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FTM Chest Masculinization

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.

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.

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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