Austin Texas Board Certified Plastic Surgeon

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Female to Male (FTM) Top Surgery in Austin, TX

What Is Gender-Affirming Top Surgery?

Top Surgery is a type of gender-affirming (transgender) surgery that occurs on the chest. Feminizing chest surgery is performed for trans women. Masculinizing chest surgery is performed for trans men and some non-binary people. Dr. Weinfeld proudly offers both types of gender-affirming surgery to people in the trans community.

 

Female to Male (FTM) Top Surgery

Female to male (FTM) Top Surgery involves removing the breast tissue with a mastectomy. The skin is left in place but comes to rest flat on the chest muscles, resulting in a masculine form. There are a variety of types of FTM Top Surgery procedures, including the double incision, keyhole, buttonhole, peri-areolar, and inverted-T methods. Dr. Weinfeld will work with patients to help determine the best method for them.

The two most common methods of masculinizing Top Surgery are the double incision and keyhole technique. 

 

Double Incision

The double incision technique works well for larger breasts because it permits the removal of large amounts of breast tissue and excess skin. A horizontal oblique incision is made at the lower breast crease, and another incision is made above the nipple. The excess skin is removed as a wedge with breast tissue. The upper chest skin is brought down and sutured to the lower incision. The nipple is then placed on top of the skin as a graft.

 

Keyhole Incision

The keyhole technique can be employed in trans men with small breasts, nipples, and areolas. It involves making an arc-like incision that follows the curve of the lower half of the areola. The breast tissue is removed via that incision. The keyhole method does not use an incision that goes all the way around the areola. Therefore, there is no opportunity to reduce the size of the areola.

 

Liposuction of the Chest 

Liposuction is often used in both the double incision and keyhole techniques to remove some of the breast fat in order to create naturally smooth anatomic transitions. 

Drains are often required in both methods. While patients would generally prefer not to have drains, Dr. Weinfeld has found that their use significantly reduces the amount and duration of bruising and the risk of fluid collections and associated scarring and infections. Drains are rarely required for more than seven days. They prevent problems and can be considered an investment in the success of the procedure. A compression vest is also an important part of recovery. Trans men are often familiar with compression tops, so these are well-tolerated.

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