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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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Cade Hildreth“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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It’s official...I’m never going to the gym aga It’s official...I’m never going to the gym again...LOL!!! 🤯🏳️‍🌈🏳️‍⚧️
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⚠️ One of the most important TRUTHS I’ve lea ⚠️ One of the most important TRUTHS I’ve learned was this:When you give yourself permission to be yourself, you give other people permission to be themselves.If someone is upset by you being fully yourself — whether that is gay or straight or gender expansive or in a relationship with someone your family disapproves of or anything else — it is sad for them, because what they are saying to you is, “I don’t believe I have permission to do what you are capable of doing.”When you realize this, the only reaction you can have toward them is compassion.Share a “💯” below if you’ve experienced this (or needed this reminder today)...👇🏽
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⚠️ UPDATE: Arkansas' Republican governor on Mo ⚠️ UPDATE: Arkansas' Republican governor on Monday vetoed an anti-transgender health care bill that would've prohibited physicians in the state from providing gender-affirming "procedures" for trans people under age 18.Gov. Asa Hutchinson told reporters that he killed HB 1570 because the bill "would be and is a vast government overreach" and because it would've created "new standards of legislative interference with physicians and parents as they deal with some of the most complex and sensitive matters involving young people."Had the governor approved it, Arkansas would've been the first state in the nation to outlaw gender-affirming health care for trans youth, according to the American Civil Liberties Union.The governor also predicted during his remarks that the state's Republican-controlled General Assembly "will likely override" his veto, noting it takes only a simple majority to do so.Leave a “👏🏽” to show support for Governor Hutchinson or share your thoughts below. 🏳️‍🌈🏳️‍⚧️Source: CNN
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✅ #WorkoutTip: If you’re looking to get a more ✅ #WorkoutTip: If you’re looking to get a more developed and defined chest, a quick bar change from traditional barbell to Swiss Bar can help you hit new muscle fibers and supercharge your gains! 🔥💪🏽Why is this? 🤔1) As you can see, it switches your grip from horizontal (your grip on a straight barbell) to parallel. This rotates your entire arm, including the position of your elbow, shoulder, and all of the attached muscle groups.2) It lets you choose from a wide variety of widths. In this example, I choose the second from the middle grip, but you can work from extremely narrow to really wide.3) The balance/loading of the Swiss Bar feels extremely different than a straight barbell, so your accessory muscles get recruited to work extra hard throughout the path of the lift.Of course, if you add a pause at the bottom of the lift as the Swiss bar touches your chest, it can also increase the difficulty of the lift and introduce a new stimulus.Have you tried a Swiss Bar before? Let me know below... 👇🏽
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Are we connected yet on TikTok? If not, let’s make it happen, so I can share in your world too. 😁
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Looking to add lean muscle mass while dropping bod Looking to add lean muscle mass while dropping body fat? 💪🏽🔥If so, you’re simply not going to beat the BIG compound lifts like the deadlift. 🔥🔥But, since the traditional deadlift puts a fair amount of strain on your lower and middle back, what should you do if you’re training multiple times per week? 🤔The answer? 👀1. Mix Up the Stimulus — The Hex Deadlift shown here is one of my favorite options, because it allows a more upright torso. This both lets you lift more weight and displaces some of the load across your hips and lower body.However, if you can’t access a Hex Deadlift bar at your gym, then you can use a normal barbell to do a...... Sumo Deadlift (wider stance)
... Deficit Deadlift (deeper range of motion)
... Or other variation of your choosing2. Vary Your Rep Range - In this video, I demo a higher rep range of 20 reps. In general, higher reps are associated with greater hypertrophy (muscle size growth).Higher reps will humble you because you’ll have to use less weight, but the muscle gains you experience will make it worth it!3. Amp Up Recovery - The two most powerful recovery tools you have at your disposal are food and sleep. So, how to best use them to your advantage?Consume whey protein and rapidly digestible carbs immediately post workout—and if you went heavy in your workout, then add a casein protein shake before bed too.Then, eat a full meal within approximately an hour of finishing your workout. Focus on consuming protein and carbs, while going lighter on fat.For sleep, nighttime is your anabolic period (i.e., when natural muscle recovery and growth occurs).So, get to bed either at or before your usual bedtime, keep the room ultra dark, and keep it cold enough that you need to be under the covers or you’ll end up shivering.I wear an @ouraring sleep ring and can confirm from personal experience that timing, temp, and darkness all have a huge effect on your sleep quality!Which tip are you going to try first? Let me know below... 👇🏽
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To all my trans, nonbinary, and gender-expansive s To all my trans, nonbinary, and gender-expansive siblings:💙 You are valid.
🤍 You are worthy.
💗 You are loved.Thank you for becoming who you were born to be, because you inspires others to be their true selves too.Always remember: Courage is contagious.Happy #TransDayOfVisibility—
From @qchristianorg:Being visible is important for the movement. For the individual, being visible can mean being one of the 20% of trans people who experience homelessness or the 25% who have been fired because of their gender identity.It could make you one of the 44 trans people who were killed last year for being trans.Being visible means risking rejection and abandonment, facing erasure in the name of religious freedom, being ridiculed, mocked, bullied and misgendered intentionally.It can mean being one of the 41% who, because of all this, attempt to end their lives.
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