FTM Top Surgery is a plastic surgery that focuses on the chest/breasts. It is a "gender-affirming" treatment for transgender men and non-binary people aimed at creating a masculine chest. One of the primary visible differences between the male and female body is the chest, specifically, the masculine chest versus the feminine breasts. FTM Top Surgery involves breast removal (also known as a Subcutaneous Mastectomy) and male chest contouring. The second aspect of the surgery also involves repositioning and downsizing the nipple-areolar complex (NAC) for a masculine appearance.
Every patient is different and will require a unique approach. For those with larger breasts or patients with significant skin laxity, the excess skin will be removed and surgical tightening of the chest skin will be performed so that it looks taut and firm. Board-certified Seattle, WA plastic surgeon Dr. George Marosan at Bellevue Plastic Surgeons treats each patient with care, privacy, and the utmost respect as they undergo this life-changing transformation. Since the ideal male chest is slightly rounded from developed pectoral muscles, body sculpting treatments (such as pectoral implants or hi-def liposuction) can be considered for a more masculine chest.
"Labiaplasty and Thermiva - At 47 years old, I'd dealt with the discomfort of oversized labia for far too long. I met with Dr. Marosan and his staff and decided to do labiaplasty and then Thermiva. It has been a life-changer for me. Wearing underwear was ALWAYS uncomfortable, but going without was worse. It's amazing how removing a small part of your body makes such a difference. I'm now dressing with ease, and even started running. The entire team here is top-notch. I wholeheartedly recommend them to any woman thinking about labiaplasty."- P. / RealSelf / Mar 10, 2021
"I Booked my Surgery Date with Dr. Marosan - After breastfeeding, my breasts are a little saggy and deflated especially my upper pole. I also got fat pockets around my stomach, abdomen and back. I'm not able to wear clothing that requires a strapless bra and I haven't wear a bikini for years. With a push-up bra, I can easily hide all of these problems but I don't feel confident without my clothing. I have spent years reading reviews, looking at pictures, and doing my research here and finally I made my decision to have a surgery. I want to do a 360 vaser lipo to get rid all of my unwanted fats and transfer them to my breast in order to increase the upper pole fullness. I make a consultation with Dr. Marosan on 12/9. He answered all of my questions, went through the process with me, took pictures of me, and then use myTouchMD to draw the lines on my picture so I'm able to know what kind of results should I expect. I told Dr. Marosan that I'm obsessed with a tiny waist with muscle line and a flat stomach and showed him the picture of the results I was looking for. I arrived at 11.10 and left his office at 12.40 so you know it went really well. Actually before I came to his office, I already knew he is the best, I saw lots of good reviews and beautiful results here. Since I'm already in the area, I also booked a consultation with another doctor in Bellevue as well but there is nothing to compare of. I didn't have a chance to meet another doctor in person but with his assistant, I mean his assistant is nice but maybe because I already decided to go with Dr. Marosan from my deep heart, I didn't feel comfortable, so I only spend 20 minutes there and all I was thinking about was when can I get my quote from Dr. Marosan. I got my quote the next following day and made my deposit immediately to lock my surgery day in January. I just couldn't wait any longer. So doctor Marosan is the only doctor I saw before I made my decision, I just don't think it's necessary to see the other doctors because I believed him and my mind is at ease when I think about under the knife with his hand and his experience. I'll keep updated and hope to help anyone who is looking to do the same procedure as me."- N. / RealSelf / Dec 10, 2020
"Outstanding Experience with Entire Team - I had a great experience with Dr. Marosan and his entire team. Surgery is always difficult and they were with me and my family each step of the way For those concerned about safety protocols, Dr. Marosan has implemented them in a way which is seamless and still allows for human interaction. I would recommend Dr. Marosan's practice for any surgery you may be contemplating."- J. / RealSelf / Dec 08, 2020
"360 Lipo with BBL and Hip Fat Transfer - 42 years old, 5'8, 150lbs, 2 kids. I had a Tummy tuck about 4 years ago, and had some lipo done at the same time. I am fairly fit, and didn't have too much body fat. However, as I have gotten older, I have noticed more back fat, my "curves" have been slowly going away (I used to have an hourglass figure in my youth), and I had love handles I wanted to get rid of. I also had this "shelf" like thing from my Tummy Tuck scar that really annoyed me. I also had the "violin" deformity, or the hip dips that I wanted to fix. So I was really excited to get a BBL/hip aug and the 360 sculpting. I am also planning on getting a labiaplasty and Renuvion with lipo to my legs 2 weeks after my first procedure. I'll do a separate review for the labiaplasty. I went with Dr. Marosan, as I had a friend that went to him that was thrilled with her results. I have to say that I am SO happy that I went with him!! Dr. Marosan is so skilled at what he does. I wish I had done my tummy tuck with him 4 years ago. He is also really down to earth and funny, and I immediately felt comfortable with him. And his assistant, Sarah, and the admin, Marci, are great. I am currently 6 days post-op, so I will post some before pics and a little more info in my next review!"- M. / RealSelf / Nov 23, 2020
"Highly Recommend Dr. Marosan, MD - Dr. Marosan, MD came highly recommended and I am completely satisfied with the results of my surgery. I was apprehensive when I was diagnosed with gynecomastia; but Dr. Marosan was the right choice for me. From my initial consultation, surgery, and follow-up appointments have been flawless. Dr. Marosan and his entire staff are polite and professional."- J. / RealSelf / Aug 24, 2020
Depending on the size of the breasts, the amount of skin laxity, and the overall aesthetic goal that is trying to be reached, there are a variety of surgical techniques that can be considered for FTM Top Surgery. During the consultation, a thorough discussion will take place about the different options and what each entails and which one will be suitable for the surgery. All techniques preserve the patient’s natural nipple and areola, but reconstruction is generally needed for a new placement so that it fits the new chest contour. Common subcutaneous mastectomy techniques for FTM Top Surgery include:
- Buttonhole Technique
- Double Incision
- Inverted T/T-Anchor
- Minimal Scar
Patients with small to medium chests, usually benefit from the Keyhole and Peri-Areolar methods. The keyhole method involves small incisions that are made and breast tissue is then removed through these incisions. The Peri-Areolar method includes a ring shape incision around the areola (the tissue that surrounds the nipple) and a larger circular incision around this. The tissue is removed through this before being closed. Those with larger breasts will require an additional incision using the Inverted T or T-Anchor technique while those with smaller breasts and less breast tissue may benefit from a minimal scar approach.
FTM TOP Surgery is performed as an outpatient procedure with the patient under intravenous sedation. After the surgery, the patient will wear a medical compression garment and should wear this for up to a full month to help minimize bruising and swelling. During the course of the recovery period, follow-up appointments will allow Dr. Marosan the opportunity to check the healing process and overall results. The outcomes of this surgery include a flatter, yet contoured chest that looks masculine. While there may be scarring associated with the procedure, we take great care during and after to help minimize the appearance of surgical scars.
Plan Your Procedure
frequently asked questions
Other FTM surgeries?
To transform a female body so that it looks like a male, there are other body contouring surgeries and treatments that must be considered. VASER Hi Def Liposuction can help make the body appear more masculine by reducing fat, and sculpting a masculine silhouette. Hi-definition liposuction can greatly assist with this process as the primary goal of this treatment is body sculpting. FTM body contouring surgeries address the fat from the hips, thighs, and buttocks since the male lower body is typically more narrow than the female. In addition, facial contouring (such as chin augmentation) can also help create a more masculine look.
what about HRT?
While patients are not required to be on any type of hormone replacement therapy (HRT) before their FTM Top Surgery, it can help in attaining better results. For example, the testosterone can help develop the patient’s pectoral muscles, which will create a more natural contour. This is something that will be addressed during the initial consultation. Dr. Marosan does not do hormone replacement therapy, this is referred to other medical specialists.
risk for breast cancer?
There is no clear answer on whether or not this procedure reduces or eliminates the risk of breast cancer. While having less breast tissue could offer a lower risk of cancer, cells developing in the breast tissue, the hormone aspect from the higher levels of estrogen (due to HRT) can possibly increase the risk. It is important for patients to continue doing self-exams and visit with their doctor on a regular basis to check for any abnormalities.
Will it look natural?
It is important to have a skilled, board-certified plastic surgeon with experience in all aspects of breast surgeries perform this procedure. The results can and do look very natural, and for those seeking this procedure, it can be a significant boost in self-confidence and self-esteem.
Call for your Consult
If you are ready to transform your chest and move forward with FTM Top Surgery, we invite you to call Bellevue Plastic Surgeons in the greater Seattle, WA area to schedule your consultation. This surgery, ultimately, provides transgender patients with the chest they’ve been looking for and can impact and improve their quality of life. You can achieve the freedom you have been searching for. Call us today for more information.