Gender dysphoria is a universal experience for those who feel their physical gender does not reflect their core identity, commonly causing turmoil in many aspects of life for those who do not identify with their biological sex. The challenges of living life with a body incongruous to your true gender identity can be taxing, both psychologically and emotionally. Transgender individuals can face a number of burdens, including greater susceptibility to anxiety, depression, health problems, substance abuse, and conflict in one’s interpersonal relationships, among other difficulties. For some transgender and gender non-conforming patients, top surgery can be a life-changing procedure to create more harmony between one’s outward appearance and authentic self. 

Dr. Tiffany McCormack, our skilled board-certified plastic surgeon, is passionate about helping individuals look and feel their best no matter how they identify. With the increased safety and predictibility in transgender plastic surgery procedures that have occurred in recent decades, Dr. McCormack is well-versed in performing both female-to-male (FTM) and male-to-female (MTF) top surgery for transgender Reno patients, in addition to those traveling to McCormack Plastic Surgery from out-of-town. The goal of Dr. McCormack and our experienced medical team is to assist you in your gender transition by carefully listening to your needs in a compassionate, judgement-free environment. Dr. McCormack will work with you throughout every step of your transformation to develop a custom treatment plan unique to your goals and help you finally achieve the appearance you deserve.  

What is FTM Top Surgery?

Female-to-male top surgery is a gender-affirming procedure designed to achieve a more masculine chest appearance by reducing the breasts. For some transgender men and/or transmasculine individuals, living with breasts can be uncomfortable and distressing—it is not uncommon for patients to bind their breast tissue with a compression garment every day in order to flatten the chest. FTM top surgery can be a transformative procedure to align your chest appearance with your gender identity for lasting results, often canceling the need to hide the breasts and allowing a greater sense of confidence in one’s gender presentation. The process of creating a more masculine chest contour involves removing skin, fat, and breast tissue through breast reduction and, in some cases, liposuction techniques. The decision to undergo FTM top surgery is extremely personal, and it is important to note that not all FTM individuals desire top surgery. Only you can decide whether the procedure can potentially achieve a positive change for your goals, health, and lifestyle. 

How is the FTM Top Surgery Procedure Performed?

FTM top surgery is usually performed using one of three techniques, depending on your current chest size and the elasticity of your skin:

  • Double incision with nipple grafts: This technique is essentially a bilateral mastectomy with repositioning and resizing of the nipples. Typically best suited for individuals with larger chests and notable skin laxity, the double incision approach is designed to achieve a more masculine chest by reducing breast tissue while removing the nipples, making them smaller, and repositioning them in a more aesthetic location. The procedure generally lasts three to four hours. 
  • Periareolar (“concentric circle”): The periareolar incision is often utilized when patients have a small- to medium-sized chest with some excess skin present. While the nipples are left intact, a ring of skin encircling the areola is removed to decrease laxity and tighten the chest appearance. Periareolar top surgery typically takes three to five hours to complete.   
  • Keyhole: Top surgery using the keyhole technique is usually reserved for individuals with small chests and little to no skin laxity. No excess skin is removed, so a keyhole incision is generally only successful for those who have tight, or “elastic,” chest skin. This procedure can last anywhere between one and a half to three hours.    

Dr. McCormack can help you determine which incision is the most ideal technique for your needs after a physical examination. Scarring is typically more prominent with the double incision procedure when compared to periareolar and keyhole top surgery, but Dr. McCormack will let you know what to expect based on your particular treatment plan. 

What is MTF Top Surgery?

Like the FTM procedure, male-to-female top surgery is designed to make one’s gender identity a physical reality. For transgender women, this may involve creating the appearance of natural breasts with a procedure very similar to breast augmentation. That said, there are some distinctions between breast augmentation and MTF top surgery and these distinguishing factors will be fully explained to you during your consultation. During MTF top surgery, implants are placed above or below the chest muscles to obtain a natural-looking breast contour. Depending on your goals for the outcome, either saline or silicone breast implants can be used to form the breasts. There are a variety of implant types, shapes, and sizes available to achieve your desired appearance and Dr. McCormack will be there to help you make informed decisions every step of the way. 

How is the MTF Top Surgery Procedure Performed?

MTF top surgery is performed in a similar fashion to a standard breast augmentation. During a thorough consultation, you and Dr. McCormack will discuss the best choices for the most ideal incision technique, implant size and type, and implant location, among other details. Saline or silicone breast implants can be inserted either through an incision around the areola, along the crease where the breast tissue meets the skin, or along a fold of the armpit. Once the type of incision is determined, the implants can be positioned above or below the pectoral muscles to achieve a more feminine chest appearance. While rare, the possible risks of MTF top surgery are the same as those that exist with breast augmentation, including the potential for capsular contracture, implant rippling, and implant rupture. The length of MTF top surgery is generally one to two hours. 

What is Recovery From Top Surgery Like?

The recovery period after FTM or MTF top surgery is similar to those of breast reduction and breast augmentation, respectively. Swelling and bruising can be expected for as long as a few months after your procedure, but should gradually subside. Oral pain medications can typically manage any discomfort until swelling decreases. A compression garment is often worn temporarily to help provide support for your new chest contours. Dr. McCormack will go over all post-operative instructions with you in person and give you tips on how to achieve a smoother healing period.  

How Much Does Transgender Top Surgery Cost?

The cost of FTM top surgery can fall anywhere between $3,000 and $10,000 depending on the state you live in, the skill and experience of your plastic surgeon, the surgical technique used, and the complexity of your procedure. This range can provide a good approximation of your surgical expenses, but it should be understood that several factors unique to your situation will ultimately determine the total price of top surgery. Additional expenses for post-surgery medications, compression garments, and similar fees are also a consideration to keep in mind.

The price range for MTF top surgery differs slightly from the FTM procedure, with expenses often amounting between $5,000 to $10,000. The desired size and shape of the breasts as well as which implants are utilized are some of the factors that will affect the ultimate cost of MTF top surgery. Unfortunately, both types of top surgeries are considered cosmetic in nature by insurance companies and—like comparable cosmetic breast procedures—are not usually covered by most medical insurance policies. Our practice does offer plastic surgery financing plans through CareCredit®, ALPHAEON™ Credit, and Prosper® Healthcare Lending, however, if you prefer to pay for surgery in smaller installments. With low- to no-interest options offered by each respective healthcare lending company, patients often find a suitable arrangement for virtually any budget. If you have any questions about the cost of top surgery, our office team is available to assist you in any way we can. 

Gender-affirming top surgery can be a powerful procedure to help you feel more confident in your own body. If you have any questions about surgery, Dr. McCormack would be happy to address your concerns in a consultation. Please don’t hesitate to contact our practice for more information about how we can help you during your transition.