The Low Down on Top Surgery

One of the biggest milestones in a transman’s life is chest masculinization surgery, also known as “top surgery”.

Not all trans guys need this surgery. Some are fortunate enough to be born without the extra flesh up top, but most of us aren’t that lucky. Some trans guys might elect to forego top surgery. This doesn’t make them any less of a transman. It’s a personal choice that people will make for different reasons.

For those of us who do make the decision to forge ahead, there are so many different things to consider. I’m probably going to end up having to revise this post several times because I’ll certainly leave some things out in the process.

But here goes…


Prior to undergoing surgery there are a few things you might want to do.

  • Depending things such as your age, where you live, and your insurance, you may need to get a letter of recommendation from a mental health professional who is informed regarding transgender health. They will need to confirm that you meet the WPATH standards of care criteria.
  • Get as fit as possible. This isn’t just for aesthetics (though it helps). Top surgery is a major surgery. The healthier you are, the faster you’ll heal, and the better your outcome will be.
  • Build up your pecs. You don’t necessarily need a gym membership to do this. Yoga and calisthenics can both help increase pectoral mass.
  • If you smoke, stop. Seriously. Stop. Not only does it take much longer for you to heal when you’re a smoker, but, if you’re on HRT, it will greatly increase your risk of heart disease, among so many other things. Take it from someone who smoked for 37 years – you’ll be doing yourself a favor.
  • You don’t need to be on T to get top surgery. I, myself, was on T and I know many others who were on T prior as well. If you’re using T, you may need to be tested to ensure your hormone levels are appropriate.
  • Invest in some comfortable compression shirts. Not binders (those days will be gone, my friend). Look for athletic compression shirts such as those made by UnderArmour, Adidas, or Nike. Get a few of them. You’ll want to use them for at least a few weeks after your surgery.

Top Surgery Methods

There are several different methods that can be used for a top surgery. The method will be chosen based on a few different factors such as size and skin elasticity. Different methods lead to different types and amount of scarring.

Below is a really good graphic that illustrates the different surgery types and potential outcomes.

displays different types of surgery: keyhole, double incision, periareolar, t-anchor

Also illustrates different nipple placements, scar shapes, and miscellaneous outcomes to be considered.
Infographic crated by Freyquinn at Tumblr

Surgery Gallery

Published by Jonah Sheridan Fenn

Nerd herder, word wrangler, working on the next chapter...

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