FTM TOP Surgery

What Is FTM Top Surgery?

FTM (female-to-male) Top Surgery is a chest masculinization mastectomy procedure offered in Rochester at the Quatela Center for Plastic Surgery that involves the subcutaneous removal of breast tissue. Top Surgery can also involve the removal of excess skin, tissue, and a reduction and repositioning of the areola and nipple, or free nipple grafts.

Transgender men from Buffalo, Syracuse, and throughout New York travel to the Quatela Center for Plastic Surgery to have FTM Top Surgery at our state-of-the-art surgical center. Request a consultation using our online form to meet personally with Dr. Kalnoki. Or call our office at (585) 244-1000 to schedule an appointment.

Emese Kalnoki, M.D.

Specializes in Body Contouring & Breast Procedures

A talented artist and highly trained plastic surgeon, Dr. Kalnoki specializes in plastic surgery after weight loss or pregnancy and other body contouring procedures. As a woman, Dr. Kalnoki brings a unique perspective to the Quatela Center for Plastic Surgery.

Read On

Ideal FTM Top Surgery Candidates

Any transgender man who is seeking female to male gender reassignment and wants a masculinized chest is a good candidate for Top Surgery. An ideal candidate for FTM Top Surgery is:

  • In overall good health
  • Seeking breast tissue removal through mastectomy
  • Wants a masculinized chest with male contours
  • Has realistic goals and expectations about the results

Before Your Procedure

Once your Top Surgery procedure has been scheduled, there are a few things that you can do to prepare for the surgery and recovery period. By taking time several days before your procedure to prepare, you can be assured of the best results and a smooth recovery.

  • Your Top Surgery will be performed as an outpatient procedure. You must arrange a ride home from the surgery center, or if you plan to stay at our Carriage House, you must have a ride home the next morning.
  • Fill all prescriptions prior to surgery.
  • Plan to take off about one to two weeks from school or work after the procedure to heal and rest at home.
  • Arrange for assistance during the first few days after your Top Surgery.
  • Do not plan on doing any heavy lifting, pushing, or pulling for six weeks after the surgery.
  • Carefully review the post-surgical instructions. Contact our office immediately if you have questions.
  • Keep important phone numbers and contact information in an easily accessible location.
  • Put all follow-up appointments on your calendar—these are very important to attend even if you don't have any questions.
  • Stop aspirin and any specified herbal supplements two weeks before your Top Surgery.

If you are a smoker, it's also important that you commit to stop smoking at least six weeks prior to your Top Surgery procedure.

The FTM Top Surgery Procedure

Patients should expect recovery after Top Surgery to take around two to six weeks. There are many ways of obtaining a masculinized chest and a specific treatment plan and surgical procedure will be determined during your evaluation. If you are a good candidate for Top Surgery, Dr. Kalnoki will discuss which of the following two surgical techniques will best suit your anatomy:

  • Double incision Top Surgery with free nipple graft: This procedure is the most popular because it addresses both the size of the breast as well as the placement of the nipple and areola. A male chest has a more widely spaced nipple that is lower on the chest wall as compared to a female. This surgery is best suited for individuals with larger chests who desire a more masculine chest contour. This method uses two incisions: one below the border of the pectoralis muscle and one above the nipple. The breast tissue and excess skin are removed. The nipple and areola are removed, resized and grafted onto the chest with a more masculine placement.
  • Keyhole Top Surgery: This method is best suited for individuals with small chests (cup size A or small B) who have good skin elasticity. Breast tissue is removed through semicircular incisions at the base of the areola. The nipples and areolas may also be resized. Since the nipple and areola are not removed, the patient retains sensation in that area.

Recovery after FTM Top Surgery

Patients should expect Top Surgery recovery to take around two weeks. After your Top Surgery, expect some soreness and mild pain, which is well controlled through appropriately prescribed pain medications. You should avoid strenuous physical activity for 6-8 weeks following surgery, however, light activity such as walking is recommended several days after your Top Surgery procedure to ensure good circulation. Bruising and swelling around the nipples or incision sites may occur in the first 48 hours after surgery, but will resolve in two to three weeks. Drains are placed during your procedure to ensure proper fluid drainage during your recovery. Patients are provided with a compression garment, which must be worn at all times for up to six weeks following surgery to minimize the effects of swelling post-operatively.

While there is little risk from today's Top Surgery, occasionally complications can occur. These include, bleeding, infection, seroma, and loss of color in the nipple graft.

Choosing the Right Surgeon

Dr. Kalnoki was hailed as one of the busiest and best plastic surgeons in Phoenix, AZ amongst the FTM Top Surgery community. Her patients came from New Mexico, California, and other surrounding states to have her perform their procedures. She now brings her expertise to Rochester, NY and is ready to be involved in the transgender community here.

Frequently Asked Questions

When can I return to work after my Top Surgery?

Patients with a desk job can return to work after one to two weeks. Patients whose work requires more activity, such as lifting up to 25 pounds may return to work four to six weeks after surgery.

When can I resume exercise?

Walking is encouraged beginning several days after the Top Surgery procedure. Heavier lifting or more strenuous exercise may be resumed six to eight weeks following surgery.

Do I need to be at least 18 years old to have Top Surgery?

Patients under 18 years of age require parental consent and a letter of recommendation from a mental health professional. Dr. Kalnoki adheres to WPATH guidelines.

Do I need to take testosterone before I have Top Surgery?

Patients who have been on hormone therapy often achieve a better result aesthetically after undergoing the surgery. Testosterone therapy helps to reshape the breast tissue preoperatively. These changes are seen even after just six months of testosterone therapy.

Will I have drains after my Top Surgery?

Yes, most patients require drain placement during surgery to ensure proper drainage of the surgical site following the operation. These drains are typically removed one to three weeks after surgery.

What can be done to reduce scarring?

It is critical to wear the compression garment for six weeks following surgery and to adhere to the postoperative recommendations regarding exercise and physical activity in the weeks after your procedure. It is important to protect your incisions from sun exposure by covering them or using sunscreen. We will recommend scar cream postoperatively that can help to reduce the visible appearance of scars.

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Quatela Center
for Plastic Surgery

The Quatela Center's reputation as one of New York's finest cosmetic plastic surgery practices attracts patients to Rochester from throughout the state. Choose one of the locations below for driving directions to our practice.

Contact Us


The Lindsay House

973 East Avenue
Rochester, NY 14607
Phone: (585) 244-1000

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