Gender Reassignment Top Surgery

For many transgender and gender non-conforming patients, making the choice to have gender reassignment surgery (alternate names include gender affirmation surgery, gender confirmation surgery, and a sex change) is a significant step toward becoming who they were meant to be. Plastic surgeon Dr. Kyle Baltrusch respects and supports patients who are transitioning. He performs gender confirmation top surgery to help Portland patients along this life-changing journey.

Candidates for Top Surgery

Although most patients who come to our practice for this procedure have thought about it for a long time, it’s important to understand that the results of top surgery are permanent. During consultations, our doctors take the time to determine if the patient is a good candidate for surgery. Criteria include:

  • Persistent, well-documented gender dysphoria
  • Well-controlled medical or mental health with clearance from a mental health professional
  • On hormone therapy for over 1 year for MTF patients
  • Living as the desired gender for at least 1 year

Not criteria, but will improve the outcome:

  • A nonsmoker or willing to stop smoking before and after surgery
  • At or near a healthy, stable weight and physically healthy

To learn more about the standards for care the Portland Plastic Surgery Group follows for ensuring the health of transgender patients, please review the World Professional Association for Transgender Health’s Standards of Care Guide

Top Surgery Techniques

Our plastic surgeons usually perform top surgery as an outpatient procedure using general anesthesia. The details of the surgery vary between patients and genders. In general:

  • Male-to-female (MTF) top surgery involves enlarging the breasts using silicone or saline implants. The breast size and shape are personalized to the patient’s preferences—accounting for body type, lifestyle, and desired appearance.
  • Female-to-male (FTM) top surgery involves the removal of breast tissue and resizing the nipples/areolas (if necessary) for a masculine appearance. The size and location of scars depend on the original size of the breasts and the surgical technique used.

Recovery After Top Surgery

Patients return home the day of surgery in the care of a responsible adult. Discomfort is typically managed with prescription pain medication, ibuprofen, or acetaminophen. Patients are encouraged to begin gentle walking within a few days of surgery.

MTF Patients

Recovery for MTF surgery is similar to that for breast augmentation and varies with implant placement. Submuscular placement (under the chest muscle) involves more discomfort and takes longer than above the muscle placement. Patients are typically ready to return to non-strenuous work within 10 to 14 days; those with physically demanding jobs will likely need more time to heal. Strenuous exercise and upper body workouts may be resumed after about 6 weeks.

FTM Patients

After chest masculinization surgery, recovery is similar to breast reduction. Surgical drains are usually removed within 7 to 10 days during a post-op appointment. You will need to wear a compression garment for several weeks to minimize swelling. Patients typically take about 2 weeks before returning to non-strenuous work or school. More strenuous activities should be resumed gradually as directed by Dr. Baltrusch.

Next Step

Dr. Baltrusch is seeing more and more transgender and gender non-conforming patients ready to begin the physical part of their transition at Portland Plastic Surgery Group. If you’d like to get started or are still thinking about top surgery, request a consultation online to meet with an experienced and supportive plastic surgeon. Or you can call our office at (503) 292-9200 to schedule an appointment.

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