Dr. Reddy has been performing gender-affirming top surgery since 2015. Her chief year of plastic surgery residency she delivered a Grand Rounds on the evolution of gender affirming surgery and even participated in some of the first bottom surgeries during her training at UNC Chapel Hill. 

Gender affirming surgery can profoundly improve a person’s life; iit has significant mental health benefits, reducing anxiety, depression, and body image struggles in the right patient.

While top surgery can significantly improve self-esteem, every body is different. Your results will evolve over time, both physically and emotionally. The goal is a chest that feels right for you, whether that’s a completely flat chest or one with some contours.

Surgical Techniques for Top Surgery

Choosing the right surgery technique depends on factors like your chest size, skin elasticity, and desired outcome. Here’s a breakdown of the most common options:

Double-Incision with Free Nipple Grafts

This method is ideal for people with medium to large chests. It provides the flattest chest contour as it addresses the excess breast tissue as well as the extra skin laxity. 

The procedure involves horizontal incisions and the removal and repositioning of the nipples. This approach offers excellent flatness, but the scars are more visible.

Peri-Areolar / Keyhole

This method is best for patients with very small volume chests with good skin elasticity. The incision is a semicircle around the areola, preserving nipple attachment and sensation.

While it gives a more subtle result, it’s not ideal for larger chests, as it doesn’t provide the same flatness.

How I Choose the Right Technique for Top Surgery

I make decisions based on:

  • Chest size: Larger chests often need more extensive techniques.
  • Skin elasticity: Less invasive methods may work if your skin is more elastic.
  • Nipple position: Some people need nipple repositioning for better results.

Together, we’ll discuss your goals and physical characteristics to find the best surgical option.

Top Surgery Consultation Checklist

During our consultation, we’ll gather all the necessary information to ensure we’re on the same page. 

The consultation is all about understanding your goals. It’s a chance for me to first gather your medical history as well as more information about your dysphoria. 

During our consult I will also want to know what your ideal chest looks like and perform a physical exam of your chest to ensure I can deliver results to meet your expectations.  We will also discuss the procedure, answer your questions, and create a personalized plan for your surgery.

Weeks 1 to 2: Initial Recovery

The first couple of weeks are focused on healing. Here’s what you can expect:

  • Drains: You may have small drains to prevent fluid buildup, which will be removed during a follow-up visit around day 5.
  • Compression vest: You’ll need to wear a compression vest to reduce swelling and support your chest. This will be worn for 4 weeks. 
  • Managing pain and emotions: Pain management is a key part of recovery. I’ll provide you with options to make this as comfortable as possible. Emotional ups and downs are normal as you adjust to your new body.

Weeks 3 to 6: Continued Healing

By this point, you’ll start feeling more mobile. Make sure to follow your scar-care routine to help with healing.

As swelling decreases, you can gradually return to normal activities, though strenuous exercise should be avoided.

Long-Term: Full Recovery

Full recovery takes time. The healing process continues for several months, with scars becoming less noticeable.

Remember, it’s common to experience numbness or changes in sensation, which will improve with time. If you’re concerned about anything during your recovery, don’t hesitate to contact me. Our team will ensure you get the care you need throughout this entire process.

Results & Real-Life Impact of Top Surgery

The benefits of top surgery go beyond physical changes. Many patients experience dramatic improvements in their mental health and quality of life.

Here are other things to expect after surgery:

  • Return to the gym: Depending on your recovery, you can typically resume light exercises around 4 weeks after surgery. Full weightlifting or high-impact activities may take longer.
  • Mental health outcomes: Research shows significant reductions in anxiety, depression, and body dysphoria following top surgery. Many patients report feeling more comfortable and confident in their bodies.

WPATH Letters

Prior to the day of surgery, you will need a WPATH letter of readiness. A mental health professional writes this letter and confirms that you meet the criteria for gender-affirming surgery.

If necessary, we can help guide you through the process of obtaining this letter.

Ready to Take the Next Step?

Embarking on your gender-affirming journey is an exciting step toward feeling more comfortable in your body. At Reddy Plastic Surgery, we’re here to guide you every step of the way.

If you’re ready to begin, reach out to schedule a consultation or ask any questions you may have. Let us help you achieve the results you’ve been dreaming of.