As a gender-affirming surgery for trans males, top surgery is an important part of the process for many. Dr. Joan Grace Valina, an excellent plastic surgeon specializing in minimally-invasive procedures, understands the importance of this surgery for a female to male transitions and understands the many benefits it provides for transitioning males. But what is it, how does it help with gender affirmation, and what are the potential complications of the surgery? Dr. Joan Grace Valina explains this often-misunderstood surgery.

Dr. Grace Valina Explains Top Surgery

Top Surgery

Top surgery is a common part of female to male transition, which removes excess breast tissue, resizes and repositions the areola and nipple, and otherwise reshapes and contours the chest cavity to create a more masculine appearance. It provides affirmation by making it easier for the patient’s exterior appearance to match their interior body image while providing the trans male with more confidence in their appearance and acceptance by society at large. In many cases, it may be the only surgery that a trans male chooses to have performed, while in other cases, it may be the first part of a series of surgeries leading to gender reassignment Dr. Joan Grace Valina explains.

Types Of Top Surgery To Consider

There are several types of top surgeries that are performed, generally sorted by beginning breast size:

  • Small chest size (A cup) combined with good skin elasticity can use keyhole or peri-areolar techniques.
  • Moderate chest size (B cup) combined with good skin elasticity can use buttonhole, peri-areolar, inverted-T or double-incision techniques.
  • Larger chest sizes with good skin elasticity or moderate chest sizes with poor elasticity can use buttonhole, inverted-T, or double-incision techniques.
  • Very large chest sizes can use buttonhole or double-incision techniques.

What To Expect From Top Surgery

Prior to the surgery, you’ll meet with your surgeon to discuss what your options are and what you want to get out of the surgery, including chest size, nipple sensation, and how much excess skin is in place. Dr. Joan Grace Valina notes that top surgery typically takes about two to four hours to complete and is usually done as day surgery. Though general/common anesthesia is used in the surgery, many patients are not catheterized for it, which can reduce urinary tract infections after the surgery.

Potential Complications Of Top Surgery

Potential Complications

Serious risks are uncommon in top surgery, but you may experience bleeding, bruising, poor healing of the incision, infection, loss of the nipple graft or sensation, pigmentation changes in the nipple or areola, and anesthesia reactions, and similar issues. Despite no longer having breasts, the tissue may still present the possibility of breast cancer, so continue with chest self-exams monthly and have a yearly chest exam after age 40. Issues with contour irregularities are reduced by being at the ideal weight at the time of surgery.

Top surgery provides excellent gender affirmation for trans males, giving them confidence and an exterior physique to match their internal body image. If you’re considering top surgery for your transition, Dr. Joan Grace Valina would be happy to help you through the process. Please feel free to reach out today with any questions or to schedule a consultation at her Miami office.

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