one or two small plastic tubes placed where your breasts were removed to drain any fluids that accumulate after surgery. You'll need to sleep with your torso elevated for the first week after surgery. Avoid lifting more than 10 to 15 pounds for several weeks.

Some breast tissue will likely remain regardless of the surgical technique. As a result, your doctor will talk to you about the need for continuing routine breast cancer screening.