Top Surgery / Mastectomy

Female to Male Mastectomy (Top Surgery) in Bangkok, Thailand 

          A mastectomy is where a surgeon removes tissue from one or both breasts. The purpose of a mastectomy is usually to remove or prevent the spread or development of breast cancer. Some people with breast cancer genes elect to have a preventive mastectomy to avoid the risk of cancer.

Sometimes, people choose to have a mastectomy for other reasons. Transgender men transitioning from female to male very often remove the breasts through a mastectomy as part of their transition to create a more male appearance.

          The plastic surgeon performing top surgery, or female-to-male mastectomy, should achieve more than just a flat chest. Ideally, the result should be fully sensate and have minimal scarring. The procedure consists of removing most of the breast tissue and excess skin. The sparing of the nipple and areola is sufficient if the nipple-areolar complex is appropriately sized and shaped. Still, the reduction and repositioning of the nipple-areolar complex are often required to approximate male nipples. 

Top Surgery / Mastectomy Techniques

Kamol Cosmetic Hospital offers three techniques, but the choice of procedures must be appropriately selected for the patient’s breast size and skin quality as follows;

         1. A periareolar (or U-shape scar) technique, the incision is periareolar or U-shape scar. This technique is available for a small breast with good skin elasticity; it may remove breast mass with a minimal incision scar, as in Picture 1


Picture 1. Shows U-shaped scar for small breasts.

          2. A concentric incision or O-shape scar technique is available for moderately sized breasts (B cup) with good skin elasticity. Breast mass is removed through a concentric incision, which gathers skin and leaves a scar entirely around the areola (or O-shape scar).



Picture 2. Shows a concentric incision or O- shaped scar.

          3. Double incision top surgery with nipple graft technique or Mastectomy by free nipple graft; this procedure is available for large or pendulous breasts to require a full mastectomy, which includes removal of the nipple, with free grafting of the nipple to the appropriate new location. This technique will impact nipple sensation significantly but may be the only option for large or inelastic breasts.


Picture 3. Shows double incision top surgery with nipple graft

Inelastic skin (often due to years of breast binding) can adversely affect the outcome and will influence (and limit) the surgeon's choice of technique.

A Good Candidate for Mastectomy (Top surgery)

  • Trans men
  • Healthy
  • Realistic expectation
  • Age is over 18 years old.

Preparation for Mastectomy (Top surgery)

  • Consult with the surgeon to choose the most suitable option, ensure you are the right candidate, and discuss how to achieve the goal.
  • Undergo physical examination to ensure no health condition may affect the surgery
  • Stop smoking at least two weeks before surgery
  • Stop some medicines that interfere with blood clotting, such as aspirin, Ibuprofen, and vitamins and herbs, at least two weeks before surgery.

Top surgery procedure

  • Step 1: The procedure performed under anesthesia
  • Step 2: Open the required incision at the marked site and remove the breast mass to flatten.
  • Step 3: Resect the excess skin and adjust the size and position of the nipple-areolar like the original male chest.
  • Step 4: Skin suture

Post-operative care for top surgery

  • Postoperative care in the hospital for 2-5 nights, depending on the techniques
  • Keep clean  and dry every day
  • Take medicine for pain, infection
  • Follow up seven days, fourteen days after surgery, and every appointment.
  • Take stitches off seven days after surgery
  • Use compression garment to prevent swelling and adjust the chest  shape 3-6 months

Risk and complications for FTM Mastectomy

After surgery, risk and complexity are possible as follows;

  • Bleeding is a risk of any operation, but the need for transfusion is rare. However, specialized surgeons are well concerned and will always keep control to stop bleeding during surgery.
  • Infections are infrequent complications.
  • Nipple necrosis. The blood supply of the nipple might be damaged with more limited operation and nipple necrosis. If the nipples are used as grafts, the nipple graft does not take well. These complications are exceedingly rare.
  • Loss of nipple sensation, numbness
  • Loss of nipple and areolar
  • Poor healing
  • Swelling after surgery
  • Painful will occur but can take a painkiller
  • The scars of the areola usually heal very well. As mentioned above, the scars below the breast will take longer to fade out and will widen. However, a raised or extensive scar is possible and might need further treatment. There may be residual tissue left, which appears as a contour deformity. This scar needs to be removed at a second stage.
  • Risk from anesthesia

Recovery from Top surgery

          Recovery time depends on the person and the surgical technique. You can return to work after surgery for 2 weeks. After surgery, you will feel uncomfortable for a few days. The swelling will be better within 2-3 weeks. It will heal completely in 4-6 months. Be concerned with physical activity such as sports, lifting, and running.

Getting to Know Top Surgery, Mastectomy

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Before and After Top Surgery, Mastectomy

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Video : Testimonials of Female to Male Mastectomy (Top Surgery)

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Why Kamol Cosmetic Hospital is the preferred choice for Top Surgery?

       A mastectomy for transgenders is a surgical procedure that removes breast tissue from the chest of a transgender individual. This procedure is often called "top surgery" and is typically performed on individuals who are transitioning from female to male (FTM).

      The main goal of a mastectomy for transgenders is to help the individual feel more comfortable and confident in their body. Many transgenders who undergo this surgery report feeling a greater sense of self-acceptance and a decrease in gender dysphoria, a condition where an individual experiences discomfort or distress due to the gender assigned to them at birth.

      Kamol Cosmetic Hospital is a popular choice for transgenders seeking mastectomy surgery due to its reputation for high-quality care and results. The hospital has a team of experienced surgeons who are skilled in performing this procedure and are committed to helping transgenders achieve their desired appearance.

      In addition to its talented surgeons, Kamol Cosmetic Hospital also offers a range of supportive services to help transgenders through their transition journey. These services include counseling, support groups, and access to hormone therapy, all of which can be essential for the mental and emotional well-being of transgenders.

      Overall, Kamol Cosmetic Hospital is a trusted and respected choice for transgenders seeking mastectomy surgery. Their commitment to high-quality care, experienced surgeons, and supportive services make them a top choice for transgenders looking to transition.