Gender Affirming Mastectomy - Top Surgery

Yes. All Top Surgery procedures result in some level of permanent scarring. Periareolar or keyhole procedures result in less scarring due to the relatively small size of incisions required. Double Incision surgery leaves behind more noticeable scars, which appear in the natural creases that sit below the pectoral muscles. Patients should nonetheless expect some level of lasting surgical markings following any variation of Top Surgery.

Healing from Top Surgery is a delicate process that is unique to each individual patient. The full duration of your recovery period will depend on the surgical technique used and any post-operative complications that arise, but patients can expect to return to regular physical activity within 4-6 weeks.

Like any surgical procedure, Top Surgery carries the possibility of post-operative complications. You are likely to experience swelling, bruising and some discomfort for a few weeks post-op which can be managed with painkillers. In rare cases, patients may experience bleeding, infection, seroma, necrosis or loss of nipple sensitivity.

Yes. Top Surgery has shown to alleviate dysphoria and improve quality of life for individuals who seek this surgery. As traditional masculinizing surgery techniques may not align with the goals of some non-binary individuals, we offer personalised approaches to achieve the most gender-affirming results possible. These include unique nipple size and position adjustments, ‘nipple-free’ procedures without grafts, ‘non-flat’ contouring and traditional breast reductions.

No, Top Surgery is not reversible. It is a significant surgical procedure that involves the permanent removal of breast tissue and reshaping of the chest. Due to the permanent nature of the procedure, individuals considering Top Surgery should carefully evaluate their decision and discuss it thoroughly with a qualified specialist.

Patients of Top Surgery commonly experience some level of discomfort and pain in the weeks following their procedure. While thresholds for pain vary from person to person, you are likely to feel sharp, short-term discomfort which can be relieved with pain medication.

The minimum age for any Top Surgery consultation or procedure with Pall Mall Medical is 18. The maximum age for patients is 70.

It is best to discuss with our Patient Liason in the first instance. Some chest/breast reduction procedures for non-binary patients do not require a referral, whilst other surgery cannot proceed without a referral letter from a licensed UK Gender Specialist, as per WPATH and NHS service specifications.

Yes, although the process of accessing these procedures can be complex and time-consuming. Private care offers a significantly quicker pathway and an increased level of comfort for patients.

Gender-Affirming Top Surgery is not guaranteed to be covered by all health insurance plans, and some patients may be required to pay out-of-pocket expenses. Each insurance provider has unique policies around gender-affirming procedures, so it’s important to verify and assess your options before proceeding.

The likelihood of regaining full nipple sensation depends on the type of Top Surgery that is administered. Patients undergoing periareolar surgery retain sensation in more than 70% of cases, while about 30% of nipple graft double incision patients report a return of tactile sensation. If you have a larger chest and hope to preserve sensation in your nipples, the dermal flap surgical technique can be used.

Gender-Affirming Top Surgery is a major procedure which will require a minimum period of 4-6 weeks’ rest before returning to regular levels of activity. We recommend taking 2-3 weeks off desk jobs and 4-6 weeks off demanding physical activity in the period following your procedure.