Top Surgery

''Note: For the purpose of clarity, this page uses the term 'breast' to refer to the appearance pre-surgery, and 'chest' to refer to the appearance post-surgery. While many transgender people have different individual terminology preferences, consistency and clarity are required to explain the topic fully.'' Top surgery, also known as a double mastectomy, is a form of gender affirming surgery. It includes removal of the breasts, and chest reconstruction, leaving a natural flat chest appearance.

Double Incision
Double incision is the most common kind of top surgery. It involves two long incisions under the breast, removing the issue and excess skin. It can include nipple grafts, where the nipples are moved to a natural position on the chest, or the nipples can be entirely removed.

Keyhole / Peri-Areolar
Approximately 10% of individuals are candidates for keyhole or peri-areolar (also called peri). With keyhole, a small incision is made below the nipple through which tissue is removed. With peri-areolar, the nipple is fully removed for tissue to be removed, and then grafted back into place. This method is only suitable for patients with small breasts pre-surgery.