FTM Mastectomy (Top Surgery): Creating a more masculine or neutral chest

Understanding Mastectomy (Top Surgery)

Gender-affirming Mastectomy (Top Surgery) is a surgical procedure that involves the removal of breast tissue (subcutaneous mastectomy) and the reconstruction of the chest to create a masculine or a more androgynous or neutral shape for some non-binary individuals. This procedure is a crucial step for many transgender men (FTM) and non-binary people seeking to alleviate gender dysphoria and live more authentically.

Mastectomy (Top Surgery) Techniques at WIH Hospital

Achieving the optimal outcome in Mastectomy (Top Surgery) requires a careful selection of surgical techniques tailored to your unique anatomy, chest size, skin elasticity, and aesthetic goals. At WIH Hospital, our experienced board-certified surgeons are proficient in advanced techniques to create a natural-looking masculine chest.

Common Mastectomy (Top Surgery) Techniques:

     Periareolar Mastectomy

  • This technique is suitable for individuals with small to moderate amounts of breast tissue, good skin elasticity, and those who prioritize nipple sensation and wish to avoid long horizontal scars.
  • The scar will be around the border of the areola, allowing for the removal of breast tissue.
  • Generally, there is a higher likelihood of preserving nipple sensation.

      Double Incision Mastectomy (with Nipple Grafts)

  • This is the most common technique, particularly for individuals with moderate to large amounts of breast tissue or significant skin laxity.
  • It involves two horizontal or slightly curved incisions made across the chest, typically along the lower border of the pectoral muscle, to remove breast tissue and excess skin.
  • Nipple sensation may be reduced or absent initially, with some potential.

A Good Candidate for Mastectomy (Top Surgery)

Our approach aligns with international standards of care, such as those outlined by the World Professional Association for Transgender Health (WPATH).

  • Transmen
  • Stable mental health
  • Age over 18 years
  • Reasonably Good Physical Health
  • Have realistic expectations

Comprehensive Personalized Consultation and Preparing for Mastectomy (Top Surgery) at WIH Hospital

  • You will have a confidential discussion in a comfortable environment. The surgeon will listen carefully to understand your desired chest appearance.
  • Your surgeon will perform a respectful examination of your chest to assess the size and shape of your breasts. Evaluating your skin quality, elasticity, and measuring chest dimensions.
  • The surgeon will discuss your hormone status and any implications for surgery. It’s generally recommended to have stable hormone levels.
  • The patients must stop smoking (including nicotine products and vaping) for a significant period before surgery.
  • Avoid alcoholic beverages for at least one week before surgery.
  • For the excessively high Body Mass Index (BMI) patients, the surgeon may recommend weight management before surgery.
  • Mastectomy (Top Surgery) is typically performed under general anesthesia.

Mastectomy (Top Surgery) Techniques at WIH Hospital

Achieving the optimal outcome in Mastectomy (Top Surgery) requires a careful selection of surgical techniques tailored to your unique anatomy, chest size, skin elasticity, and aesthetic goals. At WIH Hospital, our experienced board-certified surgeons are proficient in advanced techniques to create a natural-looking masculine chest.

Common Mastectomy (Top Surgery) Techniques:

     Periareolar Mastectomy

  • This technique is suitable for individuals with small to moderate amounts of breast tissue, good skin elasticity, and those who prioritize nipple sensation and wish to avoid long horizontal scars.
  • The scar will be around the border of the areola, allowing for the removal of breast tissue.
  • Generally, there is a higher likelihood of preserving nipple sensation.

      Double Incision Mastectomy (with Nipple Grafts)

  • This is the most common technique, particularly for individuals with moderate to large amounts of breast tissue or significant skin laxity.
  • It involves two horizontal or slightly curved incisions made across the chest, typically along the lower border of the pectoral muscle, to remove breast tissue and excess skin.
  • Nipple sensation may be reduced or absent initially, with some potential.

A Good Candidate for Mastectomy (Top Surgery)

Our approach aligns with international standards of care, such as those outlined by the World Professional Association for Transgender Health (WPATH).

  • Transmen
  • Stable mental health
  • Age over 18 years
  • Reasonably Good Physical Health
  • Have realistic expectations

Comprehensive Personalized Consultation and Preparing for Mastectomy (Top Surgery) at WIH Hospital

  • You will have a confidential discussion in a comfortable environment. The surgeon will listen carefully to understand your desired chest appearance.
  • Your surgeon will perform a respectful examination of your chest to assess the size and shape of your breasts. Evaluating your skin quality, elasticity, and measuring chest dimensions.
  • The surgeon will discuss your hormone status and any implications for surgery. It’s generally recommended to have stable hormone levels.
  • The patients must stop smoking (including nicotine products and vaping) for a significant period before surgery.
  • Avoid alcoholic beverages for at least one week before surgery.
  • For the excessively high Body Mass Index (BMI) patients, the surgeon may recommend weight management before surgery.
  • Mastectomy (Top Surgery) is typically performed under general anesthesia.

Mastectomy (Top Surgery) Techniques at WIH Hospital

Achieving the optimal outcome in Mastectomy (Top Surgery) requires a careful selection of surgical techniques tailored to your unique anatomy, chest size, skin elasticity, and aesthetic goals. At WIH Hospital, our experienced board-certified surgeons are proficient in advanced techniques to create a natural-looking masculine chest.

Common Mastectomy (Top Surgery) Techniques:

     Periareolar Mastectomy

  • This technique is suitable for individuals with small to moderate amounts of breast tissue, good skin elasticity, and those who prioritize nipple sensation and wish to avoid long horizontal scars.
  • The scar will be around the border of the areola, allowing for the removal of breast tissue.
  • Generally, there is a higher likelihood of preserving nipple sensation.

      Double Incision Mastectomy (with Nipple Grafts)

  • This is the most common technique, particularly for individuals with moderate to large amounts of breast tissue or significant skin laxity.
  • It involves two horizontal or slightly curved incisions made across the chest, typically along the lower border of the pectoral muscle, to remove breast tissue and excess skin.
  • Nipple sensation may be reduced or absent initially, with some potential.

A Good Candidate for Mastectomy (Top Surgery)

Our approach aligns with international standards of care, such as those outlined by the World Professional Association for Transgender Health (WPATH).

  • Transmen
  • Stable mental health
  • Age over 18 years
  • Reasonably Good Physical Health
  • Have realistic expectations

Comprehensive Personalized Consultation and Preparing for Mastectomy (Top Surgery) at WIH Hospital

  • You will have a confidential discussion in a comfortable environment. The surgeon will listen carefully to understand your desired chest appearance.
  • Your surgeon will perform a respectful examination of your chest to assess the size and shape of your breasts. Evaluating your skin quality, elasticity, and measuring chest dimensions.
  • The surgeon will discuss your hormone status and any implications for surgery. It’s generally recommended to have stable hormone levels.
  • The patients must stop smoking (including nicotine products and vaping) for a significant period before surgery.
  • Avoid alcoholic beverages for at least one week before surgery.
  • For the excessively high Body Mass Index (BMI) patients, the surgeon may recommend weight management before surgery.
  • Mastectomy (Top Surgery) is typically performed under general anesthesia.

Recovery after FTM Mastectomy (Top Surgery)

  • Avoid raising your arms above shoulder level for the first few weeks.
  • Expect moderate to significant swelling and bruising across the chest and potentially extending to the abdomen. This is normal.
  • Do not lift anything heavy for the first 4-6 weeks.
  • Showering may be permitted depending on drain removal and the surgeon’s instructions.
  • Most individuals can return to non-strenuous work or daily routines after 2- 4 weeks.
  • Can see the final result after the surgery, 6 months, and 1 year.

⏱️ Surgery & Recovery Timeline

  • Surgery Duration: 2–3 hours

  • Hospital Stay: 1–2 nights

  • Full Recovery: 4–6 weeks

  • Back to Work: Most patients resume light activities in 2–3 weeks

Our team provides detailed aftercare instructions and is available to support you through your healing process.

Potential Risks

  • Bleeding (Hematoma)
  • Infection
  • Seroma
  • Poor wound healing
  • Pain

Benefits

  • Achieving a chest appearance that aligns with one’s true gender identity.
  • Improvements in mental health
  • More comfortable and confident
  • Ability to wear a wider range of clothing without concerns about chest appearance or binding.
  • Social and Physical Comfort

💬 Patient Testimonial

“The surgery at WIH gave me not only a flat chest, but also confidence. The staff were professional and deeply respectful. I finally feel like myself.”
— K., Trans man and patient at WIH Hospital

FTM-Mastectomy-Double-incision-technique-front-view-1-1024x538-1

Result of FTM breast Surgery by Double Incision Mastectomy

FTM-Mastectomy-Front-View-2-1024x538-1

Result of FTM breast Surgery by Double Incision Mastectomy

If you would like to view more results of Adam’s apple reduction, you can go to  click

Potential Risks and Side Effects

Post-Surgical Bleeding

  • Due to the vascular nature of breast tissue, bleeding may occur, necessitating drainage to prevent hematoma formation.

Swelling and Pain

  • Some swelling and discomfort are common but manageable with pain relief medications.

Infection Risk

  • Infection is rare but can occur.

Tissue Necrosis

  • Insufficient blood supply may lead to necrosis in nipple or breast tissue.

Scarring

  • Scarring is possible, and sensation changes, including numbness, may occur.

Anesthesia Risks

  • All surgical procedures carry risks associated with anesthesia.

Potential Risks and Side Effects

Post-Surgical Bleeding

  • Due to the vascular nature of breast tissue, bleeding may occur, necessitating drainage to prevent hematoma formation.

Swelling and Pain

  • Some swelling and discomfort are common but manageable with pain relief medications.

Infection Risk

  • Infection is rare but can occur.

Tissue Necrosis

  • Insufficient blood supply may lead to necrosis in nipple or breast tissue.

Scarring

  • Scarring is possible, and sensation changes, including numbness, may occur.

Anesthesia Risks

  • All surgical procedures carry risks associated with anesthesia.

One protocol for every depth-creating technique

Skin graft vaginoplasty, colon vaginoplasty, and PPV vaginoplasty all follow this identical dilation schedule — there’s only one routine to learn, no matter which of these three techniques you had.

Potential Risks and Side Effects

Post-Surgical Bleeding

  • Due to the vascular nature of breast tissue, bleeding may occur, necessitating drainage to prevent hematoma formation.

Swelling and Pain

  • Some swelling and discomfort are common but manageable with pain relief medications.

Infection Risk

  • Infection is rare but can occur.

Tissue Necrosis

  • Insufficient blood supply may lead to necrosis in nipple or breast tissue.

Scarring

  • Scarring is possible, and sensation changes, including numbness, may occur.

Anesthesia Risks

  • All surgical procedures carry risks associated with anesthesia.

One protocol for every depth-creating technique

Skin graft vaginoplasty, colon vaginoplasty, and PPV vaginoplasty all follow this identical dilation schedule — there’s only one routine to learn, no matter which of these three techniques you had.

Frequently Asked Questions

WIH Hospital generally follows international standards of care, such as those from WPATH. This often includes requiring a letter from a qualified mental health professional diagnosing gender dysphoria and confirming your capacity for informed consent. Specific requirements will be discussed during your consultation.

The duration of the surgery typically ranges from 2 to 5 hours, depending on the complexity of the case and the specific techniques used.

Initial recovery is about 1-2 weeks. Most people can return to light activities and desk work within 2-3 weeks. Strenuous activities and heavy lifting should be avoided for 4-6 weeks, or as advised by the surgeon.

While many transgender men are on testosterone, it is not always a strict requirement for all individuals seeking   top surgery, particularly for some non-binary people.

Absolutely. WIH Hospital surgeons understand that non-binary individuals may have unique goals for their chest appearance, which may not be a traditionally masculine flat chest. We encourage open discussion about your desired outcome, and surgical plans can often be customized.

WIH Hospital

Book your consultation

Ready to learn more, or need support with your dilation routine? Contact Dr. Chettasak’s team at WIH International Hospital.

WhatsApp: +66 95 650 3892
info@wihhospital.com