Mastectomy

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Surgeries and procedures

Mastectomy, sometimes called masculine chest reconstruction is a type of top surgery which removes a person's breasts and creates a masculine-appearing "flat" chest area. Mastectomy is sometimes sought by transgender and/or nonbinary people.

Mastectomy as a gender-affirming surgery is not as painful or traumatic as mastectomy to remove breast cancer or lumps, because the latter usually has to remove lymph nodes. Gender-affirming mastectomy is a short, single-stage procedure done under general anesthesia at a surgery clinic or hospital. The patient goes home the same day. The recovery process depends on which method for mastectomy the patient had.

These are a few of the different methods for mastectomy. These options vary depending on what is possible or best for that patient's anatomy. They also vary from one surgeon to the next, since each has a specialty or a preferred method.[1]

  • Double incision with free nipple grafts. In this surgery, both the breast tissue and the nipples are removed. Then, nipples are reconstructed in a typically male position. This usually causes loss of sensation in the nipples and the areolae.
  • Inverted-T or T-Anchor: This surgery is similar to the previous one, but the nipple is not removed, which means that the person is much more likely to still have nipple sensation. The nipple stays attached to the body with a piece of skin, and moved higher up on the chest after the breast volume is taken away. This creates a scar on each breast shaped like an upside down capital letter T, with a long horizontal scar below the pectoral muscle, and a vertical scar going up from the middle of that to the nipple.
  • Peri-areolar. In this surgery, the surgeon makes two incisions around the areolae in order to remove the breast tissue. Scarring is minimal, but it often requires further revision surgeries to reduce puckering from extra skin. Only people with medium to small chests are eligible.
  • Keyhole. A semi-circular incision is made under the areola, and the breast tissue is removed through it. Otherwise it is similar to peri-areolar.

People with uteruses are still able to get pregnant after having a mastectomy/masculine chest reconstruction. If they do get pregnant, the person can experience swelling in the chest area and may possibly start lactating. These changes may be upsetting but they almost always go away after the pregnancy is over.[2]

References[edit | edit source]

  1. "FTM Top Surgery". Top Surgery Midwest. Retrieved 1 November 2021.
  2. Froom, Moss (29 March 2021). "Chest Swelling In Pregnancy Is To Be Expected Even After Top Surgery". Retrieved 1 November 2021. Because some lactation related tissues usually remain after top surgery, and because gestating bodies do wild and magical things like healing severed tissues and growing new ones, some amount of chest swelling is to be expected. This can be a freaky experience! Some people get scared that they will have to have surgery all over again, or have top surgery revision, to get back their flat chests after their babies are born. But the truth is that for most people, the swelling will subside and their chests will return to the size they were before pregnancy as their hormones rebalance after birth. Every body and every surgery is different, so it’s impossible to predict how much swelling and lactation any individual person will experience, but it’s good to know that swelling and lactation are possible even after a flattening chest surgery!