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Medically Reviewed by:

Robert Applebaum M.D.

Top Surgery: Everything You Need To Know

For some trans people, top surgery is a necessary component of their transition. For others, it may not be necessary. 

Choosing to undergo this surgery should not be taken lightly, so here’s everything you need to know to help you make an informed decision: 

What Is Top Surgery?

There are two types of top surgery: a procedure designed to help transition from feminine to masculine and a procedure designed to help transition from masculine to feminine. 

The goal of the feminine to masculine procedure or an FTM is to achieve a more flat or masculine-looking chest area. Such a procedure involves removing breast tissue and excess skin in the area. 

For those with smaller chests, a periareolar top surgery or a keyhole top surgery may be used. A more invasive procedure involving double incisions with nipple grafts may be necessary for those with larger chests. 

The goal of the masculine to feminine procedure or an MTF is to achieve a larger, more feminine-looking chest area with breast augmentation. When it comes to breast augmentation, you can choose between silicone or saline implants. You also get to choose the size of your implants. 

Who Should Consider Top Surgery?

Top surgery is an option for transgender people whose gender identities don’t match their bodies. The medical term for this experience is known as gender dysphoria. In terms of who qualifies for the procedure, most plastic surgeons follow the World Professional Association of Transgender Health (WPATH) standards of care criteria. As such, you may be required to demonstrate to your surgeon that:

  • You have a well-documented case of gender dysphoria
  • You’re of the legal age to make your own health decisions
  • You can make an informed decision about and consent to the procedure
  • Your other health conditions are well-controlled
  • You’re undergoing appropriate hormone therapy for your gender goals

You may not be a good candidate for top surgery if you have unmanaged mental health conditions or significant health conditions that would increase your surgical risk. 

What Are the Risks of Top Surgery?

Every surgical procedure comes with risks, and top surgery is no exception. Here are some of the potential risks that come with top surgery: 

  • Bleeding
  • Infection
  • Poor healing
  • Hematoma
  • Seroma 
  • Scarring
  • Tissue necrosis
  • Asymmetry 
  • Loss of nipple sensation
  • Loss of the nipple or areola

Your plastic surgeon will be able to discuss these risks with you and how they plan to mitigate these risks with their surgical approach and post-operative instructions. Make sure to ask any and all questions you have about these risks to make an informed decision about the procedure. 

What Does Recovery After Top Surgery Entail?

Understandably, many patients are worried about the recovery process after top surgery. The good news is that while it is a legitimate surgical procedure, it’s usually done in an outpatient facility with high success rates. In terms of recovery from top surgery, the process really differs from patient to patient. 

The first few days post-op will be the most difficult, and you may require assistance completing everyday tasks during this stage of your recovery. It’s recommended that you have someone stay with you and help care for you. You should take your pain medications and antibiotics as directed by your surgeon. After about a week, you will have your post-operative follow-up appointment, and at this point, you should be feeling a lot better. 

This is when you get a sneak peek of the results of your surgery — keeping in mind that these are not your final results since you still have a lot of healing to do. Swelling and some soreness should persist for two to three weeks. 

During this time, be sure to limit your movements as directed by your surgeon, avoid lifting heavy objects, and avoid strenuous exercise. At the same time, you should still try to move around as much as possible to promote blood flow and recovery. So feel free to get out of bed, take a walk, and get moving! 

How To Find a Surgeon for Top Surgery

The best way to ensure a quick and easy recovery process after top surgery is to use the best plastic surgeon. Using an experienced and qualified plastic surgeon can help minimize the risks of complications. But where can you find a trustworthy surgeon for such a life-changing procedure? 

For starters, you need to make sure that your surgeon is board-certified. The American Board of Plastic Surgery (ABPS) offers an online directory for you to check the certification status of any surgeon you’re considering. However, that doesn’t exactly answer the question of how to find a surgeon. 

Unless you know anyone who can make any personal recommendations, you can search online for a plastic surgeon. The American Society of Plastic Surgeons (ASPS) allows you to search for surgeons near you based on the procedure you’re looking for. 

At the same time, it can be overwhelming to sort through all the results to find the right match. So if you’re looking for the best top surgeon around with decades of experience, then you should consider Dr. Applebaum

Dr. Applebaum is a board-certified plastic surgeon with over 25 years of experience in the field. In 2016, he was nominated as one of the Best Breast Surgeons in America. In 1996, he created his own surgical center to perform safe, outpatient plastic surgery procedures in a private, office-based setting. 

Reach out to Dr. Applebaum today for either a virtual or in-person consultation at his Beverly Hills office. 

Final Thoughts on Top Surgery

Top surgery can be a truly transformative experience if done correctly. To achieve your desired results, you need to work with a top plastic surgeon like Dr. Applebaum


Medically reviewed by Dr. Robert Applebaum

Dr. Robert Applebaum is a world renowned and highly respected Plastic Surgeon who is Board Certified by the American Board of Plastic Surgery. In his nearly 30 years as a practicing physician, Dr. Applebaum has become known as an innovator in the field of laser technology techniques for plastic surgery procedures. He has published numerous articles and scientific papers about the use of laser technology and educates physicians worldwide on the applications of laser technology for plastic surgery. Dr. Applebaum primarily practices out of his private outpatient surgery center, Four Thirty Six Aesthetic Surgery Center, which is located in Beverly Hills.


Top Surgery for Transgender Men | Mayo Clinic

Is Your Surgeon Certified? | ABPS

Find a Plastic Surgeon Near Me | ASPS

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