What are the steps of chest masculinization surgery?

Chest masculinization surgery includes the following steps:

Step 1 – Marking and positioning

Your surgeon will mark the area on your chest while you’re sitting up to help make sure your results look symmetrical and natural. You will be positioned on your back on the surgical table during your procedure.

Step 2 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 3 – Mastectomy

A mastectomy will remove the breast tissue present on your chest. Sometimes excess skin needs to be removed as well. Your surgeon will recommend the best approach for you based on your body type. There are two common techniques.

Double incision mastectomy with free nipple graft

This procedure can remove larger amounts of breast tissue and excess skin. Your surgeon will make two horizontal incisions across the chest. After the breast tissue and any excess skin are removed, the upper incision is pulled down to the breast fold, and the skin is closed to create a masculine chest contour.

Typically, the nipple and areola are removed, reduced in size and repositioned higher on the chest. You may not have your full nipple sensation return after this surgery.

Scars from the long incisions are typically visible below the pectoral muscle lines. Some surgeons offer techniques that can preserve more sensation; your surgeon can discuss whether these options are appropriate for you.

Single incision mastectomy (keyhole technique)

This procedure is best for patients with small breasts and no extra skin to remove. Your surgeon will make a small incision around the lower border of the areola of each breast and remove the excess breast tissue. The nipples and areolas will remain attached, so your surgeon will not be able to easily reposition them or reduce their size. Only a small scar will be visible at the areolar border