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What is Revision Gynecomastia

Female to Male Top Surgery & Non-Binary

Since you are researching gender confirmation options, it’s a good bet your journey is underway. Perhaps you’re in the information-gathering stage, learning about all the options in transitioning from female to male, or toning down your female appearance and achieving a more androgynous, non-binary identity. Or maybe you’re further along-having begun counseling and hormone therapy. If this is the case, your next goal might be top surgery. Dr. Elliot Jacobs is ready to meet with you, share information and help you understand what the procedure involves.

As a board-certified plastic surgeon in Boca Raton, Dr. Jacobs is a great choice as a partner for you in this important change. You can probably guess that he performs breast reduction surgery for women, but you may not know that he is widely regarded as the “go-to” cosmetic surgeon for male breast reduction as well. With 40+ years of experience serving people of both sexes, he is ready to deliver the results you’re seeking.

Understanding FTM Top Surgery

During your consultation, Dr. Jacobs will work with you to determine the best technique for reducing the size of your breasts. The strategy will focus on creating a more masculine-looking chest while minimizing incisions and scars. Factors involved include the size of your breasts, your age, and the quality of your skin. Here’s a look at the approaches we most often use:

Reducing Smaller Breasts

We often perform breast removal surgery on patients who are young, have good skin quality, and have small breasts. It involves a tiny nick on the side of the chest that allows liposuction to remove fat. Additionally, we make an incision around the areola to remove gland tissue.

There will be a spontaneous tightening of the skin as well as a reduction in areolar diameter. After healing, this method produces very small, nearly invisible scars, which makes it a popular choice for the right patients. Your breasts may already have shrunk on their own if you have been on testosterone for a while. If so, this technique may be more appropriate.

FTM Surgery

Options for Moderate Sized Breasts

Before and After 2 FTM Surgery
Before and After 2 FTM Surgery

If you have medium-sized breasts and fairly elastic skin, you and Dr. Jacobs can decide together how to proceed. It is possible to choose the minimal scar approach, then wait several months to see how much the skin tightens. We can perform a second procedure if your skin has not completely recovered.

Waiting will result in tighter skin, which means smaller incisions for removing any remaining excess skin. If you are older and your skin isn’t in the best condition, you may wish to consider the approach we use for larger breasts. Fortunately, Dr. Jacobs’ experience with thousands of breast reduction patients will enable him to give you a reasonable idea of what to expect prior to your surgery.

Patients with Large Breasts

Typically, transgender patients with large breasts can achieve the best results with an approach similar to mastectomy – a procedure that leaves scars below the inframammary fold breasts. This technique allows for the removal of fat, breast tissue, and extra skin, plus relocating the nipples higher on the chest.

The resulting scars are larger than those created by the procedure for smaller breasts, but they do fade in time. One consideration is that nipple sensation may change-Dr. Jacobs will discuss this with you to help you make decisions.

What to Expect During Top Surgery?

FTM surgery in Boca Raton will be performed at our state-licensed surgical center. A general anesthetic is typically used, and no hospital stay is required.

During the initial consultation, your surgeon will determine which surgical approach is best for you based in part on the size of your breasts. Keyhole surgery is the first option, which may be appropriate for people who wear an A-cup or a small B-cup bra. Dr. Jacobs makes an incision along the border of your areola, then removes the breast tissue through this opening. In most cases, he will not remove extra skin or resize or reposition your nipple or areola, and your nipple sensation will be preserved.

A “double incision” top surgery is the most common method for treating patients with large chests. This procedure involves creating an incision around the nipple and along the lower border of the pectoralis muscle. Those openings are used to remove excess breast tissue and reshape and reposition the nipple-areola complex. As needed, liposuction is an option. This gives a great masculine contour. However, it usually means losing nipple sensation.

The last approach is the “periareolar” technique, which is for patients with small to medium breasts, large areolas and minimal skin excess. Dr. Jacobs makes an incision around the areola to do this procedure. During the procedure, he’ll remove the excess breast tissue, along with the remaining skin. Afterwards, he’ll suture the area to tighten your skin around your areolas.

Before and After 3 FTM Surgery
Before and After 3 FTM Surgery

Are You A Candidate for FTM Top Surgery?

We follow guidelines established by The World Professional Association for Transgender Health (WPATH) to ensure a patient is a candidate for FTM surgery in Boca Raton.

Teenagers

Patients should be able to consent to treatment and make a well-informed decision

Older men

Medical and mental health concerns should be stabilized before treatment

What to Expect from Recovery

You can relax now! When the day of your FTM top surgery in Boca Raton arrives, most of the hard work and stress of transitioning is behind you. You have done soul searching, been to counseling, and talked about your true self with loved ones. You’ve started hormone therapy and come to the conclusion that reducing the size of your breasts is the right step.

You’ve also been in to meet with Dr. Jacobs, and together you’ve created a surgical plan that makes sense. Now it’s time for a procedure that’s straightforward with a team that will be with you every moment.

You’ll need someone to stay with you that first night in case you need assistance. In fact, we recommend you have someone with you for a day or two. For the first couple of days you will rest most of the time, so having someone prepare a meal or two, take care of pets and perform small tasks is a big help.

For a few weeks post-op, there will be some swelling and bruising. You can help keep these at bay by maintaining a low heart rate and blood pressure. You will probably experience light to moderate discomfort at first. Most people use prescription medication for a day or two, then switch to OTC pain relievers.

After a few days of rest, you can resume light activity at home. You should plan to be away from work for at least a week. If you have a strenuous job, you will want to take a little more time off. And activities such as lifting weight or aerobic exercise should wait a few weeks.

Your new shape will emerge over time. You’ll notice some change right away, but swelling takes a while to disappear completely and your skin will also need some time to fully tighten. Do not feel discouraged if you don’t see the ultimate sleeker appearance you have been anticipating for a few weeks. If you are waiting to determine whether you might need additional skin reduction, you’ll need to be patient for a few months. Similarly, scars continue to fade for several months.

During the post-op period, you will see Dr. Jacobs a few times so he can check your progress. You and he can determine if any further measures would be beneficial. For instance, if a scar looks prominent to you, a simple injection can often help smooth it out.

What to Expect from Recovery
Benefits of Gynecomastia Revision Surgery

Top Surgery Risks

You’ll be glad to hear that breast reduction performed by an experienced, board-certified plastic surgeon like Dr. Elliot Jacobs is typically very safe. Whether Dr. Jacobs operates on a woman with heavy, pendulous breasts, performs gynecomastia surgery for a male patient, or reduces breasts as part of transsexual surgery, there are few risks involved.

Any surgery carries risks. Most of them are familiar to you. Among the most common are infection, hematoma (blood buildup), seroma (fluid buildup), and excess swelling. Blood clots and tissue loss rarely occur. You will learn how to minimize risks before your top surgery. The majority of complications resolve themselves or are easily treated.

Specific Risks of FTM Top Surgery

  • Adverse scarring: Even when having a full mastectomy, most people find their scars fade over time and become thin, light lines. The scarring process is inherently unpredictable, however, and it’s possible you could end up with scars that are bumpy or wider than expected. If so, they can be treated with injections or minor surgical repair if desired.
  • Loss of sensation: Most nerve endings generally reattach during the healing process. Some patients find sensation is permanently diminished, either in spots or in a more widespread manner. The more extensive your incisions, the higher the risk.
  • Regret: Patients undergoing female to male surgery occasionally ask what will happen if they regret the decision to have a breast reduction. While it’s theoretically possible to use breast implants to rebuild a chest-just as it is for women who undergo mastectomy for cancer treatment – you should consider FTM top surgery to be permanent. Results from a revision procedure would never give you the look you had prior to surgery.
Risks of Revision Male Breast Reduction Surgery
Why Choose Dr. Jacobs for Breast Reduction Surgery?

Why Choose Dr. Jacobs for FTM Top Surgery

Reconstructing your chest is a brave step toward physically matching the shape of your upper body with your gender identity. Results can be exciting, and you are likely to feel more self-confident as a result. Dr. Jacobs offers arguably the best FTM South Florida has to offer. To learn more, or to schedule a consultation, call today.

Contact Us

Contact Us

Reach out to Dr. Jacobs today to schedule your consultation!

FAQ

What type of sedation is used?

Our preferred method of anesthesia – twilight (or IV) sedation – will also be a benefit. With the medicine administered intravenously, you will sleep completely through surgery. After surgery, you’ll awaken quickly and easily. Unlike general anesthesia, there’s no breathing tube, sore throat, nausea, or grogginess after surgery.

The typical breast reduction surgery takes 90-120 minutes. As we finish, we’ll wrap your chest in soft bandages and transfer you to the recovery room where we’ll keep an eye on your comfort. Within an hour or two you can go home to rest with the assistance of a friend or loved one.

What can be combined with top surgery?

One key ingredient in your satisfaction is realistic expectations. After surgery, you will not have feminine-looking breasts any longer. But Dr. Jacobs will not remove all breast tissue, as some breast glands and fat are needed to build masculine contours.

Be sure you are not expecting to look automatically more muscular or have a more masculine appearance in other ways, however, as the change in your appearance will be confined to your chest. Some patients choose additional procedures to support their transition. A good example is liposuction to slim hips, buttocks, and thighs. It’s likely we can combine FTM top surgery with another procedure to save you money and recovery time – just let us know your goals.

What can be expected after FTM top surgery?

As your results begin to emerge during recovery, we will be excited to hear your reactions. We are very aware that breast surgery is not a simple cosmetic procedure for a transgender individual; it’s an event that will impact your life in a profound way. We look forward to learning about the experience from your perspective.

We can say that patients who choose FTM top surgery are most often very satisfied with their results. Having identified as male for some time prior to their procedure, having undergone counseling, and becoming increasingly certain that surgery is the right step, patients are relieved to finally achieve the silhouette that conforms with their true identity.

Will breasts produce milk after surgery?

Your breasts will not produce milk after surgery. Though some breast gland tissue will remain to help create masculine contours, there will not be enough ducts left to produce milk. Another reason to be sure top surgery is right for you!

What if I have been binding my breasts for a long time?

Most individuals who bind their breasts are sensible about it – meaning they don’t bind 24/7 or constrict their body so much that pain and sores result. Assuming this is the case for you, the binding should not affect your FTM surgery. It’s possible your skin quality may have changed with long-term, regular binding; Dr. Jacobs will assess this during your consultation.

Can I have a breast reduction without removing the entire breast?

Yes, certainly, Dr. Jacobs can reduce the size of your breasts without removing them. Some people go this route feeling that smaller breasts will make them much happier in their own skin, while some individuals deliberately seek an androgynous appearance. A few choose smaller breasts thinking that they may want them completely removed later in a second operation. This is ok too, provided the additional scars are acceptable to the patient.

Will I still be at risk for breast cancer?

FTM top surgery will reduce your risk of breast cancer since you will have scant breast tissue remaining. This doesn’t mean the risk declines to zero, particularly if you have a history of cancer in your family. You may still need screening, especially as you get older, which may mean seeing a specialist. Our best advice is to talk with your primary care physician about this and plan a detection strategy that makes sense.

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