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Mastectomy (Female to Male Top Surgery)

Female to Male - Thailand Cosmetic & Plastic Surgery

FTM Top Surgery in Bangkok, Thailand

What is the Mastectomy Procedure?

Mastectomy surgery is a common breast cancer surgery performed by doctors worldwide. However, FTM Top Surgery can also be used on transgender patients.

FTM Surgery is when breast tissue is removed. It is most commonly done to prevent the spread or progression of cancer cells. Some patients that test positive for the breast cancer gene undergo total mastectomy or breast removal as a preventative measure.

For transgender men, a mastectomy is a popular top surgery in the transformative journey. Through mastectomy surgery, transgender patients remove breast tissue and excess skin.

A highly trained plastic surgeon is required for female to male mastectomy surgery. This is because the procedure is not just to remove the breasts but also to create a fully sensate flat chest that has minimal to no scarring.

A health care provider is also required to ensure the nipples and areolae are sufficiently sized, shaped, and spaced. In some instances, they are already balanced after initial breast mass and skin removal. In other cases though, they must be reduced or repositioned to better approximate a more masculine chest.


What is the Mastectomy Procedure?

Mastectomy surgery is when the tissue from one or both breasts is surgically removed. It is most commonly done to prevent the spread or progression of breast cancer. Some patients that test positive for the breast cancer gene undergo mastectomy as a preventative measure.

For transgender men, a mastectomy is a popular top surgery in the transformative journey. Through mastectomy surgery, transgender patients remove breast tissue and excess skin.

A highly trained plastic surgeon is required for the female to male mastectomy surgery. This is because the procedure is not just to remove the breasts but also to create a fully sensate flat chest that has minimal to no scarring.

A trained surgeon is also required to ensure the nipples and areolae are sufficiently sized, shaped, and spaced. In some instances, they are already balanced after initial breast mass and skin removal. In other cases though, they must be reduced or repositioned to better approximate a more masculine chest.

Mastectomy/Top Surgery Techniques

There are different types of techniques used for mastectomy. A consultation with the patient alongside a physical examination will help determine which technique would be most beneficial.
  • Periareolar Technique (U-shaped scar technique) –This procedure is best utilized on small breasts that exhibit good skin elasticity. The surgeon creates an incision shaped like a “U”. Breast mass is removed with minimal scarring.
  • Concentric Technique (O-shaped technique) – This is the technique used for medium-sized breasts (usually B-cups) that have good elasticity. In this technique, the breast mass is removed through a single O-shaped incision. The skin is carefully gathered and a minimal scar is left just around the areola.
  • Double Incision Mastectomy with Nipple Graft – This is the procedure surgeons use for larger breasts that will require a full mastectomy alongside the removal of the nipples and re-grafting of the nipples in the right place. While this technique may impact nipple sensitivity it is, unfortunately, the only procedure for those with larger breasts.
The plastic surgeon will need to do a thorough physical examination of each patient to determine which surgery option to utilize. While trying to minimize scarring, sometimes they will have no choice on surgery techniques due to the physical limitations of the patients (ex: large breast size, nipple placement, etc).

It is important to note that alongside breast size, skin elasticity also plays an important role in determining which procedure a surgeon will use and the overall success of the operation.

Is mastectomy performed under anesthesia?

Regardless of the surgical technique the surgeon chooses, all mastectomy operations are done under general anesthesia and usually take approximately 2-3 hours. The doctor will explain further if there are special considerations per patient.

When is mastectomy needed?

While mastectomy top surgery is not necessarily a requirement for all transmen, many opt for it because they are tired of binding or they find binding painful. Other patients opt for mastectomy because they just don’t think that binding is working for them. As this is a major factor in determining gender, mastectomy tends to rank highly on the surgery priority list for female to male patients.

What can I do to minimize scarring?

No matter which mastectomy procedure is done, post-operative care will be required to help reduce scarring. There are several ways patients can help reduce the chances of scarring after the operation including avoiding exposing the area to sunlight for several months to minimize hyperpigmentation and stunted healing.


Is a hospital stay required for mastectomy?

Mastectomy requires a hospital stay for observation and post-operative medical care. The length depends on the patient, their procedure, their physical health, and other factors.

When can I do my normal activities again after mastectomy?

Activity after mastectomy should be limited. Light activity may be tolerated but anything taxing or strenuous should be avoided for a minimum of 4-6 weeks after the surgery if healing is proceeding well and only with your doctor's consent.

Will long-term follow-up appointments be required?

Mastectomy is generally a common procedure and results are often very good. There are rarely any complications and hardly any that would require long-term medical care. While a few general follow-ups are needed right after the procedure only a few progress checks will be required after that.

Surgeons are always available for any questions and concerns patients may have about their mastectomies.

Who is a good candidate for female to male mastectomy?

As mastectomy is a relatively simple procedure and the requirements to be a good candidate are not that extensive.

  • Transman
  • Physically healthy
  • Expectations managed with the surgeon
  • Must be over 18 years of age

Preparation for Top Surgery or Mastectomy

Before a patient undergoes mastectomy surgery, they should undergo the following preparations:
  • A consultation with the surgeon to ensure the patient is a good mastectomy surgery candidate.
  • Patients must also have a full physical examination to rule out any potential health conditions that may impact the surgery.
  • No smoking for a minimum of 2 weeks before surgery
  • All blood-thinning medications like Aspirin, Ibuprofen, hormones, and some supplements must be stopped 2 weeks before the surgery.

How is the mastectomy done?

Mastectomy surgery is routine and completed in approximately 4 steps.
  • Patient to be put under general anesthesia.
  • Surgeon opens the breast with an incision in the pre-determined area to remove breast tissue and effectively flatten the chest.
  • Excess skin is then resected and nipples and areola are adjusted and manipulated as needed to mimic a male chest.
  • Skin is sutured and closed.

Post-surgery care for mastectomy

Postoperative care for a mastectomy surgery begins at the hospital and continues at home. Patients should expect the following requirements for a full recovery.

  • A 2-5 night stay in the hospital is required after the procedure depending on the patient.
  • Patients must keep the wound clean and dry.
  • Pain medication may be used for pain management as needed.
  • Patients must arrange and keep follow-up appointments 7 days after surgery and 14 days after surgery.
  • The stitches are usually removed 7 days after the mastectomy.
  • Patients must use binding and compression implements to prevent swelling and help adjust the chest shape. These must be used for a minimum of 3 months up to 6 months for optimal results.

Risks associated with female to male mastectomy

The risks are minimal but some complications to potentially look out for include: 
  • Bleeding
  • Infection
  • Necrosis of the nipples. This is very rare. Sometimes compromised blood supply to the nipples may contribute to nipple necrosis or nipple grafts don’t take.
  • Loss of sensation in the nipples and areolar
  • Nipple numbness
  • Poor or incomplete healing
  •   Pain (managed with painkillers)
  • Scar healing. Typically scars around the areola heal quickly and completely. Any scars from incisions below the breast may take longer to heal and fade. In very rare cases where some residual tissue remains a deformity can occur and will need to be removed.
  • Risks associated with anesthesia
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Recovery time for mastectomy surgery?

Mastectomy recovery depends on the technique used and the physical health and overall wellness of the patient. . In some cases, the doctor may require the patient to stay in the recovery room for at least two nights.

Most may return to work 2 weeks after the surgery. There will be some discomfort but the swelling should resolve within approximately 3 weeks.

Full healing usually happens between 4 months and 6 months post-procedure. Patients should approach physical activities with caution and consult with their doctor before returning to strenuous exercises or sports.

Why choose Thailand as your plastic surgery destination?

On the whole, Thailand is an open and accepting society for transgender people and this has allowed hospitals for gender transformation to flourish and grow. Facilities in Thailand provide first-class treatments, cutting-edge technology, and world-class surgeons performing hundreds of mastectomy surgeries per year.

Plus, Thailand has another big advantage as a highly competitive destination for Mastectomy Surgeries since it is also less expensive compared to other destinations. You still get the best treatments and facilities, but you pay less.