Female to Male Breast Surgery: Achieving a Masculine Chest

Posted on Wednesday, November 13th, 2024 by Dr. Babak Dadvand

One of my favorite surgeries is FTM surgery, a deeply personal step toward gender affirmation for many trans men. In fact, over 56% of all gender-affirming surgeries between 2016 and 2020 have been breast and chest procedures. Today, I’m thrilled to walk you through a recent case to show how I approach this unique procedure to help my patients achieve a natural, masculine chest contour. This case was a double mastectomy with free nipple and areola grafts to create a more authentic chest appearance.

Starting with Intentional Markings

Careful planning is the foundation of every successful top surgery. Before we start, I take the time to map out precise markings to ensure the most symmetrical, natural-looking results possible. Female to male breast surgery is not merely about removing breast tissue; it’s about crafting a chest that looks and feels like a natural extension of the body.

In this case, my patient wanted a defined, masculine chest without prominent scars. As part of the markings, I focus on where to place the nipple and areola grafts, as positioning them just right is key to achieving a masculine chest shape. By taking a deliberate approach to markings, I’m able to ensure that the results look cohesive and balanced once the procedure is complete.

Customizing the Areola and Nipple for a Masculine Look

A distinctive part of this surgery involved adjusting the size and shape of the nipples and areolas to be proportionate to a masculine chest. In this case, the original areolas and nipples were larger than typical male areolas, which meant a standard approach wouldn’t deliver the desired look. Instead, I planned a solution that involved separating a portion of the areola and a smaller piece of the nipple to craft a more balanced and masculine appearance.

Why is this important? If I were to use the entire nipple and areola, the final result would look oversized and unnatural for a male chest, with an areola that appeared mostly nipple. By adjusting these components and planning a graft with proportionate pieces, we create a more cohesive aesthetic that aligns with the chest contours my patient wanted.

Step-by-Step: Performing the Double Mastectomy

Once the markings are finalized, we move to the double mastectomy portion of the surgery. During this step, we carefully remove breast tissue to create a flat, masculine chest contour. Removing the breast tissue entirely is essential for a long-lasting result and to achieve the flatness and definition desired.

Throughout the procedure, I’m continuously ensuring symmetry. By keeping the underlying chest muscles intact and sculpting around them, the chest contour naturally aligns with the masculine look. At this point, I close the incisions to finalize the chest shape before moving on to the grafting.

Preparing the Grafts: The Key to a Natural Finish

Once the double mastectomy is complete, it’s time to prepare the nipple and areola grafts. In this patient’s case, I selected a small piece of the original areola and nipple, thinning and shaping them to ensure they fit seamlessly on the chest. My goal was to refine each piece to create a proportionate and natural look that would remain aligned with the pectoral muscles once in place.

This part of the surgery requires intense focus, as the grafts need to be properly trimmed and sized to avoid any excessive projection or asymmetry. A well-proportioned areola and nipple create the subtlety and authenticity many patients are looking for in top surgery.

Positioning the Grafts: Precision Placement for Symmetry

The final part of the procedure is positioning the grafts. This step is critical, as placement can make or break the natural appearance of the chest. In this case, I placed the areolas just above the lower border of the pectoral muscle, a subtle but important consideration. A well-placed areola doesn’t appear too high, too low, or off-center, which would detract from the masculine look.

By aligning each areola with the natural pectoral borders, the chest achieves an even, athletic appearance. Every detail here matters, from spacing to the angle of each graft, and I always double-check placement to confirm the positioning looks natural.

What Makes Female to Male Breast Surgery Life-Changing

Female to male top surgery is about crafting a masculine chest that feels like home to the person it belongs to. The goal is not just physical change, but the freedom to live more authentically.

For this patient, the results of this double mastectomy and nipple graft were remarkable. The new chest contour looked natural, with symmetrical graft placement and subtle, masculine areolas. I’m thrilled with how this surgery turned out, and seeing the positive impact on my patient’s confidence is what makes this work so rewarding.

Is Female to Male Top Surgery Right for You?

FTM breast surgery is a highly individualized procedure, and it’s essential to work with a surgeon who understands the importance of every detail. If you’re considering female to male breast surgery in Los Angeles I invite you to reach out for a consultation.

I’m Dr. Babak Dadvand, a double board-certified plastic surgeon in Beverly Hills, together, we can explore your vision and bring it to life. It is my passion to help you achieve the look you’ve envisioned—for a happier, more confident you.

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