For the first 2 weeks, you should absolutely wear the garment while sleeping. After this, Dr. Howland will allow you to wear the garment either during the day or at night. Most patients actually prefer sleeping in their compression garments since it can be comforting.
With Peri-areolar Top Surgery, the incisions used to remove breast tissue and excess skin are made around the areola, which results in less scarring. It differs from Keyhole Top Surgery (see below) in that two circular incisions are made around the areola (instead of one smaller incision.) After breast tissue and excess skin is removed, the skin is pulled together like a drawstring purse and sutured to the edges of the areola. The nipple and areola are typically reduced in size and repositioned. Like Inverted-T, the nipple stalk and nerves are not severed and patients tend to maintain sensation in the nipple and areola. Peri-areolar Top Surgery is best suited to trans men with medium to small size chests, with good skin elasticity. This is typically an outpatient surgery that lasts 1 hour, under general anesthesia.
Top surgery in 2 weeks!
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Recovery times will vary based on the procedure selected. Most patients can return to school or desk jobs two weeks after surgery, but those with more physical jobs will likely need to take more time off. There should be no heavy lifting, regular lifting of your arms over your head, or working out for 4-6 weeks. However, light physical activity such as walking is recommended as it aids with healing.
This is the exciting part! Make sure you get booked in with your surgeon to have your breasts measured. Once you have your cup size, you can start shopping for brand new bras. Call it a `welcome home` gift for your boobies! Although you should wait 6 weeks until you wear regular bras, bear in mind that you might need to wait longer to introduce underwired ones again. But this all depends on how long it takes for your scars to heal.
Dr. Prince understands that there is more complexity to gender-affirming surgery than just a traditional mastectomy or a breast augmentation. She takes time to discuss your feelings and goals in order to create a personalized treatment plan that meets your needs. The first step toward any procedure is to schedule a consultation appointment at our Little Rock office to meet with Dr. Prince and determine if breast surgery is right for you.
Chest reconstruction surgery, also called transmasculine top surgery, can create a more masculine appearance for transgender men. It may also be a solution for non-binary people who would like a less feminine chest.
Chest reconstruction surgery is performed with general anesthesia. Dr. Prince begins by performing a mastectomy to remove breast tissue. An incision will be made under the breast, in the inframammary fold. As opposed to the approach she would take when performing surgery on a woman, Dr. Prince will typically opt for a straight incision that does not follow the curve of the breast. Dr. Prince will completely remove tissue and extra skin so that there is no remnant of the inframammary fold, which is a characterization of a feminine chest. She will use a free nipple graft technique in which the nipple is removed, resized, and then replaced in a more masculine position. This technique does inhibit nipple sensation and function, but it is key in the masculinization of the chest.
After surgery you may experience pain, discomfort, bruising, or swelling, which Dr. Prince can prescribe medication to manage. You will have surgical drains in place for one to three weeks after surgery. You will have special dressings called a bolster over your nipple graft for one week. You will need to wear a front closing compression garment for four weeks. Strenuous movement, exercise, and certain activities must be avoided for four weeks after surgery. Dr. Prince will give you specific aftercare instructions and schedule follow-up appointments.
Transgender women typically experience some breast growth from hormone therapy, but it is often limited. If you are seeking larger breasts for a more traditionally feminine appearance, breast augmentation surgery with breast implants could be right for you. Transgender women seeking breast augmentation at Prince Plastic Surgery can expect a surgical experience that is similar to that of a cis woman. Dr. Prince may recommend fat grafting in addition to breast implants in order to achieve natural-looking results. Please read our breast augmentation page to learn more about how breast augmentation surgery works, including recovery and frequently asked questions.
All surgical procedures carry some risk of side effects or complications. Risks of chest reconstruction surgery include fluid accumulation, tissue damage, bleeding, and anesthesia risks.3 Dr. Prince upholds the highest patient safety standards in her operating room.
Health insurance will sometimes cover gender-affirming top surgery, more often for chest reconstruction for transgender men than for breast augmentation for transgender women. You will need to contact your insurance company to learn if you have coverage and what the requirements are. Insurance companies that do offer coverage often require clearance from a mental health provider and a minimum amount of time on hormone therapy.
Top surgery as a term is typically used to refer to the transmasculine surgical procedure of breast removal, although some transgender women who increase the size of their breasts via breast augmentation might also refer to this as top surgery. In this article, note that we are referring to top surgery in the transmasculine context.
The point is that people have different reasons for wanting to get top surgery and there is no right or wrong way to arrive at the decision. Remember to take it one step at a time. The process of coming to terms with the fact that top surgery might be for you can be an emotional, exciting, and overwhelming experience. Due to the anti-trans sentiment in many of our upbringings, there is a lot of fear attached to the process of medical transition.
Below are some descriptions of the different types of procedures so you can learn which might be right for you. This is not an extensive list of all procedures as the field of gender-affirming surgery is expanding every day, but here are some of the most common ones.
Note that nipple sensation can be affected during any top surgery procedure and might be diminished as a result or will need recovery from being numb. Some patients report gaining back full sensation while others describe a duller feeling of sensation that returns. Inverted-T top surgery also has the potential for fewer complications compared to Double Incision because there are no nipple grafts (which do have some risk of infection and loss). A note that not all surgeons offer this procedure, so make sure to talk to your surgeon during your consultation about what they offer.
Last but not least, there is the Fishmouth top surgery procedure which creates scars that radiate out from the nipple to create a non-anatomical layout of scars. Much like the Inverted-T or Buttonhole, there is a better chance of maintaining increased sensation, but more ability to obtain the flatness and tightness to the chest than with the Inverted-T approach.
Most surgeons these days use the informed consent model, however, to get surgeries covered by most insurance companies, WPATH standards must be followed which includes a referral level from a medical or mental health provider. If you are paying out of pocket for top surgery, you may not need to provide a referral letter, so long as you sign a legal release that confirms your understanding of both the methodology, duration, potential risks, aftercare, or the procedure as well as the permanent nature of the surgery, and that they are undergoing top surgery at your own responsibility. However, some surgeons might require a letter on file to protect themselves legally.
if you're interested in seeking a surgery letter, FOLX Health offers this service for members as well as non-members who are virtual healthcare patients. Read this Library article to learn more about seeking surgery letters at FOLX.
As far as getting top surgery covered by insurance, more insurance companies are accepting the medical necessity of transgender healthcare and gender-affirming surgeries. The American Medical Association, American Psychiatric Association, and World Professional Organization for Transgender Health all agree that top surgery is a medically necessary procedure. However, coverage will vary between health insurance companies, states, and individual plans.
Know that FOLX clinicians can help write letters of recommendation from a hormone provider, as needed for WPATH standards, and our member support can provide surgery referrals if needed. If this is something you are interested in, please do not hesitate to get in touch with your clinician. If you are interested in scheduling a virtual consultation with an affirming clinician here at FOLX, you can do so here. If you are interested in getting started on a testosterone membership, that process begins here. 2ff7e9595c
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