FTM Chest Surgery

Hi There!  You might not be aware that Dr. Mosser has a complete website committed to transgender chest and body surgery.   To visit this resource, which has many more photos, resources, and a wealth of information on many aspects of top surgery and body contouring please visit: www.GenderConfirmation.com or click on the link below:

Transgender Surgery

San Francisco Gender Confirmation Center

FTM Chest Surgery  (Keyhole incision, Periareolar breast excision , inverted T or Double incision Mastectomy with nipple grafting)

Dr. Mosser is highly experienced in FTM Chest Surgery. The process involves removing breast tissue, and creating the appearance of a male chest. Options for breast tissue removal can include liposuction to the chest and/or a more involved surgery which removes firm and glandular breast tissue. The type of surgery that will achieve your goals is based on your anatomy, and this is best determined during your consultation with Dr. Mosser.   We will cover a bit of the procedure types below, but for much more information on individual types of surgery please visit www.genderconfirmation.com/surgical-techniques.


The peri-areolar incision in FTM chest surgery, in contrast is made along the circumference of the entire areola, leaving only a small section attached to preserve sensation and blood supply. Liposuction is used,  however at times breast tissue is removed using a combination of liposuction and scalpel as well.

Excess chest skin may be trimmed away and the areola may also be trimmed to reduce size. Skin is pulled to the center of the incision and the nipple is reattached, with possible repositioning necessary to achieve a pleasing “male” appearance.

In order to keep excess fluid from building beneath the skin, drains (long, thin tubing) may be placed in the chest, which curve through the original incision, along the pectoral area, and exit from a small incision beneath the armpit. These can be required for a week, depending on the amount of drainage that happens.

Scarring is limited to the area around the areola. Most normal daily activities can be resumed shortly after surgery and high exertion activities (such as working out, heavy lifting, and other activities which elevate heart rate) can be resumed in about 21 days.

Breast Tissue Removal/Mastectomy with Free Nipple Grafting: If a larger amount of tissue needs to be removed such as a C cup size or higher (and often even for a B cup size) or if there is excess or loose skin, a surgical procedure beyond Liposuction would be recommended for you to receive optimal results.

The goal of such a procedure is to remove excess glandular and firm breast tissue, remove excess skin, and reposition the nipple if necessary. Incisions would be made in the natural skin folds around the nipples and sometimes in the crease where the breast meets the chest. Mammary glands and fatty tissue is then removed by scalpel.

At times, liposuction may be used as well, in certain harder to reach areas. Once all of the breast tissue is removed, any excess chest skin is trimmed and the incisions are closed. The nipples may or may not be resized and repositioned to a more aesthetically “male” position, depending upon the individual patient.

Every effort is made to make scarring as minimal as possible, but it may be detectable with this type of FTM chest procedure, just a bit lower than the edge of the pectoral muscles. As with the former surgical option, just before the incisions are closed drains are placed to keep excess fluid from building beneath the skin, which may be left in for up to a week.

Recovery time with this gender reassignment procedure is similar to that of Liposuction to the chest, with some increased discomfort immediately after surgery. This discomfort can be controlled by medication, and does not pose many issues for patients of this type of surgery.

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Many more FTM Top Surgery photos available here