Guide to Transgender Chest Development in Female-to-Male Patients

Understanding Top Surgery for Transgender Men

When people think of the ideal male figure, the first thing that usually comes to mind is the image of a sculpted, well-defined, yet proportionally flat chest. Top surgery is one of the leading surgical procedures sought after by transgender men who have already begun the process of masculinizing their bodies.

In most cases, both transgender men and women have been found to favor chest surgery over genital confirmation surgery. This is primarily because the ability to outwardly present and be recognized as their authentic selves is often the primary concern for transgender people beginning their transitions. And for most, this begins by undergoing hormone replacement therapy.

How Does Testosterone Affect the Bodies of Female-to-Male Transgender People?

Hormone Replacement Therapy (HRT) is an on-going treatment of medications that help transgender and other gender non-conforming people who suffer from gender dysphoria develop secondary sexual characteristics that better align with their gender identity.

Female-to-Male hormone therapy primarily involves the use of androgens such as testosterone to masculinize the body. Such changes can include facial hair growth, increased acne, a change in body odor, a deeper vocal register, significant clitoral growth, and a loss in breast size.

And while some transgender men are satisfied with such changes and use binders as a means to remain flat throughout the day, others will opt to surgically remove their breasts altogether to attain a more masculine definition.

How is Female-to-Male Top Surgery Performed?

Trans men who desire a more outwardly masculine contour have the option to undergo FTM top surgery. Similar to a mastectomy and flat closure, the tissue is removed from the breast during surgery. A free nipple graft, roughly 25 millimeters in diameter, is taken from the existing tissue to reshape the nipple and areola complex. Liposuction is utilized to remove breast tissue along the pectoralis muscle’s lower borders to define a masculine chest shape. The excess skin is reshaped, and the nipple and areola complex is then grafted symmetrically on the chest wall.

FTM top surgery results are immediate and can take anywhere from 6 months to 1 year for scars to settle.

Is FTM Top Surgery Beneficial to Transgender Men?

For many transgender men, the physical changes from both top surgery and hormone replacement therapy can yield an undeniably masculine aesthetic. When combined with continued HRT use under an endocrinologist’s guidance, transgender men can enjoy satisfying and validating lives.

Given a strong and understanding support system and access to proper medical care, transitioning allows transgender people in the Midwest the ability to live honest and authentic lives. For transgender men currently residing in Ohio, Indiana, and Kentucky, I recommend consulting with a licensed therapist who is experienced in working with patients who have already begun their transition. This can eventually lead to finding a team of doctors and specialists who can help you bring your true self out into the world.