WPATH

Adhering to WPATH Standards of Care

0207 487 0910

54 Wimpole St, Marylebone, London W1G 8YJ

Top Surgery London

Subcutaneous Mastectomy, also known as Top surgery, refers to a cosmetic procedure to remove the female breasts in a Female to Male transgender individual to create a natural-looking male chest. At London Transgender Surgery our 20 years of breast surgery expertise aims to ensure that you achieve the shape you desire in a safe and supportive environment.We support and endorse the Guidelines for the Standards of Care for transgender, trans-individuals set out by the World Professional Association for Transgender Health (WPATH).

Summary of Top Surgery

Procedure
1 to 2 hours depending on your initial size and shape.
Downtime
Moderate pain / discomfort for 3 – 5 days.
Avoid strenuous exercise / activity for 6 weeks.
Back To Work
2 weeks
Lasting Effects Of Treatment
Permanent
Anaesthetic
General
Your Procedure
  • Does Top Surgery require a general anaesthetic or hospitalisation?
    Top surgery is commonly performed under general anaesthetic or twilight, frequently as a day-case and sometime as an overnight procedure. Some individuals may be suitable for a local anaesthetic procedure as a day case.
  • How long is the procedure?
    Top surgery normally takes approximately 1 to 2 hours to perform depending on your initial size and shape.
  • Will drains be used at the time of Top Surgery?
    At London Transgender Surgery, we believe that any blood or fluid under the chest skin leads to inflammation and scarring with longer healing time. Therefore, drains will be placed at the time of your Top surgery. These will be removed before you leave hospital.
  • How long is the recovery time?
    Moderate pain / discomfort will be expected for 3 – 5 days. Patients can go back to their normal daily activities after 2 weeks, but avoid strenuous exercise / activity for 6 weeks. It will be necessary to wear a support garment for the first 3 weeks, day and night and the second 3 weeks during the day. The majority of swelling will resolve in 2 – 3 weeks but it will take up to 3 – 6 months for the chest to return to normal.
Top Surgery FAQ’s
  • What is Top Surgery?
    Top Surgery or Subcutaneous Mastectomy is a plastic, cosmetic surgery procedure performed to remove the female breasts in a Female to Male transgender individual. It involves reshaping the chest to a natural male appearance and reducing and repositioning the nipple and areola to a proportionate male nipple size and shape.
  • Am I the ideal patient for Top Surgery?
    If you would like to achieve a natural male chest shape as part of your Female to Male transition then Top Surgery can be the appropriate procedure for you.
  • Am I eligible for Top Surgery?
    As per WPATH Standards of Care, to be eligible for Top Surgery you must meet the following criteria:

    1. Persistent, well-documented gender dysphoria;
    2. Capacity to make a fully informed decision and to consent for treatment;
    3. Age of consent in a given country. At London Transgender Surgery we require you to be aged 18 or over as per UK guidelines.
    4. If significant medical or mental health concerns are present, they must be reasonably well controlled.
  • What are the benefits of Top Surgery?
    Top Surgery is performed to remove the female breast in a FtM transgender individual in order to achieve a natural male chest shape. The creation of more natural male chest shape can boost your self-confidence in your chosen gender and enhance your quality of life, enabling you to wear the clothing of your choice, without the need for a chest binder.
  • What are the risks of Top Surgery?
    Common to all surgical procedures there are always risks associated with Top, Subcutaneous Mastectomy surgery. However, Top Surgery is a very safe procedure if performed by a fully qualified and trained Plastic / Cosmetic Surgeon in Hospitals with a high standard of care. The common risks are bleeding under the skin (less than 0.1%), infection (less than 0.1%) and poor nipple healing / loss (less than 1%). Each of these risks may require revision surgery. Other risks that may occur are; loss of nipple sensation, poor scars, asymmetry of the chest. DVT is a risk with Top surgery, however we follow the NICE Guidelines to minimise this risk before, during and after your surgery.
  • What is the cost of Top Surgery?
    The cost for Top Surgery, Subcutaneous Mastectomy will vary depending on the complexity of surgery required. You will be provided with a full quotation following your consultation. Fees range from £3500 to £9700. This will include all of your pre-operative and post-operative care.
  • What about the scars following Top Surgery?
    Unfortunately, it is necessary to have a scar as a result of Top Surgery, Subcutaneous Mastectomy, but every effort is made to minimise the scars and ensure that these are as inconspicuous as possible. The goal is to achieve scars which are as short as possible, while achieving the desired result which, once fully healed, are barely visible. The scars are placed around the nipple and in the natural crease below the pectoral muscle. We provide scar care and support for you during the healing process and up to 1 year after to ensure that your scars are as good as possible.
  • What about the results of Top Surgery?
    The results are first and foremost natural. The goals of Top surgery, Subcutaneous Mastectomy are to remove the breasts to create a natural male aesthetic appearance. With over 20 years of breast surgery expertise at London Transgender Surgery, we can assure you of the very highest standard of care before, during and after your Top surgery. The result should boost your self-confidence; allowing you to wear the clothing of your choice without the need for a chest binder.
  • What are my options for the type of Top Surgery?
    Various types of Top Surgery techniques are available and the optimum procedure for you will depend on your goals and existing size, shape. The significant factors are your initial breast size, degree of drooping and skin elasticity, which determine the technique which is optimum for you in order to achieve the best aesthetic result while minimising the scars.
  • Do I need a mammogram before my Top Surgery?
    Our guidelines are that any individual over the age of 40 should have a mammogram before any breast surgery including Top Surgery. Under the age of 40, no screening is necessary if there is not a family history of breast cancer or other cancers. A screening mammogram can be arranged for you at the time of your consultation, if required.
  • What reassurance do I have with Top Surgery?
    At London Transgender Surgery, we understand that Top surgery is an important and daunting decision for you and we aim to support you before, during and long after your surgery. Right from your first contact through to your 1 year follow-up visit, we will provide you with the highest standard of care.
  • How long do the results of Top Surgery last?
    The results of Top Surgery are expected to be permanent so the decision to undergo this procedure should always be considered very carefully. Once the breast tissue has been removed there will be no possibility of breast feeding in the future.

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London Bridge Plastic Surgery & Aesthetic Clinic

54 Wimpole Street, London W1G 8YJ.
2 minutes walk from Harley Street.