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You are here: Home / LGBTQ+ / Top Surgery: Your Guide to Transgender and Nonbinary Chest Reconstruction
Top Surgery: Your Guide to Transgender and Nonbinary Chest Reconstruction

Top Surgery: Your Guide to Transgender and Nonbinary Chest Reconstruction

March 2, 2021 By Cade Hildreth Leave a Comment

For some of the 1.4 million American adults who identify as transgender, top surgery is a way of obtaining the form that matches their gender identity, rather than the gender they were assigned at birth.

You may have heard of top surgery referred to as transgender chest reconstruction or gender-affirming surgery. Regardless of the name, the procedure follows a similar approach.

What is Top Surgery?

Top surgery is a way for transgender and nonbinary patients to reshape their chests, so that what they feel on the inside can be visible on the outside. It can be a way to quiet gender dysphoria, which some transgender and nonbinary people feel. Gender dysphoria is a discomfort experienced when one’s body doesn’t wholly align the gender with which they identify.

Of course, not all trans people feel drawn to undergo surgery—it’s a personal decision, not one that is required.

For transgender men and nonbinary patients, top surgery can be an effective way to reconstruct the chest to appear flatter and more masculine. For nonbinary people, the surgeon may take steps to make the chest appear more gender neutral.

Similarly, transgender women can change the look of their chests too, and many do. However, most will see natural curves form when they start taking estrogen.

Types of Top Surgery

There are multiple ways for transgender men and nonbinary folks to alter the look of their chests. Most commonly, these procedures involve a mastectomy, during which the breast tissue is removed. The surgeon may also re-contour the area so that the pecs are more pronounced.

There are a few different surgical methods that doctors commonly use.

A double incision approach is often deployed for trans men with larger chests. This procedure can take between three and four hours and creates visible scars across the chest. Of course, these scars fade dramatically with time. Additionally, if the patient’s pec muscles become well-developed in the months or years post-surgery, these scars will tend to “fit” naturally into the contour of the pec muscles.

With a double incision approach, the surgeon removes the breast tissue and excess skin, as well as excises the nipples, resizes them, and places them back on the chest in the desired position. The end result is a look that matches a more “male” or “masculine” physique. Liposuction may also be performed.

The main benefit of this surgery is that it provides the freedom to shape and sculpt the chest as the patient desires.

A periareolar top surgery results in less scarring, but it only works for trans men with smaller chests. It retains more nipple sensation than the double incision procedure and the only visible scars are directly around the nipples, which makes them discreet.

With this procedure, the surgeon removes a “ring” of skin around the nipples to flatten and “pull in” excess skin. The procedure also includes removal of the breast tissue (a mastectomy), and potentially, liposuction to flatten out the contour of the chest.

Keyhole surgery works for a small number of trans men who have very small chests and little excess skin. It requires the shortest surgery— 90 minutes to three hours—and results in the least amount of scarring. The only visible scar is a partial scar around each nipple, which is barely visible in the years after surgery.

Preparing for Top Surgery

Your doctor will tell you how to prepare for top surgery. In most cases, prep will be similar to that of any other procedure. For example, you may not be able to eat or drink for a certain amount of time before you go under.

You must wear loose-fitting clothing to your top surgery so that you can put on the same comfortable clothes afterward. Many top surgeries are outpatient procedures, meaning you’ll go home once you’re finished. So, dress thoughtfully on the day.

Trans men may be asked to take a pregnancy test before surgery, which can trigger feelings of gender dysphoria. Not all doctors understand or are adept at dealing with this, so try and have a conversation before the procedure to understand what will be expected of you.

With the current COVID pandemic, you may also be asked to take a COVID test in the days prior to your procedure.

Finally, you should know the top surgery costs you’ll have to pay. Most procedures cost between $7,000 and $10,000, with surgeon and anesthetic fees included. Travel expenses might push your costs over that benchmark, though.

Currently, only a small number of top surgeons accept health insurance.

A Better Understanding of “What Is Top Surgery”

Perhaps this information has galvanized your desire to have top surgery. Perhaps it has not. Either way, the decision is powerfully and uniquely yours—and our community is behind you every step of the way.

Want to learn more from Cade, who is LGBTQ and nonbinary?

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Filed Under: LGBTQ+ Tagged With: nonbinary, transgender

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“As an LGBTQ+ entrepreneur, real estate investor, former USA Rugby Player, and fitness fanatic, I’ll teach you what your parents and teachers should’ve taught you, but didn’t know themselves.” -Cade Hildreth

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Or, listen to Cade’s articles on the go as a Podcast.

Because it’s the New Year, let’s talk about ch Because it’s the New Year, let’s talk about change...

For a long time, I’ve thought about top surgery. I remember when I was 6 or 7 years old when I wanted to run around outside on a hot, sunny day with my shirt off…and I first saw my parents… hesitate. Ughh. 

It wasn’t their fault but I still remember that heart wrenching feeling. To their credit, they ultimately said, “Ok, go do it!” While I did “do it”, I remember the feeling of shame that crept in.

Over the years, being in affirming sporting/rugby circles helped suppress the urge to get top surgery, but it never quite “stayed down.”

So last summer I got keyhole #topsurgery. I’ll talk about recovery in another post because it was definitely weird to not strength train for months.

But in THIS post, I want to share two things:

1. I am SO grateful to my wife Erin for being the supportive and growth oriented partner that she is. 🥰🙏❤️ 

She is now following her call to get a divinity degree and she’s already working in ministry as a Pastor in Training at an incredible, inclusive Presbyterian church here in Virginia. I am grateful to her for supporting me as I become more and more of who I am—and I’m enjoying watching her do the same! Love you, babe!

2. Second, I’m grateful to get to share who I am with my family. This summer we took a trip to Madden’s resort in MN to celebrate my parent’s 50th wedding anniversary. (It was actually their 52nd, because we had to postpone it twice due to Covid.)

I was nervous to be in the pools and lakes around them, but I could feel it was my only choice because I knew I wanted them to “know me”. And, how could that happen if I “hid me”?

Ultimately, I have to tell you…it was freeing to be me, as I am, who I am. 

I had the BEST time splashing around and biking and goofing around with my wife, niece, nephew, & sister. 🌊🏖🐟

So, I suppose, this is a gratitude post to thank those who have supported me over the years as I become more and more of who I am. 

Top of that list is my wife, Erin, but there are countless others. ❤️

If you’re reading this, thank YOU for being one of those people in my life too. I am deeply grateful. 🥹
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#lgbtqfamily #nonbinary
How to set a boundary? 🤔 . . . . #lgbtqia #lgb How to set a boundary? 🤔 
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#lgbtqia #lgbtqcommunity #emotionalhealth
What do you do if you’re telling a past story ab What do you do if you’re telling a past story about someone who has transitioned? 🤔 Share a 💯 if you agree ➡️🏳️‍⚧️🏳️‍🌈
7 things I got clarity on in 2022: 1. Good and b 7 things I got clarity on in 2022: 

1. Good and bad are labels. All things are experiences. 

2. Maturity is taking full responsibility for oneself. 

3. Having a loving, conscious relationship with myself is a core value. 

4. Emotions do not mean that anything has to be done. 

5. When I am in congruence with what I want, I have it. 

6. I have permission from myself to stop doing anything that doesn’t lead to my peace and empowerment. 

7. Stepping toward emotions and being able to feel them is a superpower. It determines the quality of my life. 

(Are there any above that you’d like me to further explain?)
 
Most importantly, which # above resonates with you? ⬆️

Happy New Year, y’all! 🎊🥳
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#lgbtqcommunity #lgbtqiaplus #lgbtsupport #nonbinary #trans #selfgrowth
Interview with Jenny Nguyen, Founder of the Sports Interview with Jenny Nguyen, Founder of the Sports Bra—The World's 1st Bar to Only Play Women's Sports - shorturl.at/doGHZ

I'm excited to introduce you to today's #podcast guest, Jenny Nguyen, who is a professional chef, elite athlete, and entrepreneur.

I invited Jenny onto the podcast because she has done something extraordinary that is long overdue: She has opened up a sports bar that exclusively plays women's sports!

Despite extensive research, Jenny hasn't found another sports bar worldwide that ONLY plays women’s sports.

Given that it's nearly 2023, this is mind-blowing. As a lifelong athlete, I find her vision compelling and inspiring.

Aptly called the "The Sports Bra", the venue is putting Jenny's culinary skills on display alongside women's sports worldwide.

The Sports Bar has taken its mission a even further by partnering with and elevating other local, women-owned businesses.

Specifically, it:

1. Sources its grass-fed beef from @CarmanRanch, an ranch run by Cory Carman, a third gen rancher out of Wallowa, Oregon).

2. Sources its alcohol from Freeland Spirits, an all-women owned and operated distillery out of NW Portland.

3. Has furniture built by @girlsbuild_org, a non-profit organization headed by @ktmhughes in Portland, OR, that teaches carpentry and construction skills to young girls as a path to empowerment.

Since opening the Sports Bra this April, people have come from ALL over the U.S. and the world to experience it—including many professional female athletes.

To learn more about Jenny as she makes history, features women's sports, and elevates women-run businesses, listen to the episode here:

shorturl.at/doGHZ

Or, you can check out the Sports Bra at:

@thesportsbrapdx
TheSportsBraPDX.com/

Have you heard of the Sports Bra or been out to experience it in person?

#lgbtqiaplus #womenownedbusiness #lgbgtqia #lgbtqcommunity #womenssports #womeninsport
Over this recent holiday stretch, we… - enjoye Over this recent holiday stretch, we… 

- enjoyed some quiet time at home
- got a sauna delivered (but not yet installed)
- decorated for the holidays
- baked a bunch
- visited our favorite farm
- did some sight seeing
- and perhaps, most importantly, survived the cold snap along with our feather friends (who lived in the garage for a few days so we could heat them with a space heater) 🥶🐔

How have the holidays treated you…and did you get hit by the winter storms? ❤️🎁☃️❄️
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