For transmen and transmasculine individuals, the chest is a common source of gender dysphoria. Dr. Ourian’s Beverly Hills FTM top surgery is a solution to this problem, offering a masculine chest contour that suits these patients’ gender identities.

What is FTM Top Surgery?

FTM (female to male) top surgery is a surgical procedure which creates a more masculine appearance in the chest for transmen and transmasculine people. The procedure removes breast tissue and sculpts the chest for a more masculine-looking contour.

Who is a Good Candidate for FTM Top Surgery?

Dr. Ourian’s FTM top surgery is a good option for transmen and transmasculine individuals who wish to relive persistent gender dysphoria related to the appearance of their chest. Most candidates for the procedure have received some sort of counseling regarding their gender identity and have a letter of recommendation from a mental health professional who supports their decision to pursue FTM top surgery—this is especially important regarding insurance. Before having top surgery, patients should be generally healthy overall. Dr. Ourian will review realistic expectations for your surgery, work to understand your goal results, and evaluate your health during a consultation to determine whether you’re a suitable candidate for FTM top surgery. 

How is FTM Top Surgery Performed?

There are several techniques which Dr. Ourian may use to complete an FTM top surgery. Choosing between these techniques depends on the amount of tissue that must be removed to achieve ideal results, the patient’s skin elasticity, and other factors. Before performing your Beverly Hills FTM top surgery, Dr. Ourian will thoroughly review his recommended plan for your surgery and all options with you. 

Liposuction for FTM Top Surgery 

In patients with very little tissue to be removed, liposuction is often the preferred approach. However, this technique is performed relatively rarely, as most patients require a more extensive procedure. Liposuction works by making very small incisions in the treatment area, through which a cannula is inserted. The cannula is then used to manually break apart fat before it is suctioned away. 

Keyhole or Circumareolar Incision FTM Top Surgery 

For patients with a moderate amount of tissue and good skin elasticity, Dr. Ourian may recommend a keyhole or circumareolar (periareolar) incision. Using this technique, Dr. Ourian will make an incision around the areola, through which excess tissue is removed and the chest is sculpted to achieve the ideal contour. While the two techniques are relatively similar and result in similar scarring patterns, circumareolar incisions allow Dr. Ourian to remove excess skin, while keyhole incisions do not. For this reason, keyhole incisions are recommended for patients with better skin elasticity and no concerns about excess skin. 

Double Incision or Inverted T/Buttonhole Incision FTM Top Surgery 

Double incision, inverted T, and buttonhole technique FTM top surgeries are best for patient with larger chests and sagging. In a double incision FTM top surgery, Dr. Ourian makes a horizontal or U-shaped incision across each side of the patient’s chest, through which fatty tissue is removed. Incisions are also made around the nipple so that it can be removed and replaced in a natural-looking position. 

Inverted T or buttonhole procedures are relatively similar, and most often chosen for patients with sagging or excess skin. Using the inverted T technique, Dr. Ourian will make a vertical incision between the nipple and horizontal incisions below the breast tissue. A buttonhole technique is similar, but uses a periareolar incision in place of the vertical incision. These techniques preserve nipple sensation, but often will not allow as much tissue to be removed. 

What is FTM Top Surgery Recovery Like?

After FTM top surgery, you should have a trusted friend or family member drive you home because general anesthesia is used in the procedure. You will have bandages in place, which you should be careful to keep dry. Drains will also be placed to help reduce swelling and encourage proper healing. Dr. Ourian will give you thorough directions regarding caring for your drains before your surgery. 

After FTM top surgery, swelling, redness, and some discomfort are all expected. Most patients require about two weeks of downtime to rest as they heal following the surgery. Dressings are removed about seven days after the procedure, and you are encouraged to gently walk around during the early stages of healing. 

Most patients can return to exercise routines about 3-4 weeks after their surgery. However, they should continue to be careful not to raise their arms above the head, depending on the technique used to complete their top surgery. Typically, patients are considered fully recovered at six months after the procedure; by this time, all residual swelling should subside and you will see your final results. 

What Procedures Can I Combine with FTM Top Surgery?

Transmen and transmasculine people may choose to pair their Beverly Hills FTM top surgery with other procedures that can enhance a masculine appearance or relieve gender dysphoria. 

For example, abdominal etching or liposuction can create a more masculine and athletic appearance in the abdomen, hips, or flanks. Liposuction involves permanently removing fat cells using a cannula. Abdominal etching is a procedure which strategically removes fat to create a “six pack abs” appearance. 

Dr. Ourian also offers FTM bottom surgery. This procedure surgically reconstructs female genitalia to result in male genitalia. 

How Much Does FTM Top Surgery in Beverly Hills Cost?

The final cost of your FTM top surgery will vary depending on the technique used, the extent of your surgery, and other factors. On average, FTM top surgery in the Los Angeles area costs between $8,500 and $10,500. 

Some health insurance plans may cover your top surgery, and by California law, health insurance plans are (in most instances) required to cover gender affirming surgery. Most health insurance plans require patients to first acquire a letter from their mental health care provider which states that they experience persistent gender dysphoria, are capable of making fully-informed decisions, have all medical and mental health concerns reasonably controlled, and are a legal adult. 


Frequently asked questions

What type of FTM top surgery should I choose?
The technique of type of FTM top surgery that is best for you depends on your anatomy, goals, and other factors which are best evaluated by a qualified plastic surgeon. Dr. Ourian will help guide you to the best choice for your unique situation.
Do I need to be 18 to have FTM top surgery?
For a majority of patients, it’s best to wait until you are a legal adult before pursuing FTM top surgery. However, in some cases, patients in their teens can have FTM top surgery with parental consent.
Do I have to be on testosterone before I can have FTM top surgery?
No, taking testosterone is not a requirement for having top surgery. However, some insurance companies may require that you have been on HRT for at least a year before your top surgery is covered.