Addressing Common Concerns about FTM Top Surgery

A female-to-male (FTM) top surgery is a procedure that gives transgender men a more masculine-looking chest. Aside from hormone replacement therapy, it is another option available to transmen to amend their gender dysphoria. This refers to the significant discomfort related to the mismatch between their gender identity and the sex they were assigned at birth.

Also called masculinizing chest surgery, FTM top surgery begins with a double mastectomy that removes both your breasts. Then your surgeon will eliminate the excess skin near the breast area with a flat closure. Your nipples and areola will be repositioned if you have substantial chest tissue. Finally, your surgeon will check if other changes have to be made for you to achieve a natural-looking flat chest.

Not all transmen feel the need to undergo top surgery. Transgender people, in general, have to make their respective choices according to their individual relations with their own bodies. However, transmen who consider an FTM top surgery have varying concerns regarding the effects of the procedure. Let us discuss other changes, aside from the apparent physical ones, that transmen can expect following an FTM top surgery.

Change in Nipple Sensation

The change in nipple sensation will depend on the amount of breast tissue that will be removed during the procedure. Transgender men with a significant amount of tissue will need a nipple graft that removes and relocates the nipples and areola to a more proportional place. This disrupts the blood supply and nerve endings and results in some loss of sensation.

While the results of this technique may seem a bit too extreme for some transgender men, this, however, allows your surgeon to contour your chest according to your desired shape.

Menstruation and Chest Tenderness

Since an amount of chest tissue is removed, the discomfort of chest tenderness during a pre-menstruation period will be significantly diminished after an FTM top surgery. Should you go for a breast reduction instead of an FTM top surgery, this discomfort (as well as the swelling and tingling in one or both breasts) may still persist during your menstrual cycle. However, you can start hormone therapy, undergo oophorectomy (the surgical removal of ovaries), or begin a treatment that will stop your menstrual cycle.

Increase in Sexual Intimacy and Overall Quality of Life

A study shows that FTM top surgery has major positive effects on the overall quality of life, sexual confidence, and mental health. Even if there is a decrease in nipple sensation, most transmen experience higher sexual satisfaction after their FTM top surgery. This high satisfaction is often a result of being comfortable in one’s own skin and having enhanced self-esteem after an FTM top or any other gender-affirming surgery.

Criteria for FTM Top Surgery

Before undergoing FTM Top Surgery, you will need an endorsement from a mental health provider competent in transgender health who will check whether or not you meet the World Professional Association of Transgender Health (WPATH) standards of care criteria. The criteria state that you must:

1. Have persistent, well-documented gender dysphoria
2. Be able to make a fully informed decision and to consent for treatment
3. Be of the age of majority in your country (18-years-old in the US)
4. Manage any medical or mental health concerns; or if present, must be already well controlled at the schedule of the surgery.

Let Us Be Part of Your Transition

It is natural to feel anxious or doubtful every time you have to make any life-changing decision. We would be happy to address these concerns and provide you an in-depth guide on FTM surgery, including its aftercare and results so that you can make an informed decision.

Book a consultation with us, and we would be happy to be part of your transition as we have been with our past transmen patients.