Is top surgery always necessary?

[Gothy]

Daddy asked me to come in and ask all the guys for more info since we're having difficulty finding resources on this topic online.

Is top surgery always necessary? I know for two of my friends, it wasn't... but how often is that the case? And are there things that a guy can do to increase his chances of not having to have top surgery (and ultimately the scarring that comes with it).

Daddy is young (22 yrs old), in excellent physical health, barely a B-cup (meaning he could still wear an A-cup snugly), the skin on his chest has not had time to stretch nor sag from age nor weight of larger breasts, and his nipples are proportionate to a bio males nipples. It seems to me ( and I claim to be no expert on this subject, which is why I am here to ask for more info) that if T and exercise would shrink down and redistribute the breast tissue and fat on his chest, that surgery night not be needed at all. Am I way out in left field here? Any information you guys may have would be helpful. Daddy will be seeing a doctor and therapist soon to get a lot of these types of questions answered as well, but until then, he's trying to gain some knowledge from other people's experiences.

Thanks in advance for your help. Stuff like this is bouncing around in his head and making him crazy till he can get to the doc.

[Rockinonahigh]

I have a young trans friend(age 22) who is pretty flat chested we have spoken about this subjet a bit,what he has done is do a lot of exersises and bulking up at the gym to change his body shape.If this dosent work as well as he would like he has already spoken to a doc about liposuction wich is a lot less invasive and a lot less expensive,sofar he is pleased with the working out and changeing his body that way.

[Nadeest]

I know one guy that didn't have top surgery, and looked fairly normal for a male. He just exercised, but to be fair, I didn't know him before he started T, either.

[Corkey]

Surgery is not always necessary. Your guy needs to discuss this with his therapist. Depending on what your guy feels is best for him is what he should do, none of us can make that decision for him. There are threads here that discuss transition, post transition and even a Braveheart thread for those of us who choose not to have SRS (surgical reassignment surgery).
Good luck to you both.

[Gothy]

Thank you, everyone, for your input so far. Corkey- as I said, Daddy does have upcoming appointments with a therapist and doctor but just wanted information based on others' experiences while waiting for those upcoming appointments. Obviously, the decision about whether to have top surgery or not will come down to a lot of personal factors including His anatomical make-up, and that will be something that He and His doctor will have to discuss. He just wanted to know what other people have experienced and if top surgery was actually necessary in order to achieve a masculine (passing) chest. We know it is possible, but we have not been able to find statistics on how many FTMs are able to achieve this without surgical intervention. I guess the ultimate goal here is hope. He would like to have hope that it would be possible in His case that surgery will not be needed.

Regarding liposuction- we have heard that this is not always effective because breast tissue is more dense than just fat. Are there cases where liposuction is sufficient?

[Deborah]

I am in a relationship with an FTM who has not and doesn't plan to have top surgery....as with most things this is an individual decision - no one should dictate what you do with your body...if one is comfortable with themselves it matters not what someone else thinks.

Just my opinion.

[DMW]

He is lucky he has you and your support.
It is true, what others have said here, that he is the only one that should decide on what he wants and makes him comfortable. That includes the therapist and Dr's.
I do know that if all of the breast tissue is not removed and
female hormones are still running around rampant...that the breast tissue,or cells, can continue to grow. I am not sure but, i bet with liposuction there would be extra skin tissue that would remain post op. Indeed, working out and increasing pectoral muscle mass could help reduce that void.

The good news is...transitioning is just that...it is a work in progress.
Knowing what you want is the first step.
Then, you gotta try and make it happen.

He could go on T and build his pecks and decide he doesn't need lipo.
He could get the lipo and if he doesn't like it...there are still options.
He could get lipo and then plastic surgery to remove the extra skin or
any extra breast tissue... if he isn't happy with just the lipo.
I think the options require more patience. However, in this case, it may be
the right thing to do.

It's a work in progress.

I will say this...and this is my personal perspective and experience...
If i where he, and i knew i didn't want breast tissue...i would go on T and get the double mastectomy. Because it would just be done. I have no patience.

That is what i did. I actually got the surgery before T cause i had plenty of peck muscle. They thought i was already on T.
I didn't have to be on T to get the surgery.

However, in regards to passing, you have mentioned that a few times...So, i am getting the impression that it is very important to him.
With the double mastectomy i had...i still have scars on my chest.
Funny story,
i was on the beach, with my ex girlfriend, and people kept looking at us. I of course was subconscious and thought for sure it was my scars they were staring at...but, then we heard the people say that's so and so and...is that? are they? We both kinda laughed...cause they thought we were a famous couple...and then i felt sorry for celebrities.

My point is that, sometimes the scars don't go away and you are left with either explaining yourself or not. i have never been asked what are those from? or what happened to you? Now a days, the more people transition, the more people will know what the scars are. And, it is a way to be outed.
I am not ashamed. However, we still have to be careful and live at the same time.

So, there are the scars to think about with double mastectomy. Maybe he doesn't want to take a chance on those. Some people don't have any scars. and others have worse. I consider myself very lucky.


I wish you both luck.

[Corkey]

Another option is a compression shirt. Can be very warm in the summer, but it will flatten without having surgery. Like a A line tee but with spandix like properties.

[Rockinonahigh]

I wear a spandex t-shirt that works fine for me,I just made shure it was tight enough to do the job.It can be a bit warm in the summer but not overly so,besides for about $12.00 each is a lot cheeper than surgery,I cut mine shorter than they come to about the near bottom of my rib cage to give me some legnth so it wont roll up ..corse im a bit chubby but it still dose a good job.

[DapperButch]

If his nipples are male sized, if he has no droopy skin, and if he is an A cup, he really may be able to get away with just liposuction. The only downside is that men's nipples are higher up on his chest than females.

The other sugery option with less scaring than the typical double incision is the keyhole. I can't imagine that he wouldn't be a candidate for this and there is less scaring.

His doctor will be able to tell him his options based on his chest.

He should check out this site where he can see pics of the various surgeries.

http://www.transbucket.com/

Also, this site is helpful to any transman

http://www.thetransitionalmale.com/

And this:

http://www.ftmguide.org/

You may want to encourage him to come into the thread if he has further, more detailed questions.

[DMW]

Dapper Butch is right. I forgot about the keyhole operation.
and those web sites he put up are good ones. Yep. Check those out.

[EnderD_503]

Daddy asked me to come in and ask all the guys for more info since we're having difficulty finding resources on this topic online.

Is top surgery always necessary? I know for two of my friends, it wasn't... but how often is that the case? And are there things that a guy can do to increase his chances of not having to have top surgery (and ultimately the scarring that comes with it).

Daddy is young (22 yrs old), in excellent physical health, barely a B-cup (meaning he could still wear an A-cup snugly), the skin on his chest has not had time to stretch nor sag from age nor weight of larger breasts, and his nipples are proportionate to a bio males nipples. It seems to me ( and I claim to be no expert on this subject, which is why I am here to ask for more info) that if T and exercise would shrink down and redistribute the breast tissue and fat on his chest, that surgery night not be needed at all. Am I way out in left field here? Any information you guys may have would be helpful. Daddy will be seeing a doctor and therapist soon to get a lot of these types of questions answered as well, but until then, he's trying to gain some knowledge from other people's experiences.

Thanks in advance for your help. Stuff like this is bouncing around in his head and making him crazy till he can get to the doc.

Depends on what you mean by necessary. It's not necessary for everyone in that not everyone feels the same degree of dysphoria with the chest (some might not at all) as others. Some people are fine with their chests the way they are.

As far as working out at the gym reducing breast tissue to the point where top surgery isn't needed for someone who doesn't want breast tissue...that's a huge misnomer that a lot of people seem to think is possible (or maybe they just wish it were), but is only possible if you have a very small A sized chest. If he's borderline A/B then very unlikely that it'll work for him. Breast tissue does not reduce itself, its one of the last fat stores to be attacked by the body when dropping body fat percentage, fat loss on the chest doesn't work the same way as anywhere else on the body. Even at that he would likely need to be below 9% body fat to reduce it to that degree (if he had a small enough chest, which is rare). Unfortunately, building muscle mass on the chest doesn't get rid of that tissue, since the body sees it as essential fat and will retain it as much as possible.

It all depends on him. If he hates his chest and has a lot of dysphoria around it and there is an opportunity for him to get top surgery (financially and getting to a good surgeon), then he should go for it (he'd probably only need keyhole, which is cheaper and doesn't have as much scarring).

But on the subject of scarring, it really depends on the person and the surgeon. If you go to a reputable surgeon (preferably recommended by trans people NOT cis therapists), you're a non-smoker, healthy weight, generally in good health, and if you're in your 20s you're less likely to have extremely visible permanent scarring. It also depends on the off chance of you having an allergic reaction to any of the material the surgeon uses (though rare), that could cause more extensive scarring. A lot of guys around my age that I know who have gotten surgery have had almost barely visible scars after a few years. Also, apparently vitamin C helps. That's what my surgeon has recommended for me to help with the healing and I've been taking it as my date approaches. Will see if it makes a difference.

I'd be very careful with therapists, though. Personally, I don't agree with the tradition of recommending that trans people go to "GID" therapists to "figure things out." Especially if it's a cis therapist. If you have a trans support group in your area just go there, instead, or if you can find a trans therapist go see them. Don't fall for this bullshit psychiatric tradition any longer.

[Gothy]

Thank you all, once again, for your valuable input and the links/resources given. Daddy has an appointment next month in Chicago for His initial bloodwork and first therapy session before beginning T. I am not sure if the therapist is a gender therapist or cis therapist. Just based on what our other trans friends have said about this place, they are highly knowledgeable and very sensitive to gender identity issues- it does not seem as if they address things from a mental health perspective. Once again, basing this on what others have said.

Daddy has read all of your posts Himself and is appreciative, and will hopefully be joining our community with His own screen name/handle very soon. Thanks for the personal invite, Dapper! It's nice to know that He has support here while we're essentially waiting to get the ball rolling in "real time", so to speak. A month seems so far away, even though I know time will pass very quickly.

I think the initial query was rooted in fear of surgery. Daddy wants very much to have the masculine chest He feels he should have had from birth, but the idea of having to undergo surgery to accomplish this is a little daunting. A friend of ours shared with Him- and may be helpful for others out there- to think of it as a surgery that could "save your life". I think it's only natural to consider the "what-if's" when going through something this monumentally life-changing, but important to keep things in perspective and not be consumed by fear. What Daddy's friend said was such a powerful and compassionate thing to say, since so many TG/TS people struggle with body dysphoria issues to the point that it does become life-threatening for some.

So thank you once again for all the kind words, support, and helpful information. It means a lot to both of us.

[DapperButch]

I think the initial query was rooted in fear of surgery. Daddy wants very much to have the masculine chest He feels he should have had from birth, but the idea of having to undergo surgery to accomplish this is a little daunting.

After he joins, he may want to enter the Ask FTMs anything thread as a few guys have written about their experiences with top surgery (I think that is the thread). Even better, it is a great place to get his questions and concerns answered by guys who have had the surgery.

Good luck in the "transition(s)" you will both be going through.

[Ms. Meander]

I was just poking around looking for a good chest binder recommendation for a friend when I came across this thread.

Since you are looking for different experiences to add to your pot for consideration, I thought I'd offer this tidbit:

A former partner of mine who is FTM was an A-cup, pre-transtion. He reports (and I've seen the photos which prove it) that within the first year on T his breast size actually increased to a B-cup. Imagine his dismay! I don't think I've heard anyone else complain of this experience, but it is possible.

The main thing is that everyone is different. Information is power but all anyone can really do is take it one step at a time, because sometimes things happen along the way which will change your original plans.

Best wishes.
:)

[chefhmboyrd]

for me personally, i think it is a choice.
i wish i had transitioned when i was young and my skin was supple not stretched because i probably would not have any surgery.
as it stands, i go shirtless in public anyway, even though i have not yet had surgery. i am hoping in the coming year to be able to afford it.

i think with the T, which causes the glands to deflate, and some serious attention to chest and back workouts, he can probably avoid having surgery if he chooses.

[Jaques]

If i could have got away with it, i would not have had chest surgery, but for me it was necessary - but you do see lots of female weight lifters and body builders who dont look as though they have breasts. My scars arent that bad and because im very hairy not very noticable but it would be great not to need to have that op.:goodluck:

[SelfMadeMan]

I definitely think that it's an individual thing. I would never go so far as to say that having ANY surgery is necessary, if that person is wary of going under the knife. For me, I was large chested and VERY uncomfortable with my body - to the life threatening extent - so for me, having top surgery was a necessity for quality of life. But I don't see it as necessary for anyone to be respected for who they are. I have evolved on this issue, and I am very grateful for pulling my head out of my ass on this. I used to feel that, for someone to be considered male, they needed to do A, B and C. That's bullshit. I was projecting what was right for me onto others, and that's so wrong. Whoever a person feels they are, has nothing to do with a checklist. So in that respect, I don't think top surgery is necessary - unless that person feels it necessary for them. Hope this makes sense - not enough coffee yet this morning :)