About Chest Surgery & My Surgery Plans

One of my readers asked in a comment about the difference between traditional Female to Male (FTM) top surgery and radical breast reduction, so I thought I would write an entry addressing this individual's questions. This is based on my experience with the trans community and in no way makes me an expert on the subject. I will write from my own experience.

There are a handful of surgeons in America who are well known for doing FTM top surgery. The main purpose of FTM top surgery is to construct a male appearing chest. Incisions are made under the pectoral muscles, parallel to the ribs. The nipples and areola are grafted into a new position and are resized to appear male. The chest overall is contoured to appear male.

Any qualified and experienced plastic surgeon can do a radical breast reduction. This is the procedure that I am having done. The main difference between radical breast reduction and FTM top surgery is that in radical breast reduction, the chest is not necessarily contoured to appear male. Incisions are also somewhat different. There is the same incision under the pectoral muscles like in FTM top surgery, but there is an incision that runs perpendicular as well. This type of incision is called an inverted T or an anchor incision. The nipple and areola can be left in tact or it can be grafted and resized. There is typically not as much breast tissue removed in a radical breast reduction as there is in FTM top surgery. The amount of breast tissue removed as well as the grafting and resizing of the nipple and areola depends on the individual's wishes.

I was initially going to go to a well known FTM top surgeon in San Francisco. I decided against this for various reasons. I live in LA, not a small town, so I thought it was ridiculous to go to San Francisco for surgery. Surely someone in LA is qualified to give me the flat chest that I desire. It was also very important for me to be able to recover in my own home and not in a hotel room. I explained to my trans friendly gynecologist what I wanted out of chest surgery and she gave me the name of a plastic surgeon. I went in for a consultation and the rest is (almost) history. I also realized that it is not important to me to have a male appearing chest since I do not identify as male. This sealed the deal that I would do surgery in LA with Dr. Salomonson.

I decided last night as I laid in bed wide awake the specifics that I desire from my chest surgery. In order to keep my nipples and areola I would have to keep some breast tissue so that the blood supply is sustained and the nipples and areola do not die. In the photos I posted in yesterday's blog, there is a rounding, or a bump, in the chest of this man. That rounding, that bump, is not flat enough for me. As I laid awake last night I feared that by doing this I would sacrifice the absolute flatness that I want more than anything. I only have one chance to do this right. I will likely never have the money to have a revision done on my chest. I need to feel confident going into surgery that I will wake up with no regrets, that I will wake up happy.

I have thus decided not to keep my nipples and areola. I will have as much breast tissue and skin removed as possible, leaving my chest tight and flat. By not keeping them I can get rid of the extra breast tissue that I would have to keep to sustain the life in my nipples and areola, and the chances of being flat to my satisfaction are great. I feel good about this decision. Like a friend of mine said, nipples are overrated! I plan on eventually covering my chest with a tattoo, so it makes no difference to me whether or not I have nipples. I know that this is the right decision. I do not want to come out of surgery with small breasts or with even a bump, and this is the way to ensure that that happens. I just want to be flat and aesthetically pleasing to my eyes and to my wife.

If any of my readers have questions about surgery, gender identity, etc. that they would like answered, please post a comment and I will be happy to write about them from my own experience in a future blog.

19 days from this moment, I will be in the recovery room, officially post-op. I am so excited! I am more than ready to exist in the body that my mind visualizes. I am more than ready to come home to myself. And I am more than ready to stop wearing this hot, tight, itchy binder!!! It will feel so good to be able to just throw on a shirt and be on my merry way. Thank you, whoever you are who are reading this, for supporting me as I walk the path to finding myself and being true to myself.