The peri-areolar, or “keyhole”, technique consists of breast tissue removal through a small incision around the nipple. This technique carries the advantage of significantly reduced scarring. However, a relatively small number of patients are considered good candidates for this procedure. The suitable candidate for this type of mastectomy is typically the young, slim patient with a small amount of breast tissue, no excess skin, and a nipple position that does not require modification. Your surgeon at ICTC will perform a physical examination and work with you to choose the best mastectomy technique for your anatomy and unique needs.

Some patients have inquired about the possibility of using a “pedicled” technique to preserve sensation to the nipple; however, this technique is often unsuccessful in maintaining nipple sensation. We generally do not recommend this technique for transmen because it necessitates leaving a fair amount of breast tissue and does not result in an optimal male chest appearance.

Patients who have a very large amount of breast tissue or chest wall fat tissue may benefit from combining lateral chest wall liposuction with their mastectomy. The decision as to whether or not this is needed will be made at the time of the consultation, or as determined by pre-operative photos in the case of our out-of-town patients.

A special dressing will stay on the nipple graft for one week, but drainage tubes are no longer needed for this procedure. We have developed meticulous quilting techniques designed to reattach the skin flaps to the chest wall, thus eliminating the need for uncomfortable drain tubes. Postoperative discomfort is typically mild to moderate and is controlled by pain medication. Arm use should be restricted during the first week. This includes driving, lifting, or reaching. At one week normal daily activities may be resumed; vigorous exercise and weight-lifting can be resumed at 6-8 weeks post-surgery. Scars are permanent, but they should fade gradually over the first year after surgery; do not tan incisions during this time period.  Your surgeon can also provide you with instructions on techniques to speed the scar healing process.

The staff at ICTC understands that each patient has his own unique needs and expectations, which is why we take an individualized, patient-centered approach to gender transition services.   During the preoperative consultation, your surgeon will take the time to discuss and understand your goals for gender transition.  Additionally, he’ll thoroughly explain each procedure and answer any questions you might have.  We want you to feel comfortable and happy with your decision to pursue top surgery with us, so please do not hesitate to let us know how we can be of assistance.

At the International Center for Transgender Care, we understand that top surgery is a vital component of the female to male transition process.  Because this procedure is so important, it is paramount to choose a surgeon with specialized knowledge and skill. Our board-certified surgeons have more than 20 years of experience treating transgender patients. We are proud to offer all of our services in a respectful, welcoming environment at our world-class surgical center in Dallas, Texas.  We look forward to assisting you in achieving the very best possible results for your mastectomy procedure. Contact us today to schedule a consultation at (972) 543-2477.