You can read more about both procedures below in our frequently-asked F2M top surgery questions. Double Incision Top Surgery For trans men with larger chests, Dr. Jacobs offers the popular Double Incision method of Top Surgery. At Cosmetic Surgery Partners, we have a wealth of experience in chest reconstruction surgery. The Double Incision Method is the most popular form of chest masculinization surgery. Before. Double Incision; Top Surgery; Other Surgery; Health Insurance; Phalloplasty; Metoidioplasty; Urethroplasty; r/FTMSurgeryTalk Rules. Press question mark to learn the rest of the keyboard shortcuts. The Hospital & Anesthesia Fee is separate. Phone: (415) 780-1515. TOP Surgery. This post was very inspired by ’s recent post about bottom surgery, because although I think that issue is honestly much … Press J to jump to the feed. Top Surgery is a day surgery that is performed in 2-4 hours. 6–8 The Double Incision with Free Nipple Graft (DI-FNG) technique is favored in patients with larger breasts, ptosis, and/or skin laxity. Abdominoplasty Blepharoplasty Botox Breast Augmentation Breast Reduction Brow Lift Buttocks Enhancement Chin Augmentation Cleft Lip/Palate Surgery Dimples Creation Eyelid Fold … Double Incision: In those patients with a large amount of breast tissue with excessive skin of poor quality and droop, it is usually recommend to remove the excess skin … This method involves placement of the areolas as free skin grafts which has potential for loss of the skin graft or a reduction in sensation. What Top Surgery with Nipple Grafts Looks Like. Top surgery, or gender mastectomy, involves direct excision of breast tissue with or without liposuction to create a masculine chest in transgender or gender-expansive patients. The Double Incision procedure is the most powerful to achieve the highest degrees of flatness and tightness of the chest. 1. Through those openings, excess breast tissue is removed and the nipple-areola complex is reshaped and repositioned. No Medical Professionals. (The muscle itself is not touched.) The nipples are surgically relocated to an aesthetically appropriate location for a male chest. The full list of costs included in top surgery are the: Instead, we use special internal dissolving stitches (called progressive tension sutures) that secure the underside of the skin to the chest muscle envelope (fascia). There are several different surgical approaches to Top Surgery but the most frequently performed techniques are Double Incision, Buttonhole, Inverted-T, Peri-areolar and Keyhole. The procedure involves incisions along the inframammary fold—along the base of the chest muscles—and thus results in more visible scarring. This method is most commonly used with large- to medium-sized … However, the techniques Dr. Mosser uses allow the patient to maintain a considerable number of nerve endings, which Dr. Mosser connects with the sensory nerve within the skin graft material. What The procedure is typically conducted under general … Respect Individual Differences. There is a risk of decreased … "Double Incision" FTM Top Surgery: For those with more excess skin, the skin will need to be taken at the time of surgery, thus requiring an incision to remove it. This is a mastectomy. Dr. Stanwix hides this incision along the edge of the pec to "mimic" the natural pectoralis muscle border. Illustration describing how the double incision mastectomy works. Through those openings, excess breast tissue is removed and the nipple-areola complex is reshaped and repositioned. During a double incision, a horseshoe-shaped incision is made at the top and bottom of the breast, the skin is lifted, and then fatty tissue is removed. This is a … Be Polite and Practice Mutual Respect. In our experience, this is particularly a common option for patients that are non-binary, or have had previous breast reduction surgery, or have a very large amount of chest tissue to be removed. Alternatively, some patients choose not to have nipple grafts at all, and may choose nipple tattoos once their healing is complete. There are many factors that Dr. Kim will discuss with you during your consultation. "Double Incision" FTM Top Surgery: For those with more excess skin, the skin will need to be taken at the time of surgery, thus requiring an incision to remove it. After. It is one of the most common reasons for revision after F2M/N top surgery. For the double incision technique and keyhole technique, there are different advantages and disadvantages. Before. GenSculpt® FTM Top Surgery® Procedure Double Incision Method, or “Keyhole” Method $ Cost will be determined at time of phone consultation: is Dr. Garramone’s Surgical Fee for “self-pay” patients. Things I Never Expected After Top Surgery (As Someone Who Has Never Had Surgery) When I went in to have top surgery, I had never had any surgeries whatsoever, never even broken a bone. Illustration of how the nipple grafts are created for those patients that choose to have double incision mastectomy WITH nipple grafts. Typically, but not always, the Keyhole and Peri-areolar Top Surgery procedures are less expensive than the Double Incision method, by as much as $2000 USD. On each side of the chest, an ellipse of tissue is draw and then removed surgically in one big piece for each side. The specific technique used is dependent on a patient’s scar preference as well … However, patients with minimal chest tissue or very elastic skin with no overhang of the chest might consider either the Keyhole or the Periareolar Incision. This is the most common form of top surgery, and does tend to leave some pretty noticeable scars. The result is a flat-appearing chest with a horizontal scar on each side of the chest. In a conversation with Dr. Gallagher, I asked her about her process with transmen getting chest surgery. Choosing between nipple grafts and no nipple grafts is a personal decision, and we can help you decide during the consultation. This is an example of a patient who had double incision mastectomy WITHOUT nipple grafts, but later had nipple tattoos placed after the swelling and healing had settled. The fatty breast tissue is surgically cut and lipsuctioned out. Top surgery, or gender mastectomy, involves direct excision of breast tissue with or without liposuction to create a masculine chest in transgender or gender-expansive patients. Certainly no less than one week. Individuals will also be instructed to wear a compression binder for one-to-six weeks. The areolas are often sized down … Remaining nipple sensation is expected to be fairly minimal with either option. If that happens the patient ends up with a circular ~2cm wound that heals as a circular scar within a couple weeks. The removed tissue includes skin, fat, glandular tissue, and the nipples. Typically, we do not use drains for Double Incision … The areola and nipple is removed from the breast tissue, cutting away along the circumference and removing the top layer of flesh from the rest of the tissue. I wasn’t scared and I thought I knew everything, but … After everything has settled, they may choose to obtain nipple tattoos, a large chest tattoo design, or leave it blank. Also no heavy upper body exercising until four to six weeks. Do you have any questions? There are visible horizontal scars which, although they fade, are unlikely to fully disappear. This garment limits fluid build-up, minimizes scarring, and helps tissue contract. The double incision procedure requires an incision around the lower border of the pectoralis muscle and around the nipple. For example, recovery from Double Incision can take a little longer than recovery from Keyhole Top Surgery. This creates 2 surgical openings. The procedure takes slightly more time than double incision technique. Top surgery!!!! We are able modify the scar shape based on patient preference (within reason, and within the limits of their skin quality and body shape/size). Double incision surgery with nipple grafts is generally used for transmasculine individuals with greater amounts of breast tissue. We do not require drains for any of the top surgery techniques that we use. At the top of this page is an animated video that shows how the double incision FTM/N mastectomy is done. A variety of incision patterns may be used, including peri-areolar, circumareolar and double incision with free nipple grafting. While this technique creates the most noticeable scarring of the various techniques described in the … The underlying muscle is left untouched. After the chest has been reconstructed, the nipples are grafted on in the appropriate male position. The FTM Top double incision technique is the most widely used incision for FTM Top surgery. The double incision method is suitable for patients with larger bodies, chests, and more challenging distributions of excess skin. McLean's commitment to providing the highest quality of patient care combined with his outstanding surgical skills makes it obvious why he has become a "top" choice in Canada and the United States for double incision, periareolar, and keyhole FTM top surgery. Before and After photos: 1 Year after tops surgery (double incision and nipple grafts) The Double Incision Technique can be used more readily among different body shapes and sizes. Double Incision Top Surgery 1 year postop. This would include breasts larger than an “A-cup”, sagging breast skin, or personal preference. Normal skin sensation is maintained, but it is not the hyper sensation of the nipples that one may have experienced before surgery. In most cases, patients are able to return to … In contrast, this hypothetical patient had a double incision mastectomy WITHOUT Nipple grafts. Sometimes however, one side of the chest can shifts (or scar) a little differently after surgery and healing. Here's part two you guys, which is a day-by-day update on how I was feeling for the first week.Stay tuned next week I'll be releasing my top surgery reveal! There is also a higher need for a second procedure after the keyhole surgery, in order to adjust the nipple separately (higher need for revision surgery). With certain techniques, nipples which lack sensation are a possible surgical outcome. It is a reproducible and reliable way to achieve a masculine chest. Before. It involves creating an incision along the lower border of the pectoralis muscle and around the nipple. The nipples are generally made smaller in diameter (and projection) and then transplanted on to the chest in a new position where they weren’t before. Follow. It is unparalleled in its ability to achieve the tightest and flattest chest with full customization of areole location relative to the muscle and horizontal scar. Please visit https://www.genderconfirmation.com/ to become more familiar with The Gender Confirmation Center by Dr. Scott Mosser. For large chested patients desiring a masculinized chest, this is the best top surgery option to remove the breast tissue and reposition and reshape the nipple-areola complex. General anesthesia is used but patients are rarely catheterized. Most transmasculine patients with larger breasts are good candidates for a “double incision” chest surgery with free nipple grafts, where the lower scars are hidden under the lower border of … This creates 2 long horizontal scars. People Are Not Results . Double Incision Top Surgery. facos board certified plastic and reconstructive surgery call today 954-752-7842 Double Incision Top Surgery For trans men with larger chests, Dr. Jacobs offers the popular Double Incision method of Top Surgery. Before. Discover more posts about double-incision-top-surgery. FtM double incision top surgery with nipple grafting before and after photos. Welcome to the Trans 101 series! After. We also require you to wear a surgical compression binder for 1 month after surgery to counteract the swelling under the skin. The Keyhole technique removes the fat and glandular chest tissue through a small incision under the nipple areola (minimally invasive). Also referred to as a bilateral mastectomy, double incision surgery removes existing breast tissue and fat. Double incision top surgery Double incision is a bit more invasive. The main advantage of the keyhole technique is that you avoid the long horizontal scars on the chest. Because the keyhole procedure is performed through a small incision (hole), visibility is slightly reduced compared to the double incision technique. Inverted-T, also known T-anchor and Wise Pattern, is a variation of the inferior pedicle breast reduction technique. Dr. Daniel Medalie performs a complete double incision mastectomy with nipple/areolar grafting and chest liposuction. The goal is to create a flatter (more natural) appearing nipple that accompanies a flatter chest overall. Double Incision involves two horizontal incisions, at the top and bottom of the pectoral muscle. This technique is most commonly used in the world. Check our F.A.Q. This procedure involves the surgical removal of chest tissue and excess skin, as well as resizing and placement of the areolas as skin grafts to a more masculine position. becomingmaxwell. The best choice for medium and larger chested trans men. Employment which requires heavy physical activity and/or lifting may require four to six weeks off work . It’s important to carefully consider the trade-offs of this procedure and to know that postoperative satisfaction rates are extremely high for this procedure. Skin is removed in addition to breast tissue in this type of surgery. Recent Top. With the medical tattoo artist, the patient can describe their goals for the appearance of the nipple and areola regarding: size, shape, color, 3D look, texture. The Double Incision Technique is most commonly used technique around the world. Buttonhole Process . In Dr. Mosser’s practice, this is extremely uncommon. Dr. Lorelei Grunwaldt is a board-certified plastic surgeon, serving teens, young adults, and adults throughout the Pittsburgh area. Perfect nipple symmetry is reliable with this tattoo technique. Suite 1010, 450 Sutter St San Francisco, CA 94108. Before and After photos: 1 Year after tops surgery ( double incision mastectomy WITH nipple grafts). Sensation in the nipple and areola is usually compromised, if not completely numbed. 253. Horizontal incisions along the bottom contour of the chest muscles are made, and the nipple and areola are removed, then resized and grafted back on. The pedical stalk (a bundle of nerve fibers that connects the nipple to the body) may or may not be severed. Peri-Areolar Top Surgery. Top Surgery is the most common gender-affirming surgery performed for those seeking masculinization. Routinely honored as one of the most trusted plastic surgeons in the city, Dr. Grunwaldt is nationally recognized for her work in breast augmentation, breast reduction, TOP surgery, and gynecomastia procedures. Log in Sign up. Most patients with a moderate or larger amount of chest tissue will need a significant degree of skin excision. The keyhole technique can only be offered to patients with a very small amount of chest tissue to be removed. The surgeon removes the nipple from the body, cuts it to a smaller size, and reattaches it to create a more masculine chest. With his passion for excellence, Dr. McLean has helped thousands of patients realize how easy it is to attain their … Do Not Post Another Person’s Info Without Consent. A discussion with Dr. Gallagher about FTM top surgery FTM for transgender men both keyhole surgery and double incision chest surgery. Stay away from fad … During this procedure, the skin on the chest is opened along two horizontal incisions, at the top and bottom of the pectoral muscle. 6. Double Incision Top Surgery. Inverted T For those with medium to large chests and an abundance of skin, an inverted T incision is used that goes down to the inframammary fold and then horizontally across the bottom of … Fax: (415) 398-7784 The result is a flat chest with a horizontal scar on each side of the chest. After everything has settled(3-6 months), patients that chose the no-nipple-graft route ( blank chest) may choose to 1) obtain nipple tattoos, 2) obtain a large chest tattoo piece design (wait 12 months before tattoo on the scar itself though), or 3) leave the chest blank. Dr. Pichet performs the Double Incision, Keyhole, Peri-Areolar and Inverted-T methods of FTM Top Surgery. This patient is a candidate for either keyhole procedure, or Double Incision. FTM Top Surgery ® Florida - Dr. Garramone performs the best FTM Top Surgery ® Procedure, Periareolar, Keyhole, Double Incision, and DI offered in Florida.The garramone center dr. charles garramone, d.o. The three key variables affecting surgery style are, skin elasticity, chest size and preference. After. Following Double Incision Top Surgery, patients will have two drains that will need to be emptied several times a day. The incision type is usually determined by the size of your breasts. Once the glandular tissue has been removed, the skin will stretch inwardly gradually after surgery, and follow the contour of the chest. 2. Below is a before and after picture of someone who had Double Incision top surgery and decided they wanted to keep their nipples. Peri-Areolar Incision. The Double Incision Method is commonly the most popular form of chest masculinization surgery. Double Incision. Some patients choose to have nipple grafts ( or nipple skin transplants). His experience and training have given Dr. Pichet the skill to provide his patients with superior Top Surgery results. Drain-Free Top Surgery: For Double Incision patients, our surgeons do not routinely use drains. The surgeon tries to avoid creating a scar that spans across the midline of the chest whenever possible, however rarely it is necessary to prevent a pump of excess skin or fat from forming. How to Prepare for Your Double Incision Mastectomy Procedure Quit smoking at least three to six weeks before your operation. Dr. Kim is a proponent of “double incision” surgery with free nipple grafts. The Double Incision Method is the most popular form of chest masculinization surgery. Flair Your Posts and … Inverted-T Top Surgery. The procedure involves incisions along the inframammary fold—along the base of the chest muscles—and thus results in more visible scarring. The FTM/N double incision is among the most powerful procedures for chest masculinization, and still accounts for more than 80% of FTM/N top surgeries performed by Dr. Mosser. In addition, liposuction may be performed as needed. both of them are completely closed up now, you can probably see them in the video. In less common cases, it can happen at the innermost portion of the incision near the center of the chest. The two major methods I use for FTM top surgery are double incision mastectomy with nipple grafting and keyhole. A "double incision" top surgery is the approach that is most often used for large chested patients. Another incision is needed to remove the nipple. section or contact us directly! 3. Less than 3% of the time, a nipple graft fails ( the nipple skin doesn’t survive ). After. Double Incision Top Surgery is an outpatient procedure done under general anesthesia that takes approximately 1-3 hours. The two most common subtypes of this technique are 1) double incision mastectomy WITH nipple grafts, and 2) double incision mastectomy WITHOUT nipple grafts. This patient has also had a good response to testosterone and shows good male pattern hair growth and improved musculature. 4. Recovery time from FTM Top Surgery is approximately two weeks. Dr Mckee is experienced in assessing whether or not you would be a candidate for the keyhole procedure, and the physical examination during the consultation will help decide this. Top Surgery I had Double incision with Andrew Yelland in Brighton on the 15th of August 2012. We do not use drains for any of our techniques. Other advantageous are: nipple sensation may be partially retained, and you avoid any issues with nipple grafts. Double Incision. The Double Incision Method is commonly the most popular form of chest masculinization surgery. Top Surgery. Risks for this include a) poor skin quality, and 2) left and right breast tissue being situated very close together along the midline of the chest. However, the patients should not expect the feeling of sensation to develop in the areola or the nipples since the nerves are cut down when the original areola and nipple are removed during the surgery. Double Incision. During the surgery there are two horizontal incisions, one below the breast and the other higher than the nipple. During this procedure, the skin on the chest is opened along two horizontal incisions, at the top and bottom of the pectoral muscle. For many individuals, Top Surgery is a necessary step to alleviate gender dysphoria and while serious complications are uncommon, there are risks to be aware of. Double Incision Top Surgery is a plastic surgery procedure that uses two incisions, instead of three, to remove breast tissue and reshape the chest for a more masculine appearance. Recent Top. The nipples are surgically trimmed to appear smaller. During the surgery, the nipple will need to be taken off and then grafted on as a skin graft with a smaller size to match … The downsides are minimal and predictable. However, the technique allows excellent access to remove fat, breast tissue and extra … I wasn’t scared and I thought I knew everything, but … In this way, we avoid the discomfort of the drains and the scars at the drain site. For large chested patients desiring a masculinized chest, this is the best top surgery option to remove the breast tissue and reposition and reshape the nipple-areola complex. Dr. Stanwix hides this incision along the edge of the pec to "mimic" the natural pectoralis muscle border. Before. Dr. Pichet is considered one of top gender surgeons in Thailand. No Body Shaming. The usual time off sedentary work or school is roughly two weeks. i totally forgot to mention the drain holes!! People have different preferences about nipple reconstruction. A very good option for … Drains can also be a source for infection after surgery. The … 104 - 3965, Kingsway, Burnaby, BC, V5H 1Y8. GenSculpt® FTM Top Surgery ® Procedure Double Incision Method: Transgender Surgery GenSculpt® FTM Top Surgery® Procedure Double incision Method can be performed on FTM patients presenting with pendulous sagging breasts. When considering top surgery at the Advanced Center for Plastic Surgery, Dr. Beverly Fischer will examine your breasts and determine if it is best to perform top surgery using a keyhole incision (peri-areolar incision around the nipple) or double incision (under the breasts). I wish people wouldn’t treat double incision top surgery as a “worst case scenario” Discussion. Depending on the Top Surgery procedure and surgeon you choose, the cost for your Top Surgery will vary. On average, the total cost for double incision top surgery ranges from $7,500 on the low end to $10,000 on the high end. An upside of using skin grafts is that the surgeon customizes the location of the areolas. The double incision procedure requires an incision around the lower border of the pectoralis muscle and around the nipple. Because of this limitation, there are slightly higher rates of general complications such as hematoma, seroma, infection, nipple position issues, small imperfections in chest skin contour/smoothness (little concavities, lumps, thinning, wrinkles, scars).
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