FTM Mastectomy

One of the first things trans men start their gender affirming surgery with is mastectomy. It helps them begin to acquire a more masculine torso and chest. No matter the stage of your own transition, it is never too late or too early to have mastectomy performed.

This procedure involves removing unwanted breast tissue and contouring your chest, so it is more masculine and attractive. There are mainly three types of mastectomy depending on the amount of breast tissue, the skin elasticity, and the incisions made: double incision top surgery with nipple grafts, periareolar, and keyhole technique.

Here is what you need to know about mastectomy before you try it

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Most surgeons will require you to present your medical history in advance of your appointment so they can determine special requirements and appoint the necessary lab tests.

Risks and Safety

Mastectomy is widely considered to be a safe procedure with very rare instances of postoperative complications (most of which you can avoid with the right certified surgeon). Some of them include:

  • Bruising and swelling
  • Poor reaction to the anesthesia
  • Infection
  • Blood clots
  • Seroma (blood plasma, i.e., fluid buildup)
  • Nausea and vomiting
  • mastect tissue atrophy (shrinking and thinning of the skin).
  • Diminished nipple sensation


Doing weight-training exercises to gain more muscle mass in the weeks and months prior to surgery is a good way to get better results from your mastectomy. Your surgeon will make a prep plan for you that involves adjusting your medication intake.

Procedure Steps

You can have one of three main procedures:

  • Double incision with free nipple grafts — this is one of the most widely used methods as it is perfect for patients with medium to large breasts. Two horizontal incisions at the top and bottom of your pectoral muscle will help your surgeon to pull back the skin and remove the breast tissue. The nipples are also removed, re-shaped and/or resized, and placed on the chest. This method leads to less sensation in the nipple/areola complex because the nipple stalk and nerve get severed during surgery.
  • Periareolar Top Surgery — also known as circumareolar or peri, this method is usually recommended to patients with smaller breasts, cups A and B, and good skin elasticity. Two concentric circle incisions are made, one around the areola and a larger one. The nipple stalk is typically left intact, but there is still the possibility of decreased nipple sensation in the first days after surgery.
  • Keyhole Top Surgery — ideal for small-chested patients, the keyhole involves a small incision at the bottom of the areola with breast tissue extracted through liposuction using this incision. The nipple stalk isn’t damaged, but the nipple itself can be resized if desired.


During the first week of your recovery, you should refrain from using your arms to drive, reach, and lift. You can resume weight-lifting and other vigorous activities after two months post-surgery. Your scars will be permanent, but they will fade with time, especially in the first year after mastectomy. It is important that you do not tan the incisions during that year!


Ultimately, the results will depend on your anatomy and the mastectomy technique used for the surgery. Some methods would require revision surgery or follow-up liposuction to ensure a flat, well-contoured masculine chest. The main result, however, will be that you are a step closer to getting a naturally-looking male chest, which will not only boost your self-esteem but also the quality of your life.


This transgender surgery cost can be anywhere between $3,000 and $10,000. It depends on surgeon and facility fees, the method used, anesthesia, and other medication.

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