Transgender Top Surgery

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What is transgender top surgery?

When transgender people are interested in surgically transitioning, top surgery is a procedure they may want to pursue. Top surgery at Cleveland Plastic Surgery refers to a group of surgeries transgender patients use to reshape their chests. Transgender top surgery only involves the chest.

Not all transgender people seek this surgical transition. Research from the National Transgender Discrimination Survey found that almost three quarters of gender diverse people assigned female on their original birth certificate either had already gone through surgery or wanted top surgery. The transition is less common in gender diverse people assigned male on their original birth certificate, with 44 percent opting for surgery or wanting surgery. This disparity could be due to the success that transfeminine people have with breast growth with estrogen supplementation without surgery.

Who is an ideal candidate for transgender top surgery?

Dr. Leedy follows the World Professional Association for Transgender Health (WPATH) Standards of Care for transgender top surgery. This is the criteria set by the WPATH:

  • Persistent, well-documented gender dysphoria
  • Capacity to make a fully informed decision and to consent for treatment
  • Be of the age of majority in the country of surgery
  • Significant medical or health concerns, if present, must be reasonable well controlled at the time of surgery

What are the benefits of transgender top surgery?

These procedures have high satisfaction rates for both transfeminine and transmasculine patients, although there is more research due to the higher numbers of transgender men opting for surgery. Overall, studies have found that outcomes from these surgeries for transgender men are extremely positive. Transmasculine people who have had top surgery often feel more confident and less anxious than before their surgery and when compared to others who have not had surgery. 

With the comfort experienced after these surgeries, patients are more physically active and more comfortable engaging in activities with friends and partners. Physical and mental health are consistently improved across various studies, surgery types, and populations.

Although there isn’t as much data, research also points to similar improvements in confidence and body image in transfeminine women who have undergone breast augmentation.

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Hear What Dr. Leedy's Patients Have to Say!

"From the time I meet Dr Leedy & his staff it has been such a great experience. I’m so confident that I chose the right Dr to help me with what I’ve been trying too get done for the last 19-20 years. I am so looking forward to this next journey I’m an about to embark on...next week is my time. IM SO EXCITED 😊" — Chris S.

"There are not enough words to express how wonderful Dr.Leedy and his staff are! Everyone was so nice and went out of their way to help me and answer any questions I had. Day of surgery was just as amazing! They reassured me and made me feel so comfortable! Thank you from the bottom of my heart for such a great experience. I will definitely recommend Dr. Leedy and his staff to everyone I know. Thank you again!!" — Kim S.

"What an amazing experience. After years of contemplating if I wanted to alter my body or not, conducting years, and I do mean years of research, I finally decided to remain local and go with Dr. Leedy. I am beyond thrilled and thankful that I chose him." — Danyale T.

How is transgender top surgery performed?

Transmasculine Top Surgery

These surgeries for transmasculine patients involve more than a mastectomy for the treatment of breast cancer. Dr. Leedy utilizes special techniques to contour and reduce the chest wall, position the nipples and areola, and minimize scarring.

If your breast size is small, Dr. Leedy may be able to minimize any tissue removal. Incisions are made around the borders of the areolae and the surrounding skin. Breast tissue is removed through the incisions and some skin also might be removed. Remaining skin is reattached at the border of the areola.

If you have larger breasts, Dr. Leedy may need to relocate and resize the nipple/areola complex to create the appearance of a male chest. This creates more scarring and potential loss of sensation to the nipple.

Transfeminine Top Surgery

For transfeminine patients, following hormone therapy, if the patient feels breast size is not large enough, Dr. Leedy will perform breast augmentation. These procedures can be done in two ways: direct augmentation with implants, or augmentation broken into two stages. 

Direct augmentation is performed on an outpatient basis, and it generally takes about one hour. Dr. Leedy makes an incision either around the areola, or at the location of the future lower breast crease for larger implants. He then forms a pocket in the breast tissue, usually behind the pectoral muscle, to hold the implant. The implant is inserted on one breast and then the other. Dr. Leedy checks symmetry and position, and he closes the incisions.

If hormone therapy did not result in enough breast development to adequately hold the implants, Dr. Leedy will have to perform a two-step augmentation. First, he places what are called tissue expanders into pockets he forms in the breast tissue. These expanders are placed where your implants will eventually be. These expanders are then gradually filled with saline solution. Over time the amount of saline is increased to enlarge the expander. This continues to stretch the skin and support tissues to create space for the implants. When the stretching is complete, the expanders are removed, and Dr. Leedy replaces them with breast implants.

What is recovery like after transmasculine top surgery?

These are outpatient procedures with Dr. Leedy. When you return home, your chest will be wrapped in compression bandages initially. You’ll be able to remove these in a few days and you’ll then need to switch to compression garments, sometimes called binders. These play an important role in healing, as they limit the swelling and bruising. Plus, they hold the surgical areas firmly in place, supporting the intended chest contours. These will be worn for up to 6 weeks after your surgery, but Dr. Leedy will discuss this timeline with you.

These are not overly painful recoveries. You’ll have prescription pain medication, but many patients feel over-the-counter options handle the discomfort. If you have a desk job, you’ll be able to return to work in 1-2 weeks. If you have a physically demanding job, you’ll probably need 4-6 weeks off.

As for exercise, you can return to light activity such as walking almost immediately. Strenuous exercise, particularly anything involving the chest, will need to wait for probably at least 8 weeks. Weightlifters need to be cautious about heavy chest workouts — avoiding them for 3 months — so as not to stretch your incision scars. 

What is recovery like after transfeminine top surgery?

These are not difficult recoveries. For the first two or three days, you will experience some pain and discomfort, but this is totally manageable. Your chest may feel tight. This is normal as your implants need to settle into place just a bit. Your breasts may appear too high initially, but this is also temporary as they settle.

Most patients can return to work in four or five days. Non-impact activity can resume in about a week, with impact exercise available again in about one month. You can return to upper body-specific exercise in six weeks.

Ready to Take the Next Step? Contact Us.

To learn more about transgender top surgery, please schedule a consultation with Dr. Jason Leedy. You can reach us by calling (440) 340-3734, or you can submit an online contact form to our office and we'll get back to you at our earliest convenience. Dr. Leedy and the Cleveland Plastic Surgery Institute staff look forward to serving you.

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2060 Lander Rd
Mayfield Heights, OH 44124

Appointments: 440-340-3734 | General Inquires: 440-461-6100

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