Female to male transgender patients need reductive surgery to create a male chest. The surgery depends on the size of the breasts, the amount of skin and the size and position of the nipples. For smaller breasts, sometimes a minimally invasive approach can be used. This technique uses a peri-areolar incision and liposuction to remove the breast tissue behind the nipple and to give a more masculine, flatter appearance to the chest.
For patients with larger breasts, the technique involves a completion mastectomy. The completion mastectomy involves a larger incision at the inframammary fold: the junction between the pectoralis muscle and abdomen. The nipples are usually reduced and made into a more elliptical pattern. They are then repositioned more superiorly (higher on the chest wall) and laterally (toward the arms) to give the appearance of a more masculine nipple shape and position. Liposuction can be combined to provide optimal chest contour.
The third technique is the keyhole pattern. This technique is rarely ever used due to the amount of scarring and lack of contour achieved in the chest.
Our surgeons make every effort to minimize the size and appearance of the scars to give the most aesthetically pleasing final result. There are many options to assist in the final appearance of the scars including scar gels, scar creams, silicone sheeting, and laser treatments.
Our surgeons do everything possible during the primary surgery to avoid the need for a revision, however, sometimes revisions are needed to improve contour, scarring or nipple distortion.