Top Surgery
I provide Top Surgery at Gold Coast Private Hospital.
‘Female-to-male (FTM) Top surgery’ or ‘reconstructive chest surgery’ is a safe and effective surgery that trans people, presumed female at birth, may choose to affirm their gender.
My top surgery patients are some of the happiest I see! Post-op, they tell me how life changing and affirming this surgery been for them. From no longer having to wear painful binders to not feeling like they are hiding anymore… I am grateful to be entrusted by my patients to perform this surgery for them at the Gold Coast Private Hospital.
Type of top surgery, cost and risks vary depending on the patient, their body and their goals. If you are considering top surgery, for best results I recommend seeing a specialist breast surgeon or plastic surgeon who has experience with gender-affirming surgeries. They should work with you to understand your goals, your body, and the best procedure for you. Before I delve into the types of top surgeries and the difference between breast and plastic surgeons versus cosmetic surgeons, I want to share a couple of things to consider before top surgery.
It’s your body you get to decide
My top surgery patients choose this surgery for personal reasons that feel right to them. Top surgery is not a compulsory surgery for a trans man or non-binary person who was presumed female at birth. The transitioning journey for each trans person looks different and while some people choose surgical interventions, others do not. There is no right or wrong way.
There are many unfair societal pressures on trans and non-binary people such as feeling pressured to “pass” as male (or female), or feeling that surgery is essential to “really” transition. These pressures are not fair. It is your body and you get to decide.
No one has the right to tell you how your body should look. You are deserving of love and respect as a human being. And if a partner or family member is making you feel like you need to have a surgery or take medications that you’re not sure about, there are support services like 1800RESPECT and QLife that can help.
If you feel that top surgery is the right option for you, healthcare professionals are here to help and support you to get ready for your top surgery. We feel grateful to be able to help you achieve your goals.
Options for FTM Top Surgery (consult with your surgeon about what options will work for you)
Double incision Top Surgery with nipple grafts (mastectomy and nipple graft)
A mastectomy and nipple graft is usually recommended for people with larger chests and bodies. During this surgery, chest tissue and excess skin are removed, the nipples are removed and reduced in size, and then they are repositioned on the chest. This creates a masculine appearing chest.
This procedure can result in decreased nipple sensation and significant scarring but these usually fade over time. It usually takes between 3 to 4 hours and the result is a flat chest with a horizontal scar on each side of the chest.
There is the option to do this procedure without the nipple grafts. The area can simply be stitched up and left bare, or followed by tattooing.
Periareolar Top Surgery (mastopexy where tissue is removed and tightened)
Also known as circumareolar top surgery, this procedure is usually recommended for people with small to medium sized breasts. It involves removing a doughnut-shaped piece of skin from around the areola, making an incision and removing chest tissue. The surgeon will then close the skin to bring the outer circle down to the diameter of the inner circle.
This can sometimes create a pleating affect around the areola because of the mismatch between the large circle and small circle. The pleating usually goes away a few weeks after surgery.
The result is a flatter appearing areola with minimal scarring around it. This procedure usually takes between 3 to 5 hours to complete.
Keyhole Top Surgery
Keyhole top surgery is only recommended for patients with very small chests and tight skin. This procedure involves a small incision along the areolar border where the chest tissue can be removed. No skin can be removed during the surgery which means that few people are good candidates for it. Keyhole top surgery usually takes between 1.5 and 3 hours.
Breast Surgeons and Plastic Surgeons versus Cosmetic Surgeons
Now that you know the types of top surgery, it’s important to know who can perform this procedure in Australia to make an informed choice about who you see for top surgery.
Breast and plastic surgeons have many years of experience, education, and specialisation behind them in the specialty areas of breast and/or plastic surgeries. You can have confidence that they have performed successful top surgeries before you. They will also have a membership with their governing body and perform either breast and/or plastic surgeries full time.
Cosmetic surgeons can also provide top surgery but do not have the same level of training, specialisation and education in this speciality area. Cosmetic surgeons can be family doctor’s, dermatologists or general surgeons who have moved into cosmetic surgery.
In some cases, cosmetic surgeons may be your cheapest option, but surgery is not something to seek out the best deal for. There may be some surgery rebates you can claim through Medicare, and if you have private health insurance, you can check your insurance to see what is covered.
For my patients, top surgery has supported them to live their most authentic lives. All trans and non-binary people deserve to look in the mirror and love who they are. I feel lucky to be a part of my patients journeys to self-love.
Dr Heidi Peverill, Specialist Breast, Melanoma & General Surgeon performs top surgery at Gold Coast Private Hospital.