Sex reassignment surgery (SRS), also called “gender reassignment surgery (GRS)” or “gender confirming surgery,” is a procedure designed to change transgender patients’ bodies so that their appearances better match their identities.
Although patients may choose to undergo SRS for a variety of reasons, many suffer from physical dysphoria, social dysphoria, or both. Physical dysphoria is a strong discomfort with the mismatch between identity and body, and social dysphoria is a strong discomfort with how other people perceive them.
Different Types of FTM Top Surgery
Top Surgery is often one of the first procedures FTM patients want to undergo for their transition, as this surgery allows patients to begin to live more easily in the male gender role.
Depending on the amount of breast tissue present, Dr. Alexander will remove breast tissue and fat through a periareolar or double incision to shape the chest into a masculine contour.
This incision forms a circle around the outside edge of the areola, and it is used for moderately sized breasts (A to C cups) with good skin elasticity. Breast tissue is removed, and a ring of skin around the outside of the areola is excised to remove excess breast skin. The edge of the remaining skin is then pulled to the center and attached to the areola. If necessary, the areola may be trimmed along the edge to reduce its size, and the nipples may be slightly repositioned.
Double Incision with Free Nipple Grafts
The double incision with free nipple grafts is used for patients with inelastic breast skin, large breasts, or saggy breasts. It involves a horizontal or U-shaped incision across each breast just below the nipple. Excess breast tissue, fat, and skin are removed, and the remaining skin is brought together and closed. The resulting scar is placed just under the line of the pectoral muscle. This method usually requires free nipple grafts, where the original nipples are removed, trimmed, and grafted onto the chest in the appropriate positions.
This procedure greatly reduces the risk of breast cancer, and mammograms will no longer be recommended following the procedure. However, even a complete mastectomy cannot remove all breast tissue cells, and there is a very slim chance that microscopic breast tissue cells will remain that can become cancerous, similar to how breast cancer has the potential to develop in the breast tissue of men.
Pectoral implants are used to create a more muscular and contoured upper body. For this procedure, FDA-approved semi-solid silicone implants are inserted into the chest. Dr. Alexander will begin by making small incisions in the armpits. A pocket will then be created under the pectoral muscles for the implants to be placed. This procedure can give patients a well-proportioned chest that is both natural looking and long lasting.
Patients who desire pectoral implants must wait at least three months after their top surgery before undergoing this procedure.
Liposuction for Body Masculinization
For FTM patients, liposuction can be performed to remove fat from the hips, thighs, and abdomen to eliminate feminine curves, giving the body a more masculine shape.
Requirements for FTM Top Surgery
Patients are required to have a letter from their gender therapist, psychiatrist, primary care physician, or psychologist. The recommended content of the referral letters must state, “Transgender surgery is the next step in the transition process.”
All FTM Patients:
- Are not required to be on hormone therapy
- Patients ages 35 years and older must have a normal baseline mammogram prior to surgery.
- Must undergo medical clearance by their primary care physician prior to surgery.
At our North Miami and Broward County offices, we welcome you to call 954-589-0722 to schedule a consultation or for any questions you may have concerning transgender procedures. You may also fill out our online virtual consultation form. Dr. Alexander has more than 30 years of experience and is entirely confidential with the information of all of his clients.