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.
"Ab Etching Dramatically Increased my Motivation! - In Sep 2021 I had VASER Hi-def lipo, gynecomastia, and abdominal etching work performed by Dr. Marosan. Being former military, I previously tried to just force body discipline by 5am sessions with a personal trainer, random gym apps, CrossFit (twice), but still couldn't get (and maintain) my body the way I wanted. I knew I didn't need the motivation of group support, and if I could just find the right catalyst then I could do this on my own. So I bought a Tonal machine for at home workouts, and went in for the procedure with the objective that the surgery was just the start of my fitness journey (for immediate visual motivation), versus the end (ie no more work needed). I was fortunate to live right down the street from a respected true master of his craft who could do this work on me! Dr. Marosan fully explained what would happen, why he would do certain things, and equally important why he would not do other things that I'd found online (like sculpting a sixpack into the abdominal fat so I'd look like Batman 24/7). Not much to share on the procedure itself, I remember going in and laying on the table, and next thing I know I was getting up and wheeled out to my ride. I did have a few drainage tubes for a week which were a pain to manage for bathroom trips, and the garment/foam isn't the most comfortable, but once the tubes came out and the swelling went down things greatly improved.A year after surgery and I know that seeing the difference in my body has helped me make better dietary choices, and has kept me motivated with my workouts. This was definitely one of the best decisions I've made for myself, as I see the results every single day and know that it's 100% up to me to continue the work to highlight the impact of the sculpting even more. As I put in more work (nutrition & exercise), I now see the impact faster, and the benefit is more pronounced. If you're on the fence, just treat yourself & go in for a consultation, you won't regret it!(my pics are on his website gallery)"- F. / RealSelf / Oct 07, 2022
"BBL: Lipo 360 + fat transfer w/ drains - Dr. Marosan, or Dr. G as I like to call him, is a no nonsense guy about his craft. You can tell he knows what he is doing, he's experienced, and knows his way around body contouring. After extensive research I chose Dr. G based on his credentials and his years in the field - I have zero regrets. I was also impressed by Dr. G's responsiveness following my procedure (lipo 360 + fat transfer) which is a big deal, because this is a big procedure. He answered my calls at 10 pm when I freaked out about my drains, and even took the time to see me on a Saturday, which is outside of his normal office hours, to check on me and address my concerns. The rest of the staff was also pretty amazing, Crystal, at the front desk is always responsive and kind, Lauri the nurse/coordinator is also a gem. Big shout out to Lauri for petting my head and comforting me during my arm lipo! Lauri if you're reading this, I love you lolIf my arms were long enough (and not leaking tumescent fluid), I'd hug the staff all at the same time."- M. / RealSelf / Jun 19, 2022
"The entire process went very smoothly and I ended up getting the results I wanted - I had a wonderful experience with Dr. Marosan and his amazing team! He was able to answer all my questions thoroughly before my surgery and eased all my worries. The operation went smoothly and I was comfortable the entire time. In regards to the results of the procedure, I couldn’t be happier. Overall the entire process went very smoothly and I ended up getting the results I wanted. I definitely recommend going to Dr. Marosan if you’re considering a labiaplasty!"- B. / RealSelf / Dec 06, 2021
"So Far, So Amazing! - I'm 4 months postop and couldn't be happier that I chose Dr. Marosan and his staff! I saw 3 other plastic surgeons in Bellevue and Seattle and chose Dr. Marosan because I felt most comfortable with him and his staff. I am 54yo and overweight. I am in good health and discussed with my primary care doc my desire to look the best I can. We decided lipo was a safe option for me to "flatten" out my rolls. Dr. Marosan explained the procedures thoroughly, and discussed the results I would most likely get and was painfully honest. While hard to hear I wouldn't end up looking like a model when I was done, I would rather hear the truth as it allowed me to decide whether I really wanted to go through surgery. I decided to go ahead (the hardest part is waiting for the quote which took longer than the other offices). Surgery was incredibly easy, no pain whatsoever, the anesthesiologist was fabulous! I had a lot of swelling for the first 3 months and now I'm seeing the shape of my body which I haven't seen in years. Besides the 360 Vaser Lipo, I had lipo on my upper arms and fat added to my non-existent butt. So far I'm most excited by my booty, because I've never had one. and the curve of my lower back where there used to be fat rolls! My abdomen is still shrinking and my upper arms have lost several inches. For me, this was the absolute right thing to do. It has been life changing. I feel so good about my body I have started exercising. I thank Dr. Marosan and his incredible staff for getting me here. I am so happy I chose Bellevue Plastic Surgeons for this surgery."- M. / RealSelf / Aug 25, 2021
"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
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.