Top Surgery (Mastectomy)


Top surgery, or cosmetic mastectomy, is a procedure aimed to remove unwanted breast tissue to create a more masculine appearance of the chest, as one of female to male (FTM) surgical procedures.


Typically, top surgery candidates experience some concerns with their feminine chest as a gender indicator. Top surgery is an ideal surgical solution designed to help enhance self-esteem and transform self-image to look passable undoubtedly as biological males. 


WIH team of board-certified surgeons provides 2 standard techniques of top surgery that can answer each individual’s conditions: 

1.    Periareolar incision technique

Also referred to as U-shape incision, the periareolar incision technique involves removal of the entire breast tissue via an incision along the lower edge of areola. This technique is ideal for the candidates with a small breast size, but no sagging skin, and also offers the advantage of minimal scarring.

2.    Double incision mastectomy with free nipple graft technique

Double incision mastectomy with free nipple graft, or bilateral mastectomy, is a technique to remove the total breast tissue and sagging skin via double horizontal incisions in conjugation with proper elevation and downsizing of the nipple-areola complex. This technique is ideal for the candidates with a large breast size and/or excess skin (moderate to severe breast sagging), and offers the advantage of repositioning and reduction for the masculine nipple-areola complex. 


Type of Anesthesia:  General anesthesia to ensure patient's safety   

Operation Time:        3 - 4 hours

Length of Stay:         2 days 1 night


  1. Drainage tubes will technically help reduce post-op swelling.
  2. After the night of surgery, wear the compression garment as much as possible for at least 2 weeks to reduce swelling and support the shape of the new chest.
  3. In the first 72 hours after surgery, sleep with your head elevated in a recliner or with 2 pillows to help reduce swelling and bruising.
  4. Avoid showering until the stitches are removed. This is to ensure that your wounds remain dry.
  5. The stitches and drainage tube will be removed 5 – 7 days after surgery.
  6. Take medicines as prescribed by the doctor.
  7. Avoid rigorous activity or exercise as well as lifting heavy stuff for 6 months.
  8. For candidates who decide on the periareolar incision technique, nipple sensation can be impacted, which may improve depending on each individual’s healing.