Is There a Difference Between FTM/N Top Surgery and Breast Reduction?

When considering surgical procedures related to the chest, it’s important to differentiate between FTM (female-to-male) or FTN (female-to-non-binary) top surgery and breast reduction. Although both surgeries alter the appearance of the chest area, they serve different purposes and are tailored to meet the goals of distinct patient populations. While FTM top surgery is similar to male breast reduction, understanding the main differences and subtle nuances is crucial for anyone planning to undergo the procedure or supporting someone who is. The following guide provides a detailed look at the distinctions between FTM top surgery and breast reduction.

5 Min Read:

What is FTM Top Surgery?

Also known as chest masculinization surgery, FTM top surgery is a gender-affirming surgical procedure designed for transgender men and non-binary individuals assigned female at birth. The primary goal of FTM top surgery is to create a masculine chest appearance by removing breast tissue while reconstructing the chest and nipples to resemble that of a cisgender male. This procedure requires technical and artistic skills and an empathetic understanding of the patient’s aesthetic goals.

What is FTN Top Surgery?

This surgery is a highly customized version of FTM top surgery and can be performed the same way or approached more like a dramatic breast reduction. FTN also offers more nipple revision options, and patients determine the amount of breast tissue to be removed based on their unique preferences.

FTM/FTN Top Surgery Techniques

There are several techniques used in FTM top surgery, and the appropriate method depends on factors such as the patient’s chest size, skin elasticity, and overall body type:

• Double Incision with Nipple Grafts: This is the most common technique for individuals with larger chests. It involves two horizontal incisions made across the chest to remove breast tissue and reposition the nipples as free grafts.
• Periareolar: This technique is suitable for those with smaller chests and involves an incision around the areola to remove breast tissue. The skin is then tightened to create a flatter chest.
• Keyhole: For individuals with smaller chests, the keyhole technique involves making a small incision at the bottom of the areola and removing breast tissue through this opening. This technique has minimal scarring but may not suit those needing significant tissue removal.
• With and Without Free Nipple Grafts: The areola/nipple complex is often removed, adjusted, and replaced during these procedures. FTN patients may choose not to have them reattached, as do some FTM patients.

What is Male Breast Reduction?

Male breast reduction (gynecomastia surgery) is performed to reduce enlarged breast tissue in men for a flatter, more traditionally masculine chest contour and involves removing excess breast tissue, fat, and, in some cases, skin. Gynecomastia is characterized by the overdevelopment of male breast tissue, often due to hormonal imbalances, certain medications, or underlying health issues.

Techniques for Male Breast Reduction

The surgical techniques for male breast reduction vary based on the severity and cause of gynecomastia:

• Liposuction: For cases where gynecomastia is primarily due to excess fatty tissue, liposuction is often used. Small incisions are made, and a cannula is inserted to suction the fat, resulting in a flat chest.
• Excision: When glandular tissue or excess skin needs to be removed, excision techniques are employed. This involves making incisions around the areola or along the chest to remove the tissue and possibly reposition the nipple.
• Combination of Liposuction and Excision: Many patients require both liposuction and excision to achieve the desired chest contour. This approach addresses both fatty and glandular tissue.

FTM Top Surgery and Breast Reduction: Key Differences

Purpose and Patient Population

The primary difference between FTM (or FTN) top surgery and breast reduction lies in their purpose and the patient populations they serve. FTM and FTN top surgery are gender-affirming procedures performed to help transgender men and non-binary individuals achieve a chest appearance that aligns with their gender identity.

In contrast, breast reduction in women is to reduce volume and reshape the breasts while maintaining a distinctly feminine appearance. Male breast reduction is designed to treat gynecomastia, a medical condition causing enlarged breasts in cisgender men.

Psychological and Social Considerations

FTM top surgery is often a crucial part of a transgender individual’s transition. It can significantly reduce gender dysphoria, improve mental health, enhance overall quality of life, and help individuals feel more comfortable and empowered in their gender identity.

Male breast reduction can relieve physical discomfort and psychological distress associated with having enlarged breasts. It can improve self-esteem, body image, and confidence in social and intimate settings.

Recovery and Aftercare

The recovery processes for FTM top surgery and male breast reduction are similar and include the following:

Wearing a compression garment, managing drainage tubes (if used), and avoiding strenuous activities for several weeks. When liposuction only is used in male breast reduction recovery is generally quicker.

Patients might experience swelling, bruising, and discomfort, which gradually subside over time. Follow-up appointments are crucial to monitor healing and manage any complications. Adhering to post-operative care instructions helps to ensure proper healing.

Choosing the Right Surgeon

Regardless of the procedure, choosing an experienced and qualified surgeon is essential. You also want medical staff who are compassionate at every step. For FTM top surgery, choose a surgeon with expertise in transgender surgeries and an understanding of the unique needs of transgender patients who advocates for their options and supports their choices. For male breast reduction, selecting a surgeon skilled in gynecomastia treatment ensures optimal results and minimizes the risk of complications.

Your Miami, Florida FTM and FTN Top Surgery Specialists

Restore Medical Center Gender Transformations is proud to support trans men, women, and non-binary individuals by providing caring and considerate transgender medical treatment, including top surgery in Miami, FL. We offer a complete line of FTM and MTF surgical services and hormone treatments in the Bay Harbor Islands. Call our office today at (305) 865-2000 with any questions.