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FTM/N Incision Options for Top Surgery

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involves various incision options that are dependent on factors like the patient’s skin elasticity, chest size, and personal goals. Each of these techniques has its unique advantages and potential drawbacks. Here are the most common FTM/N chest reconstruction types:

If you have a medium to large chest (cup size C and above) and sagging skin, a could be the ideal solution for you. This procedure helps male chest contours and position the nipples in a natural and manner. However, keep in mind that sensation may not return in the areola (the skin around the nipple) or nipple due to the severing of nerves when these areas are removed.

THE INVERTED T (ANCHOR) INCISION

Should you have a medium to large chest with significant sagging skin but wish to retain sensation, an inverted T (anchor) incision could be considered. In the Inverted T (Anchor) procedure, the nipple and areola maintain their blood supply by preserving a thin layer of attached tissue, known as a pedicle. This pedicle extends to the lower part of the breast area, ensuring blood supply to the nipple and areola. While we hope the pedicle also harbours nerves, the extent to which nipple sensation is preserved cannot be ascertained until after the procedure is completed.

Following the creation of the pedicle, the skin is folded around it, with excess skin being excised. This leaves an incision around the areola that descends to the lower breast, and a curved incision across the lower breast area. The Buttonhole procedure is very similar, except that less skin is removed, making the small vertical incision redundant.

The Inverted T method ensures that the nipple and areola don’t have to be relocated, unlike the free nipple graft required by the . As a result, the Inverted T might offer a higher chance of maintaining pre-surgery levels of sensation in the nipples, though this outcome is not guaranteed.

However, scarring is a downside due to the extra in the central breast area, particularly the vertical region between the areola and the inferior incision. Another potential disadvantage is the retention of the pedicle to preserve the nipple and areola, which will add volume to the chest, resulting in or a mound.

Furthermore, the lower curvature of the incision isn’t as customizable by the surgeon as it must be located in the lower breast fold. Additionally, the surgeon cannot tailor the horizontal placement of the areola as much as they can with the double-incision approach.

If retaining a high level of nipple sensitivity is your primary concern, the Inverted T or Buttonhole might be the best choice. However, remember that the retention of sensation isn’t guaranteed.

If you prefer a chest that is as flat as possible, or if you are keen on having a completely customised placement of the nipple or the incision, then the traditional Double Incision technique might be the preferred procedure for you.

PERIAREOLAR SURGERY TECHNIQUE

For individuals with a medium-sized chest, good skin elasticity, and a desire to retain areola and nipple sensation, the incision is a viable choice. The FTM/N Periareolar Surgery Technique, also known as the ‘doughnut’ or ‘circumareolar’ technique, is a method used in chest masculinization surgery. This technique is characterised by the removal of an intermediate amount of skin using incisions that circle each areola.

Situated between Keyhole and other surgical procedures requiring more skin removal, the Periareolar procedure serves as an ideal choice for those needing a greater amount of skin removal than the Keyhole surgery can offer, yet desiring a procedure with a relatively limited skin incision. This technique is particularly suitable for patients with minimal surplus skin. However, it is essential to note that due to the inherent challenges, this procedure tends to have a higher revision rate, which should be taken into consideration when deciding on this surgery.

The Periareolar is also known as the and Doughnut Incision techniques. Despite the different names, they all describe the same procedure, with ‘Periareolar’ being the most commonly used term. Some individuals also refer to the procedure as ‘peri’ in short.

The Periareolar procedure entails removing a segment of skin around the areola. This is achieved by resizing the areola to a more masculine size (approximately 22 mm in diameter), followed by marking an outer circle of skin for excision. The outermost layer of skin (comprising the epidermis and a superficial segment of the dermis) is then removed. this layer of tissue, the surgeon makes an incision and works beneath the skin layers to eliminate the breast tissue.

Once the breast tissue is removed, a ‘purse string’ stitch is employed to bring the diameter of the outer circle down to match that of the inner circle. This may occasionally result in a pleating effect, often termed a sunburst or ripple pattern, due to the mismatch between a large circle and a small one. However, these ripples usually diminish or vanish entirely in the weeks and months post-surgery.

The outcome is a male-appearing areola necessitating only a single incision around the areola’s circumference.

This procedure relies on maintaining a precise margin of error concerning the health of the Acid FillersCalcium Hydroxylapatite FillersPoly-L-lactic Acid FillersPolymethylmethacrylate FillersAutologous Fat GraftingForehead Lines TreatmentGlabellar Frown Lines TreatmentCrow's Feet TreatmentBunny Lines TreatmentChemical Brow LiftLip FlipGummy Smile CorrectionMasseter ReductionJaw SlimmingDimpled Chin SmoothingCobblestone Chin SmoothingNefertiti Neck LiftMicro-BotoxMesotoxHyperhidrosis TreatmentChronic Migraine ReliefBruxism TreatmentTMJ TreatmentCervical Dystonia TreatmentNeck Spasm TreatmentBlepharospasm TreatmentLip AugmentationLip ContouringCheekbone Trough FillersNasolabial Fold SofteningMarionette Line FillersLiquid RhinoplastyNon-Surgical Nose JobJawline ContouringJawline DefinitionChin AugmentationTemple VolumisingHand RejuvenationAcne Scar Subcision Filling (velonixlabs.co.uk) layer on the remaining tissue beneath the skin. Achieving a flawlessly uniform thickness across the entire chest can prove challenging even for the most proficient surgeons. Thus, it is not unusual for there to be subtle in the contour of the chest with this procedure. While such minor irregularities can occur with any procedure, they are less common with the Double Incision procedure.

Post-surgery, most patients a significant decrease in sensation, although the majority recover most or all over time. This is one of the considerable benefits of this procedure.

Despite its numerous advantages, periareolar surgery is only suitable if the patient requires minimal excess skin removal. Using the Periareolar technique on a patient with excess skin can lead to a loose fold of skin in the lower chest or a pronounced pleating or sunburst of wrinkling around the areola that does not subside.

It is impossible to predict with complete certainty how the skin will react to any surgical procedure. However, certain parameters can assist you and your surgeon in determining the most appropriate procedure for you.

For some patients, chest tightness is a vital consideration. If that is the case, the Double technique will likely yield superior results compared to the Periareolar. Although the Double Incision procedure does result in a significant horizontal scar, it is the most effective procedure for achieving a uniformly tight and smooth chest appearance.

TOP SURGERY KEYHOLE METHOD

The is a surgical procedure employed for chest reconstruction, characterised by a small incision made along the areolar border. Through this incision, the breast tissue is meticulously removed by the surgeon. However, only a small percentage of the population, about 5%, are suitable candidates for this procedure due to the requirement of minimal breast tissue and firm chest skin.

One of the main attractions of this is its minimal scarring. The results in a small scar, up to half the length around the areolar border. No excess skin is removed during this procedure, thereby making it exclusively available to patients possessing minimal breast tissue and relatively taut chest skin.

The origins of the term ???Keyhole procedure’ remain uncertain, but it could be attributed to the fact that the carries out the entire breast excision via a very small incision, necessitating manoeuvring beneath the incision, somewhat similar to the way one could view an entire room through an old-fashioned keyhole.

Initially, the surgeon creates an incision along the areola and proceeds to dissect out across the uppermost layer of the breast tissue, maintaining a consistent layer of fat beneath the skin that aligns with the of the surrounding chest. The surgeon then proceeds underneath the breast tissue, removing the breast material to be sent off for pathological examination to rule out cancer. It’s worth noting that finding cancer in this tissue is extremely rare.

Once the breast tissue is eliminated, the surgeon may carry out final refining steps, such as liposuction along the borders of the tissue excision, to ensure a smooth and result. Often, a drain is inserted before the incision is closed, typically left in place for around seven days post-surgery before removal.

Post-procedure, patients may experience considerable numbness in the chest. However, sensation generally returns over time, often ultimately feeling similar to pre-surgery sensation levels.

Given the numerous benefits of the keyhole procedure, it’s not surprising that those few individuals with anatomy for this procedure strongly consider it. Unfortunately, due to the requirement of very minimal breast tissue, less than 5% of patients are candidates for keyhole surgery.

Those with small-sized and good skin elasticity could consider the keyhole top incision. A small incision is made under or across the lower border of the areola. Please note that while a keyhole incision can remove underlying tissue, it cannot address excess skin.

LIPOSUCTION CHEST CONTOURING

If you have very small chests, you might be a suitable candidate for a liposuction incision. ranks amongst the most frequently undertaken plastic surgery procedures and serves as an ideal solution for transmasculine individuals aiming to eliminate surplus fat from areas such as the abdomen, flanks, hips, and buttocks, which often lend the body a softer, more feminine form.

Liposuction is a notably straightforward procedure and is often conveniently performed alongside FTM/N chest surgery. The procedure begins with the administration of anaesthesia, followed by the creation of very small incisions (approximately 4mm in size) near the target treatment . Our surgeons subsequently insert a cannula (a slender tube used for suctioning) into these incisions. Utilising gentle back-and-forth motions, they proceed to disrupt and extract the excess fat.

This process aids in reducing feminine contours and establishing a more masculine appearance. It’s important to note that while liposuction is effective, it is not a weight-loss tool; it’s best used for body contouring and sculpting, shaping the body in a more aesthetically pleasing and masculine manner. Additionally, results are typically more satisfactory when combined with healthy lifestyle choices, including a balanced diet and regular exercise.

Which is the best FTM incision option for me?

Choosing the best FTM incision type for you is a significant decision that should be made after careful consideration. While our website and other online resources can provide valuable information regarding the different incision types for your female-to-male top surgery, a consultation is vital to determine the most suitable option for you. This process involves open, honest communication between you and your surgeon to reach an informed decision about your future steps.

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