1. Breast
2. Transgender Surgery

Transgender Top Surgery FTM MTF

 

What is a Transgender Surgery?

 

There are a number of surgical procedures that provide permanent physical characteristic changes to enable individuals to achieve the gender form that they identify with.

Chris Porter has a specialty interest in all aspects of transgender breast surgery and has been performing top procedures for transmen (FTM) and transwomen (MTF) since 2006. However he does not perform bottom procedures.

FTM surgical options depend on individual physical characteristics, these include:

• Double mastectomy with free nipple grafts
• Wise incision (also known as an anchor or inverted T scar)
• Peri-areolar incision
• Liposuction 

Liposuction is commonly performed in conjunction with surgical excision with a peri-areloar scar, this type of scar is well concealed around the pigmented skin of the nipple. A wise pattern scar is uncommon unless the patient has a large excess of skin which cannot be removed with a peri-areolar approach. Similarly, liposuction alone is uncommon as most times both fat and skin needs removing to gain a masculine shape.

Similarly, MTF surgical options depend on individual physical characteristics, these include:

• Breast augmentation with implants
• Breast augmentation with fat grafting
• Breast lift
• Breast flaps

 

 

Am I a Transgender Surgery Candidate?

 

Individuals are good candidates for surgery if they are healthy non-smokers and do not have conditions or take medicines that may impair healing. Individuals need to have realistic expectations and understand that transgender surgery does result in scarring, that although permanent are an acceptable trade-off for the improvement in chest shape. They will also be aware that chest shape can change with aging and weight changes, and as such their rejuvenated post-surgical appearance can change with time.

 

 

What is the Transgender Surgery Process?

 

To start, at your pre surgical consultation you will meet Chris Porter and together discuss your personal goals, medical health and previous treatments, surgery and anaesthesia. A list of your current medications is required but you do not need a referral from your family doctor. You do need a referral or documentation from a psychologist or psychiatrist stating that you have met the criteria for transgender identity. If you are on hormone treatment under an endocrinologist then these medical records will also need to be supplied. Your breast characteristics will be examined and explained to you. At the end of the consultation you will have discussed:

• surgical options and have a recommended treatment plan based on your goals and individual characteristics
• the general anaesthesia required to perform your surgery
• realistic surgical outcomes
• possible risks or complications of the surgery or anaesthesia
• cost of the surgery and possible surgery dates
• any questions that you wish to ask

You will also have the opportunity to satisfy any nervousness or personal concerns, you should be comfortable discussing your feelings during the consultation. Remember, your individual goals are specific to you but are also commonly experienced by other plastic surgery patients.

On the day of surgery you will be admitted to the hospital where you will be assessed by the Anaesthetist who may administer medication to settle any pre-surgical nervousness. Chris Porter will perform pre-surgical markings and take photographs for your personal file. Following this, you will be transferred to the operating room where you will meet the surgical team and then your general anaesthetic will be started. While you are asleep under the anaesthetic your surgery will be performed and you will be given pain relief medication so you are comfortable when you wake up following the anaesthetic. Following completion of your surgery and anaesthetic you will be transferred to the ward where the nurses will keep you comfortable and guide your recovery. Typically you will have a one night hospital stay and on discharge you will be provided with pain relief medication, instructions to optimise your recovery, and post-operative appointments.

 

 

What is Transgender Surgery Recovery Like?

 

You will have some post-surgical bruising, swelling and discomfort which will subside towards the end of the first week. Following discharge from hospital you should not drive or return to work during the first week after surgery. During this time you need to rest at home to minimise swelling, bruising and as well as optimising your wound healing. Your dressings are sufficiently waterproof to allow showering from the first day after your surgery. Typically you will be able to return to driving and office based work in the second week after surgery. I recommend that general activity is limited to gentle walking for the first three weeks, if you are progressing well at that stage then you will be able to increase your activity aiming for unrestricted activity just as you were prior to surgery at week four to six, depending on your level of exercise.