FEMALE TO MALE AND NON-BINARY CHEST MASCULINIZATION TOP SURGERY PLASTIC SURGERY SPECIALIST UPPER EAST SIDE NYC AND LOS ANGELES

Our top rated, best in class NYC and Los Angeles plastic surgeons offer female-to-male (FTM) and non-binary top surgery. Top surgery is the most commonly performed gender-affirming surgery, allowing patients to live more comfortably, thereby improving psychological and social functioning. Oftentimes, top surgery is the only gender-affirming surgical procedure performed for a patient. It is not required to be on hormones in order to undergo top surgery.

Please note: To provide a more streamlined and convenient process, ALL consultations are scheduled virtually.

Our chest masculinization top surgery surgeons in NYC and Los Angeles (LA) perform a unique FTM and non-binary top surgery which we refer to as a Genderplasty surgical procedure. A Genderplasty, available only through our practice, involves three main components: (1) a bilateral chest masculinizing breast reduction which will leave a flat but not “scooped out” chest and does not require drains, (2) an intraoperative nerve block that eliminates the need for postoperative prescription pain medicine, and (3) cosmetic liposculpting for superior aesthetic results. Learn more about Genderplasty.

The main surgical component of Genderplasty is a bilateral chest masculinizing breast reduction. Bilateral” means both breasts. “Chest masculinizing” means recontouring the chest to achieve a more masculine phenotype. The term “chest masculinizing” is simply used as a way for the surgeon to communicate to the patient what is trying to be achieved in the operating room. This term is used regardless of gender identity (whether a patient identifies as masculine or non-binary). The term “breast reduction” is used instead of the term “mastectomy” to describe the operation. This is because a mastectomy is an operation in which the goal is to remove all breast tissue, and typically would only be performed for treating or preventing breast cancer. Top surgery is a different type of operation. It is a plastic surgery procedure for recontouring the chest, not for managing cancer, and a small percentage of breast tissue may be left behind to keep the subcutaneous layer a bit thicker. This approach prevents a “scooped out” appearance to the chest, smoothens out contour irregularities, and helps mimic the pectoral bulk consistent with the male phenotype. This is what makes our Genderplasty technique different from how many other plastic surgeons approach top surgery. It should be noted that the small amount of breast tissue left behind will not resemble a female breast – the chest will be flat. Furthermore, although the patient’s risk of breast cancer is dramatically reduced after top surgery, it does not become zero, and breast cancer screening may be necessary postoperatively.

A variety of surgical approaches are available for top surgery. Your surgeon will explain which approach is best suited for you based on your individual anatomy. A majority of patients are candidates for the “double incision” technique. This approach is best suited for patients with larger breasts because of the extra skin that must be removed. The extra skin is cut out as an ellipse, the edges of which are then sewn together leaving a transverse scar along the lower border of the pectoralis muscle. The double incision technique generally involves using a free nipple-areola graft. However, some patients elect not to have grafting performed. A smaller number of patients are eligible for the “periareolar” technique. This approach is better suited for patients with smaller breasts where no extra skin needs to be removed. An incision is placed along the lower border of the areola (which makes this procedure virtually “scarless”).

Regardless of the technical approach used in Genderplasty, there are no drains and all of the stitches are beneath the skin and do not need to be removed.

The second component of Genderplasty is a special technique performed during surgery called an intercostal nerve block, which places long-acting anesthetic medicine along the rib cage. This eliminates the need for postoperative prescription-strength medication. All that is needed will be Tylenol and ibuprofen (Advil or Alleve) allowing patients a quicker return to work and school.

The third component of the Genderplasty surgical procedure is cosmetic liposculpting. This involves using liposuction at the end of the procedure to enhance the aesthetics of the chest by smoothening contour irregularities, adding more definition, accentuating the “V” shape of the lateral male chest, and allowing better symmetry. Adding liposuction should be thought of like a sculptor using a fine chisel to finish the work. Although top surgery can be done without it, it is an extra tool to help enhance the result.

The procedure is performed under general anesthesia and takes approximately three hours. Patients return home that same day with an elastic garment placed over the chest to provide snug compression.

Bruising and swelling are normal and may take a few weeks to resolve. The dressings and compression vest must stay on and remain dry for one week. Patients are permitted to walk and return to their activities of daily living immediately following surgery, however strenuous exercise and heavy lifting and pulling should be avoided for two weeks. Patients typically return to work that doesn’t require manual labor in about a week. It takes about one to two months for patients to feel like they’re able to get back to their preoperative activity level. 

Major complications and postoperative emergencies are uncommon. Our surgeons take a conservative and educated approach to top surgery and will discuss in detail all the risks, alternatives, and benefits prior to performing surgery.

Some health insurance plans will cover top surgery. However, liposuction is never covered by health insurance plans.

The honor and privilege of caring for our patients come with the responsibility and dedication of our best in class, plastic surgeons, and our staff to adhere to the utmost standards of excellence in patient care and final surgery outcome. If you have any questions or would like to schedule a consultation please feel free to contact our practice:

Upper East Side Plastic Surgery Practice
800A 5th Ave
Suite 300A
New York, NY 10065
(212) 427-3982

Los Angeles Plastic Surgery Practice
416 N Bedford Dr.
Suite 400
Beverly Hills, CA 90210
(213) 319-2741