Mastectomy

(also: chest reconstruction, mammaplasty, top surgery)

Introduction
General Information
Drains
Different Types of Surgery
External Links: YouTube Videos
External Links: Breast Reduction Resources
External Links: United States-Based Resources
External Links: Additional Resources

Introduction

Originating as a cancer treatment for cisgender women with breast cancer, a mastectomy is a surgical procedure for removing one's breasts. There are also some cisgender and intersex men who seek out this surgery for their own respective reasons (such as breast cancer or gynecomastia). In the context of this page, we will be discussing the role that mastectomies play in gender-affirming care.

Having visible breasts is generally an indication that someone is a woman, regardless of the rest of that person's gender presentation. For transgender men (as well as many nonbinary people) there is typically a desire to have his unfortunate visual indicator removed. Top surgery can be very effective at relieving gender dysphoria and providing gender euphoria for those who seek it. Some transgender men prefer to use a binder or trans tape; either permenantly or as a method to determine if he would like top surgery at some point.

Some transgender individuals will prefer to get a breast reduction as opposed to a full on mastectomy - though the vast majority do prefer to have it all removed in favor of a truly flat chest. Some insurances are more likely to cover a breast reduction (particularly if you have a condition other than gender dysphoria, such as back pain) so some people first seek out a breast reduction followed by a full mastectomy once they are able to afford it. The cost of a mastectomy will vary depending on where you live, and which version of procedure you seek out.

Regardless of one's path or method to altering/removing/shrinking their chest to achieve their own version of gender euphoria, top surgery is vital for the happiness of many, many transgender men.

General Information

Top surgery, regardless of the method, is a quick and easy outpatient procedure done under general anesthesia by a plastic surgeon. The chest is recontoured to appear more masculine (or however the patient desires it to look). Each method has verious risks and benefits. They are easily distinquished by the different types of scarring. The scarring is influenced via the type of surgery sought out (specifics of various kinds of top surgery mentioned below). What surgery you get will depend on the starting size of the breasts that need to be removed. In general, those with smaller breasts are more likely to be able to keep their nipples attatched for the duration of their surgery.

After a mastectomy, most patients are required to temporarily wear a compression wrap to deal with post-surgical swelling.

All types of top surgery involve liposuction - aka the removal of fat. This is very rarely performed by itself. Very few people have such a small amount of tissue that they would be able to achieve satisfactory results with only liposuction.

Typically, it is required that you be a minimum of 18 years of age to have top surgery. Occasionally, some transgender people at the age of 16 or 17 are able to get it, though this is uncommon.

Breasts will not grow back after top surgery regardless of if the patient is taking testosterone after surgery. They will also not grow back if someone undergoes pregnancy after top surgery. That being said, if someone overall gains weight after having surgery, they may have a larger chest (similar to some cisgender men) but this is not the same thing as actual breast regrowth.

Drains

Most patients of top surgery end up having a pair of medical drains, one on either side of their body. They exit from a small incision under each arm, and collect excess blood and lymphatic fluid in a bulb. The length of time these are in varies from patient to patient, as well as based on surgeon preference.

Different Types of Surgery

There are several main different types of top surgery. The different types mainly revolve around incision techniques. Different techniques are more effective for those with different sized breasts. No one can tell you which surgery you should get, other than your surgeon.

The Transgender Dictionary

Mastectomy

(also: chest reconstruction, mammaplasty, top surgery)

Table of Contents

Introduction

General Information

Drains

Different Types of Surgery

YouTube Videos

Breast Reduction Resources

United States-Based Resources

Additional Resources