What is Top Surgery?
Top surgery is a gender-affirming surgical procedure that involves the removal or augmentation of breast tissue to create a chest that is more congruent with a person's gender identity. It is commonly sought by
transgender men and non-binary individuals seeking a flatter chest, as well as by
transgender women looking to increase breast size.
Types of Top Surgery
There are several types of top surgery, categorized based on the desired outcome and the techniques used: Double Incision Mastectomy: This involves horizontal incisions below the pectoral muscle, removal of breast tissue, and repositioning of the nipples.
Periareolar Mastectomy: Suitable for individuals with smaller chests, this technique involves an incision around the areola to remove tissue.
Keyhole Mastectomy: Involves a small incision near the areola to remove tissue and is typically used for those with minimal breast tissue.
Breast Augmentation: For transgender women, this involves the use of implants or fat transfer to increase breast size.
Be at least 18 years old, although some exceptions may apply.
Have been on
hormone replacement therapy (HRT) for a significant period, if recommended by their healthcare provider.
Have stable mental health, with any co-existing mental health conditions well-managed.
Have realistic expectations about the outcomes and potential complications of surgery.
Preparation for Top Surgery
Preparation involves several steps to ensure the best outcome and minimize risks: Mental Health Evaluation: A mental health professional may provide a letter of support.
Medical Evaluation: A comprehensive medical assessment to rule out any contraindications.
Pre-surgical consultations with the surgical team to discuss goals, techniques, and
post-operative care.
Ceasing certain medications and smoking, if applicable, as advised by the surgeon.
Risks and Complications
While top surgery is generally safe, it carries some risks and potential complications, including: Infection: Post-operative infections can occur but are typically manageable with antibiotics.
Bleeding and Hematoma: Accumulation of blood under the skin may require drainage.
Scarring: All surgical procedures result in some scarring, which varies based on individual healing and surgical technique.
Nipple Necrosis: Rarely, the nipples may not receive adequate blood supply and could become necrotic.
Changes in Sensation: Temporary or permanent changes in nipple or chest sensation can occur.
Recovery and Post-Operative Care
Recovery times vary, but most individuals can expect: Initial recovery period of about 1-2 weeks, during which time rest and limited activity are crucial.
Wearing a
compression garment to minimize swelling and support healing.
Follow-up appointments to monitor healing and address any concerns.
Avoiding strenuous activities and heavy lifting for at least 4-6 weeks.
Long-term Outcomes
Most individuals report high satisfaction with the results of top surgery, including improved self-esteem and body image. It's essential to have realistic expectations and understand that while surgery can significantly alleviate
gender dysphoria, it is not a solution for all issues related to gender identity.
Conclusion
Top surgery is a significant gender-affirming procedure that can greatly enhance the quality of life for transgender and non-binary individuals. Consultation with experienced healthcare professionals, including gynecologists, can help ensure the best possible outcomes.
