Double Incision

(also: chest reconstruction, mammaplasty, mastectomy, top surgery)

Introduction

Double incision is the most common varient of a mastectomy. This is a procedure typically sought out by transgender men (and some nonbinary folks) who experience gender dysphoria regarding having breasts.

As with any type of top surgery, only a surgeon can tell you which ones you qualify for - but chances are that if you are seeking a mastectomy, you probably qualify for double incision. If you are a C cup or above, and want to get top surgery, this is probably the surgery you are going to have to get. Double incision is typically required for those with large and/or saggy chests.

General Information

First, two incisions are made; one above, and one below the breast. Next, breast tissue is removed. Some remaining material is kept, and reshaped in a more masculine manner. This process is repeated on the other breast. Once this process is complete, the incisions are sewn together. Depending on prefences of either patient or surgeon, these scars can connect, or be separate. Shape can also vary depending on preference, or depending on one's body type.

The finished result of this surgery typcially consists of two long horizontal scars across the chest.

Typically, the scars will extend out to (or near) the armpits. That being said, the angle and length of the scars will vary depending on your surgeon's technique, personal preference, your body type, and how you heal. Some surgeons may require that you shave your armpits prior to surgery.

It is not uncommon to have drains (one on each side) for the following week or so after surgery. Drains, and instructions to go along with them will vary from surgeon to surgeon.

Some people will use products such as silicone scar strips to manage scarring, but this varies depending on personal preference.

About The Nipples

Standard double incision top surgery is highly customizable in terms of the nipples. Typically, during the stage of this surgery where the incisions are being made, an incision is made to remove the nipples. The nipples are set to the side and are cut/reshaped to be smaller/more masculine. Once the main incisions have been sewn together, small holes are cut into the skin to make way for the nipples. This is called a free nipple graft.

Some people decide to go without nipple grafts. Some people get 3D medical tattoos in place of nipples, or seek out adhesive prosthetics. Plenty of others don't bother, and live the no-nip life. Really, it all depends on personal preference.

T-anchor/Inverted T-anchor

This is a varient of double incision surgery which leaves the nipple stalk intact. An extra scar is left, below the nipples and connecting to the bigger incision scar. Unlike regular free nipple grafts, this version does not come with the risk of loss of nipple sensation. However, it is a lot more difficult to resize the nipples/place them in a more 'typically' masculine spot.

YouTube Resources

YouTube Playlist: Ashton Daniel - Top Surgery
YouTube Playlist: Jammidodger - Top Surgery
YouTube Playlist: Matt Turner - Top Surgery
YouTube Playlist: NOAHFINNCE - TOP SURGERY
YouTube Playlist: roadmapzach top surgery diary
YouTube Video: Female to Male Transgender Top Surgery
YouTube Video: LIVE SURGERY of Transgender FTM/Non-Binary DOUBLE INCISION Top Surgery Performed by Dr. Mosser
YouTube Video: Trans 101: Ep 22 - Double Incision (Top Surgery) CC
YouTube Video: Transgender & Non-binary Buttonhole or Inverted T Incision by Dr. Scott Mosser

Additional Resources

Cade Hildreth - What Is Double Incision Top Surgery?
Gender Confirmation Center - Double Incision – The Most Popular Top Surgery Procedure
Gender Confirmation Center - Nipple-Sparing Double Incision Top Surgery
genderconfirmation - Types of Top Surgery
journals - Chest Masculinization
Simontsao - Double Incision Mastectomy
top surgery .net - double incision
Wikipedia - Pectoral Muscles