An expert explains: what to expect from top surgery

People going through gender reassignment may undergo a procedure to alter the appearance of the chest which is known generally as top surgery. Top surgery may involve removing breast tissue or adding breast implants to give the desired appearance. In this informative guide, highly respected consultant plastic surgeon Miss Tania Cubison offers expert insight on the risks involved in gender reassignment top surgery, the associated recovery period and patient satisfaction.

What is gender reassignment top surgery?

Top surgery relates to the breasts and patients who are transitioning from female to male (FtM) will have the breast tissue itself removed along with the extra skin in the area. The nipples are also removed so they can be repositioned on the chest.

A male patient transitioning to female (MtF) will undergo a breast augmentation procedure with silicone implants, very similar to the type of surgery many women undergo to increase the size of their breasts.

What are the main risks associated with top surgery?

Both MtF and FtM patients require a general anaesthetic for this operation which carries with it some moderate risk. There is also significant scarring, particularly for FtM patients who will have a linear scar across the chest and around the nipples. Occasionally, the nipple grafts that we perform in surgery don’t take well and some people end up with partial loss of a nipple. Generally speaking, however, the nipples migrate quite effectively and take up blood supply after the surgery.

There are some general risks of surgery which apply to all patients, including infection and bleeding. There are also significant risks associated with silicone breast implants which patients need to be aware of. One such risk is capsule formation, an aggressive scarring which means the implants become tight over time and need to be removed.

Additionally, we are very aware these days that simply having silicone within your body can result in a form of cancer, specifically acute large cell lymphoma, so this is something patients undergoing a breast augmentation or MtF top surgery should consider.

What is the recovery process like?

Both MtF and FtM patients would require a period of time in hospital, usually overnight, and will need to wear specialist garments, such as a bra or a compression vest. It’s important to rest well for the first couple of weeks following surgery and attend follow up appointments so we can check on their recovery. The final result won’t be apparent until around three months after surgery.

Are most patients satisfied with their results?

Most patients are delighted with the results of their top surgery. By the time they come to undergo the procedure, many people have been on this pathway for a considerable period of time and so they are very satisfied with their results and pleased that they have gone through with the process.

If you are looking for a leading specialist to perform top surgery and wish to book a consultation with Miss Cubison, you can do so by visiting her Top Doctors profile.