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FTM Chest Masculinization

FTM Top Surgery/Chest Masculinization
 Before & After Photos

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FTM Top Surgery/Chest Masculinization
 Before & After Photos

Keep in mind that each patient is unique and your results may vary.

Case: 1 of 51

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Case: 1 of 51

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Before and After (1 week)

Case: 1 of 50

Case #11200

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This is a 30 year-old trans-male from the Midwest who had minimal side-to-side chest skin excess, and therefore was a good candidate for a "button-hole" FTM/Top Surgery (with the nipple still attached, but delivered via a separate round incision - hence truly "double-incision" Top Surgery). 414 grams of tissue were removed from the right side and... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 mo)

Case: 2 of 50

Case #674

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24 year-old trans-man with an excellent pre-operative testosterone effect, maintained and complementing the standard-approach chest masculinization procedure to address asymmetries and leave the nipple attached and sensate.  Photos are from approximately 1 month post-op. If you are in the process of "gender affirmation" and... Read More

Surgeon: Paul Steinwald

Before and After (2 weeks)

Case: 3 of 50

Case #11202

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This 33 year-old patient traveled from the U.K. to see Dr. Steinwald. This patient desired Top Surgery with the nipple attached; underwent inverted T- top surgery. 378 grams of breast tissue were removed from the right side and 394 from the left. He did have some bleeding on the right side approximately 10 days post-op requiring surgical attention,... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (3 mo)

Case: 4 of 50

Case #673

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Surgeon: Paul Steinwald

BEFORE / AFTER

Case: 5 of 50

Case #559

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33 year-old transgender male with a 42DD bra size chest, already on testosterone. Underwent chest masculinization as a single-stage procedure (with adjuvant axillary liposuction), which resulted in excellent flattening/masculinization of the chest, and very acceptable, well-located scars (photographs are from approximately 6 months post-op). Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 mo)

Case: 6 of 50

Case #701

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\t52 year-old woman who had significant mammary hypertrophy and wished to be "gender-neutral"; essentially underwent a Denver breast-reduction, but also had "free-nipple grafting", as leaving them attached would likely be unsuccessful (shown here healing at approximately 1 month post-op). Read More

Surgeon: Paul Steinwald

Before / After (6 months)

Case: 7 of 50

Case #855

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22 year-old FTM who wished to have nipples removed outright; shown approximately 6 months post-op.

Surgeon: Paul Steinwald

BEFORE / AFTER (6 mo)

Case: 8 of 50

Case #658

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Surgeon: Paul Steinwald

Before and After (1 month)

Case: 9 of 50

Case #11209

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This is a 27 year old, 5'6," 155 pound male who traveled from out-of-state to undergo FTM top surgery/Chest Masculinization to help with his gender dysphoria. He was previously a D/DD cup size, and 567 grams of breast tissue was removed from his right breast, and 556 grams from the right. He is shown in his after photos at just 1 month post-op. His... Read More

Surgeon: Paul Steinwald

Before and After (1 week)

Case: 10 of 50

Case #11203

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This is a 22 year-old patient who came to us from Scandanavia who sought out nipple-sensation-preserving Top Surgery. Shown here just over one week post-op with mild left nipple congestion (nipple survived), but otherwise good early contouring/symmetry. If you are from outside of the United States but wish to have nipple-attached Top... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (4 mo)

Case: 11 of 50

Case #642

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Re-do FTM/"top surgery" (several months after attempted circumareolar/liposuction approach by a Chicagoland surgeon); photos are from approximately 4 months post-op (hypertrophic scars expected to fade with vit E therapy, but mostly time). Read More

Surgeon: Paul Steinwald

BEFORE (3 years) / AFTER (3 years)

Case: 12 of 50

Case #663

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\t24 year-old transgender male approximately 3 years following standard one-stage FTM procedure (starting as a 32D cup, with significant ptosis or drooping).

Surgeon: Paul Steinwald

BEFORE / AFTER (1 wk)

Case: 13 of 50

Case #671

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Trans-male in young 20's, treated with bipedicle (bridge) pedicle to attached nipple-areolar complexes; shown approximately 1 week post-op (after drain removal).

Surgeon: Paul Steinwald

BEFORE / AFTER (1 mo)

Case: 14 of 50

Case #672

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\t20 transgender male with small breast size, well-developed muscularity, shown with pre-op markings for a Wise (anchor)-pattern closure; results are shown at approximately 3 months post-op.

Surgeon: Paul Steinwald

BEFORE / AFTER

Case: 15 of 50

Case #506

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This 21 year-old patient was fairly early in the process of gender reassignment, having bound her chest for several months (and still favoring the “she” pronoun), but was committed to the idea of “top surgery” to masculinize her chest, which was otherwise in a moderate B-cup bra size range.  She came to me from Connecticut,... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER

Case: 16 of 50

Case #561

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Surgeon: Paul Steinwald

BEFORE / AFTER (6 mo)

Case: 17 of 50

Case #610

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Surgeon: Paul Steinwald

Before and After (1 week)

Case: 18 of 50

Case #11204

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This 23 year old patient traveled from out-of-state to have Dr. Steinwald perform his FTM gender affirming top surgery. After photos taken just before he returned home at a little over 1 week  post op, so there is some slight swelling and bruising still present.At Center for Cosmetic Surgery,  we have streamlined the surgical process... Read More

Surgeon: Paul Steinwald

Before / After (1 month)

Case: 19 of 50

Case #768

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Surgeon: Paul Steinwald

BEFORE / AFTER (1 week)

Case: 20 of 50

Case #697

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Surgeon: Paul Steinwald

Before and After (8 months)

Case: 21 of 50

Case #11205

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This is a 21 year-old with an A-cup who Came to see Dr. Steinwald for FTM Top Surgery/Chest Masculinization. He actually had some nipple healing (breakdown) issues on the right side; but is shown here with acceptable scarring at 8 months post-op.Dr. Steinwald is known nationally (and internationally) as one of the best gender affirming surgeons. Read More

Surgeon: Paul Steinwald

Before / After (3 months)

Case: 22 of 50

Case #856

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20 year-old trans-male from Denver seeking FTM chest masculinization, with very large and low-lying breast tissue, which is why a "free-nipple graft" was recommended to get the patient as flat as possible in a one-stage "Top Surgery", with good healing here noted at 3 months, and redness expected to fade further over... Read More

Surgeon: Paul Steinwald

Before / After (1 week)

Case: 23 of 50

Case #766

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29 year-old student who traveled from China for "FTM/"top surgery", who had a decreased chest size to a "small-C" range after being on T for approximately 1 year.  The patient was advised he was a good candidate for the "button-hole" technique, which was indeed performed as an outpatient, removing... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 week)

Case: 24 of 50

Case #649

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21 year-old trans-male seeking gender reassignment/top surgery; presented with a youthful/fuller B-cup bra size and aesthetics, which made him an excellent candidate for a single-stage FTM chest masculinization as an outpatient.This indeed was performed in just over two hours under lighter general anesthesia.  The patient went home, was... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 week)

Case: 25 of 50

Case #693

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Surgeon: Paul Steinwald

BEFORE / AFTER

Case: 26 of 50

Case #560

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This patient was a 28 year-old trans-male from out of town who otherwise would have been in a 36 C-cup bra size range, with minimal ptosis (drooping). I advised him that he was an excellent candidate for single-stage FTM "top surgery" chest masculinization. This was able to be completed as a single stage operation (with the removal of 400-450gm... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 week)

Case: 27 of 50

Case #565

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Surgeon: Paul Steinwald

Before / After (3 months)

Case: 28 of 50

Case #858

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Surgeon: Paul Steinwald

Before / After (1 week)

Case: 29 of 50

Case #767

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18 year-old trans-male with an A-cup range breast interested in FTM/top surgery, and treated with the "button-hole" (aka true double-incision) technique, leaving nipple-areolar complexes attached and delivered from underneath the skin via a separate incision; photos approximately 1 week post-op. Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 wk)

Case: 30 of 50

Case #651

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Surgeon: Paul Steinwald

BEFORE / AFTER (1 wk)

Case: 31 of 50

Case #702

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24 yo African-American patient from the Pacific Northwest with severe breast hypertrophy, drooping and asymmetry; underwent Denver "Top Surgery" and was able to have nipple remain attached (and somewhat sensate); photos are from approximately 10 days post-op. Read More

Surgeon: Paul Steinwald

Before and After (1 week)

Case: 32 of 50

Case #11201

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This 22 year-old trans* male came to us from the Midwest to have his gender affirming Top Surgery with Dr. Steinwald. He underwent an inverted T procedure, which leaves the nipple attached and sensate. 694 grams of tissue were removed from the right side and 751 grams from the left.After photos here are from just one week post-op, so swelling... Read More

Surgeon: Paul Steinwald

Before / After (1 week)

Case: 33 of 50

Case #643

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FTM chest masculinization in a younger (22 year old) thinner patient with a B cup bra size to start; photographs are from approximately 1 week post-op (just after drain removal).

Surgeon: Paul Steinwald

BEFORE / AFTER

Case: 34 of 50

Case #562

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Surgeon: Paul Steinwald

Before and After (1 week)

Case: 35 of 50

Case #11212

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This is a 26 year-old patient from TX who identifies as  "gender neutral" (who wanted an extreme reduction, but not to be left completely masculinized) and was treated with standard "inverted-T" Top Surgery, leaving the nipples attached and sensate. Swelling is, of course, still present here just after the drains were removed 1 week post-op,... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (3 mo)

Case: 36 of 50

Case #703

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28 year-old female who had actually undergone a breast reduction 8-10 years earlier (by similar techniques); wished to transition and therefore underwent a post-reduction FTM "Top Surgery" procedure.  Had some minor wound healing issues at the left nipple area, but ultimately had a very acceptable result (shown here at approximately... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER

Case: 37 of 50

Case #564

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Surgeon: Paul Steinwald

BEFORE / AFTER (1 week)

Case: 38 of 50

Case #611

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Fuller D-cup FTM patient with nipples left attached; photos shown approximately 1 week post-op (just after drain removal).

Surgeon: Paul Steinwald

BEFORE / AFTER(6 mo)

Case: 39 of 50

Case #609

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\tRE-DO FTM:  This 27 year-old trans-male had already had an attempt at chest masculinization elsewhere, basically via a breast reduction not taken far enough.  The patient also had superiorally displaced (too high) nipples, but fortunately they had been kept attached at the previous procedure, allowing a repeat approach without nipple... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 wk)

Case: 40 of 50

Case #700

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22 year-old female from Canada who wished to achieve a "Female-To-Neutral" (also called "Neutrois") effect, and therefore not transitioning to the male gender, in which case an "A-cup" is often the goal (photos here are from approximately 1 week post-op). Read More

Surgeon: Paul Steinwald

BEFORE / AFTER

Case: 41 of 50

Case #563

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Surgeon: Paul Steinwald

Before and After (6 months)

Case: 42 of 50

Case #11213

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Surgeon: Paul Steinwald

BEFORE / AFTER (1 mo)

Case: 43 of 50

Case #670

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Surgeon: Paul Steinwald

Before / After (4 months)

Case: 44 of 50

Case #689

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25 year-old trans-male from the midwest who wished to undergo FTM Top Surgery/chest masculinization, keeping the nipples attached. The patient weighed approximately 130 pounds and had approximately a B-cup chest size. Approximately 130gm was removed from the right side, and 150 gm from the slightly larger left side; photos are from approximately... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 year)

Case: 45 of 50

Case #566

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\t28 year-old hispanic transgender male from Chicago seeking "top surgery"/chest masculinization via the "keyhole technique" to help preserve nipple sensation.  Had been "identifying male" and binding for several years, on testosterone for one.  5'4", 145' at time of surgery.  Had 460 gm removed... Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 mo)

Case: 46 of 50

Case #698

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24 year-old patient who was interested in a "Button-Hole" version of FTM surgery (nipple remaining attached, but no vertical scar); shown here at approximately one month post-op with swelling/scarring yet for further resolve.

Surgeon: Paul Steinwald

Before and After (15 months)

Case: 47 of 50

Case #11211

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This 27 year-old trans patient, who identifies as non-binary, traveled from the East Coast to have their "Inverted-T" (nipple attached) Top Surgery performed with Dr. Steinwald. They are shown here before and 15 months after surgery with very nicely healed scars. Read More

Surgeon: Paul Steinwald

BEFORE / AFTER (1 mo)

Case: 48 of 50

Case #622

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\tThis case demonstrates the utility of this procedure to not just achieve chest masculinization, but also to address extreme asymmetry (in this 22 year-old transmale with essentially a left constricted breast deformity).

Surgeon: Paul Steinwald

BEFORE / AFTER (1 wk)

Case: 49 of 50

Case #699

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Surgeon: Paul Steinwald

Before / After (1 month)

Case: 50 of 50

Case #857

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Surgeon: Paul Steinwald

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Keep in mind that each patient is unique and your results may vary.

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Over the past decade-plus, many transgender males in the process of undergoing “gender affirmation” have contacted Dr. Paul Steinwald to inquire about chest masculinization (“top surgery”) in Denver, especially in light of the potentially disappointing results associated with nipple excision and grafting (somewhat misnamed the “double incision” technique). Dr. Steinwald is now able to achieve a masculine-appearing chest in most cases in one stage. A pioneer in the field of optimal chest masculinization while maintaining a degree of nipple sensation, Dr. Steinwald has delivered several formal lectures on the topic, and has built an international patient base, having performed hundreds of FTM chest masculinizations for patients from near and far.

What is involved in top surgery?

This is basically an extended or “extreme” version of a standard breast reduction, applying established principles of that procedure. This usually results in an anchor-shaped scar (mostly along the fold beneath the breast) and has a reasonably high probability of retaining at least some nipple sensation.

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Am I a good candidate for top surgery?

There are risks above and beyond a standard breast reduction, especially in patients with D cup breasts or larger, or those who smoke. Patients are carefully screened preoperatively for the above reasons, but mostly because this is a (relatively) irreversible procedure that will have a significant impact not just on their life, but their actual identity. In appropriate candidates with realistic expectations, however, the results can be dramatic (as with all plastic surgery!), and most patients express extreme satisfaction with the results. A consultation with Dr. Steinwald in Denver will determine whether top surgery will work for you.

Will my insurance cover this procedure?

Because this procedure is being performed to dramatically change one’s appearance (and not for chronic symptoms associated with mammary hypertrophy), and because Dr. Steinwald is one of the few surgeons in the country applying specialized techniques and taking on added risks to perform this surgery, we do not accept insurance for this procedure. If you are interested in more detailed information on this innovative and effective procedure that Dr. Steinwald performs for Denver-area FTM patients, we invite you to also visit www.topftmsurgery.com.

Where is the surgery performed?

Your surgeon will perform your gender reassignment procedure at our Apex Surgical Facility in Denver on an outpatient basis.

What kind of anesthesia is used?

Most cases require general anesthesia from our board-certified anesthesiologists. Top surgery generally takes 2 to 3 hours depending on the amount of tissue to be removed and other factors.

What is recovery like?

Recovery following chest masculinization is similar to standard breast reduction surgery for women. Patients can either have their surgery as an outpatient procedure or they may choose overnight nursing care. Patients usually have small surgical drains after their procedures, which are usually removed within 7 to 10 days at a follow-up appointment. Patients may be asked to wear a special compression garment for several weeks to provide support and help with swelling.

Most patients are pleasantly surprised at how little discomfort they experience (usually a heaviness or general soreness). Most discomfort is in the underarm area, as the central breast skin is relatively numb for several months. Patients are usually sent home on a moderate strength pain medication and 5-day course of oral antibiotics.

Patients are encouraged to rest during the days just after surgery, returning slowly to light activity in the first week. Most return to work and other activities in about 7 to 10 days. After about 2 weeks, light exercise such as walking is encouraged, and patients can return to full exercise levels after about 4 to 6 weeks.

Meet Our Surgeons

Board-certified plastic surgeons Dr. Steven Vath, Dr. Andrew Wolfe, and Dr. Paul Steinwald lead our patient-centered practice with warmth, honesty, and respect. Their combined expertise and credentials have placed us among Colorado's premier aesthetic centers.

Meet Dr. Wolfe

Meet Dr. Vath

Meet Dr. Steinwald

The Center for Cosmetic Surgery has 2 offices conveniently located in the Denver metropolitan area. One is just outside Denver in lovely Golden, Colorado, immediately off 6th Avenue West, and the other is downtown in Cherry Creek, Denver. Please schedule a personal consultation to learn what top surgery can do for you. Simply call (303) 278-2600 or request your consultation online.

For information about preparing for your surgery and postoperative guidelines, visit our patient resources page.

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