Female to Male Top Surgery
Female to male (FTM) top surgery is a gender affirming surgical procedure that alters characteristics of the chest, typically through the removal of breast tissue, allowing for a more masculine appearance.
At Haddonfield Primary & Specialty Care, An LGBTQ+ Affirming Practice, dedicated and highly-skilled primary care providers, behavioral health specialists, board certified surgeons and partner plastic surgeons understand the complexities involved with breast-related procedures and guide patients, and their families, through both the physical and emotional journey of FTM top surgery.
Haddonfield Primary & Specialty Care follows the WPATH (World Professional Association for Transgender Health) Standards of Care. Each patient’s care, well-being, and overall process for any gender affirming treatments are handled carefully and with complete oversight by their providers, who work together for the patient’s best interest.
Benefits of FTM top surgery at Jefferson Health
Patients who have undergone FTM top surgery at Jefferson Health have found that it:
Greatly improves their quality of life
Reduces or even eliminates many of the symptoms of gender dysphoria that have been affecting their mental health
Allows patients to be recognized as male among their peers and live their life according to a male role socially
The decision to undergo FTM top surgery is not one to be made lightly. Finding the right healthcare provider is essential. Our compassionate and highly skilled team of providers wish to help every patient on their journey toward achieving the physical appearance that matches their identity.
Are you a candidate for top surgery?
Before surgery, patients undergo a series of medical and psychological evaluations to ensure that FTM top surgery is an appropriate course of treatment. Ideal candidates have a long- standing and well-documented condition known as gender dysphoria. According to the American Psychiatric Association, gender dysphoria is “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity.”
Some patients experience this in early childhood, while others are diagnosed much later after puberty. During evaluation for top surgery, a letter written by a behavioral health specialist is necessary to ensure the patient’s physical and emotional readiness for surgery and discuss how the surgery will address their gender dysphoria.
For more information on Haddonfield Primary & Specialty Care, an LGBTQ+ Affirming Practice or to set up a consultation about FTM top surgery at Jefferson Health, please click here.
FAQs about FTM Top Surgery:
Is FTM top surgery covered by insurance?
The majority of insurance companies accept gender affirming surgeries as medically necessary and cover these procedures. Letters of attestation are written by the behavioral health provider and/or the PCP and submitted to the patient’s insurance company verifying the treatment steps taken, the diagnosis of gender dysphoria, and the length of time the patient has had the condition. Insurances vary as to levels of eligibility for coverage and may be tailored to the specific plans of each carrier.
What is discussed beforehand?
During surgical evaluation, the surgeon gets to know the top surgery candidate and their story. A physical exam is done, and they discuss the look the patient wishes to achieve. Any potentially complicating medical comorbidities, such as cardiovascular disease, diabetes, or a history of smoking, as well as family history of cancer, are taken into consideration. The surgeon describes the joint approach with plastic surgery; the expected incision placement; the necessity of a one-night stay; and the use of drains.
Informed consent is an important aspect of any surgical procedure, and risks and benefits are thoroughly covered. Preoperative breast screening is needed to check for any suspicious lesions/potential breast cancers that could require further workup after surgery. A separate consultation with the partner plastic surgeon is set to learn about that aspect of care and its postoperative course.
How is FTM top surgery performed?
This procedure is unique for each patient. Incision placement is based on patient body type and desired result, including whether the patient wishes to maintain their nipples. All the breast tissue is removed (complete mastectomy), and the plastic surgeon then moves remaining soft tissue to achieve the final aesthetic outcome. For larger-breasted patients, this usually involves moving the nipples to a more male-appropriate position on the chest and making the areola smaller. A subcutaneous drain is placed on each side to evacuate the fluid and blood, which is normal after this type of surgery to reduce the risk of bleeding and improve healing.
How long does FTM top surgery take?
FTM top surgery takes approximately 2-3 hours.
How long is the hospital stay after FTM top surgery?
FTM top surgery typically requires a one-night stay.
What is recovery like after FTM top surgery?
After surgery, patients’ chests are padded generously, and an ACE wrap is wrapped around the body for two days. A drain is placed on each side to evacuate any blood or fluid and allow for better healing. Most patients describe a feeling of being "sore" after surgery, but do not require heavy narcotics for pain. An over-the-counter pain reliever, such as Tylenol or Motrin, will help relieve most discomfort. During surgery, regional anesthesia (numbing medicine) is injected directly into the chest’s sensory nerves, providing significant pain relief for the first six hours following surgery.
Patients follow up with both surgeons two weeks after surgery, and periodically after. Drains are removed when appropriate, typically around two weeks after.
When can patients return to normal activities/exercise after FTM top surgery?
Patients can walk for exercise almost immediately after surgery. It is recommended that patients wait at least 2-3 months before lifting weights or heavy objects.
What kind of scarring can be expected?
Depending on the size of the native breasts, a large incision may be necessary to remove all of the tissue. The surgical team selects the most optimal placement for the incisions -- which will fade with time -- to achieve pleasing cosmetic results.
Are there side effects or complications from FTM top surgery?
The most common complication is bleeding. Another potential complication may be a loss of nipple sensation, which typically occurs less than 5 percent of the time. Patients will feel sore after surgery and should limit strenuous activities until cleared by the doctor.
Do you have testimonials from patients who have undergone FTM top surgery at Jefferson Health?
Yes. We are pleased to share the following stories from patients who have undergone FTM top surgery at Jefferson Health:.
Click here for Ash’s story.
Click here for Xander's story.
What Jefferson Health facilities perform FTM top surgery?
Cases are performed in New Jersey at Jefferson Washington Township Hospital and Jefferson Cherry Hill Hospital. Top surgery is also performed at Thomas Jefferson University Hospital in Center City, Philadelphia.
Who should you call for more information on FTM top surgery?
For patients seeking care in New Jersey, call 856-218-2100. Patients seeking treatment in Center City should contact 215-503-2346. Click here for more information on Haddonfield Primary & Specialty Care, an LGBTQ+ Affirming Practice.
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