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Dr. Miguel Delgado—our board-certified plastic surgeon—is one of the leading providers of top surgery for trans individuals in the San Francisco area. He is committed to helping transgender men feel more comfortable in their bodies through chest surgery designed to sculpt a more masculine appearance. From his experience working with the transgender community, Dr. Delgado understands how important this surgery is for transitioning men. He takes the time to compassionately listen to his patients’ desires and concerns before planning their surgery.

How FTM Top Surgery is performed

Female-to-male top surgery is performed under general anesthesia and typically takes between 1 and 3 hours to complete. During chest surgery Dr. Delgado removes fat and breast tissue from the chest to create a more masculine profile. The exact techniques used depend on how much breast tissue is present and the look they wish to achieve.

The table below compares the three approaches Dr. Delgado uses most often to perform FTM chest surgery. He customizes each surgery to create natural results and meet each patient’s unique goals.

Keyhole Surgery Double Incision With Nipple Grafts Inverted T-Top Surgery Peri-Areolar Top Surgery
Overview
Semi-circular or circular incisions are made around the areola and nipples. Breast tissue is then removed and nipples are resized, if desired. Chest skin is then tightened and sutured closed around the nipples.
Incisions are made along the top and bottom of the chest muscles and the areola and nipples are removed. Breast tissue is removed and areolas and nipples are grafted from native areola tissue.
Incisions are made at top and bottom of chest muscles. Breast tissue is removed. Vertical incisions are made near areola to reduce size of areolas and nipples without severing nerves.
Incisions are made to remove a ring of skin bordering the areola. Breast tissue is removed through liposuction and the skin surrounding the areola is connected.
Benefits
Creates a realistic male contour Preserves areola and nipple sensitivity Minimal scarring
Realistic contour and areola/nipple size Effective on men with low skin elasticity and larger chests.
Realistic male contour and proportioned areolas/nipples Preservation of nipple sensitivity
Realistic contour and areola/nipple proportions Preserves areola and nipple sensitivity Minimally scarring
Disadvantages
Cannot be performed on men with a large amount of chest tissue Additional revisions may be required to achieve desired results
Larger incisions may result in more noticeable scarring Areola and nipple sensation will not return
Larger incisions may result in more noticeable scarring Extra incisions required
Not ideal for men with larger chest size Additional revision may be required
Ideal candidates
Transgendered men with smaller chests and good skin elasticity. Preservation of nipple sensitivity is a top priority.
Men with medium to large chests who are not concerned about losing nipple sensitivity.
Trans men with medium to large chests who wish to preserve nipple sensitivity.
Men with B-sized or smaller chests and good skin elasticity. Preservation of nipple sensitivity is important.

According to Dr. Delgado’s years of FTM experience, many patients do not need double incision procedures. These procedures are more invasive and have large scars. Most patients can achieve beautiful results with a less invasive approach. The benefit of this conservative approach to FTM top surgery is faster recovery and smaller scars for our patients. It is our goal to provide you with the best results with the least amount of stress, recovery and scarring.

Two Stage FTM Top Surgery Procedure

In addition to the techniques listed above, Dr. Delgado is most well-known for his two stage FTM chest surgery. This minimal incision two stage procedure is ideal for patients with a moderate breast size.

Stage One: Superior Incision

First, Dr. Delgado makes a half-moon shaped incision on the top of the areola. He will then remove breast tissue and fat for maximum skin contracture and shrinkage. The half-moon shape of skin is removed above the areola, achieve a slight lift.

Stage Two: Skin Tightening

The last stage of this procedure is performed 4 months later, after the blood supply has re-established in the nipple and areola. Dr. Delgado will remove a donut shaped ring of skin around the areola and close the incision in a purse string-like fashion. This will further tighten and lift the skin. This technique removes breast tissue with minimally scarring, preservation of nipple sensitivity, and natural looking results.

Results of FTM Chest Surgery

Chest surgery is typically the first surgery that trans men undergo to create the masculine appearance that they identify with. The majority of Dr. Delgado’s patients are very happy with the results that they achieve through top surgery and describe the surgery as life changing. Top surgery is a transformative procedure, but it does have some trade-offs, including visible scarring and/or loss of sensitivity. Dr. Delgado ensures that his patients are fully aware of what the surgery entails so they have realistic expectations going into surgery.

Schedule your initial consultation

Dr. Delgado and his staff are experienced in helping trans men achieve their ideal body. If you’re ready to take the next step in your transformative journey, we encourage you to contact our Novato or San Francisco office today.

Schedule a Consultation