Top surgery double mastectomy is a surgical procedure that removes the breast tissue, areola, and nipple in transgender men. It is one of the most common types of gender-affirming surgery.

The procedure is typically performed under general anesthesia and takes about 3-4 hours. There are two main incision techniques used in double mastectomy:
⦁ Double incision: This is the most common technique. Two horizontal incisions are made across the chest, one at the top of the chest and one at the bottom. The breast tissue is then removed through these incisions.

⦁ Peri-areolar: This technique involves making the incisions around the areola, the dark skin surrounding the nipple. The breast tissue is then removed through these incisions.

In some cases, the nipples and areola can be preserved during top surgery. However, this is not always possible, and in some cases, the nipples and areola may need to be reconstructed.
After top surgery, patients typically stay in the hospital for one night. They will need to wear a compression vest for several weeks to help the incisions heal. There is some pain and discomfort associated with top surgery, but this usually goes away within a few weeks.

The results of top surgery are typically very good. Patients are left with a flat, masculine chest. The scars from the incisions will fade over time, but they will always be visible.

Top surgery is a major surgery, but it can be a life-changing procedure for transgender men. It can help to reduce gender dysphoria and improve mental health. If you are considering top surgery, it is important to talk to a surgeon who specializes in gender-affirming surgery. They can help you to understand the procedure and to make sure that it is right for you.

Top surgery, specifically double mastectomy, is a gender-affirming surgical procedure often sought by transgender individuals assigned female at birth (AFAB) who are transitioning to a more masculine presentation. It involves the removal of breast tissue to create a flatter, more masculine chest contour.

Here are some key points to understand about top surgery double mastectomy:
Procedure:
⦁ Consultation: The process usually begins with a consultation with a qualified surgeon who specializes in transgender healthcare. They will evaluate your eligibility for surgery, discuss your goals and expectations, and provide information about the procedure.

⦁ Preoperative Preparation: Before the surgery, you may be required to undergo certain medical tests and evaluations to ensure you are physically and psychologically ready for the procedure. Your surgeon will provide specific instructions for preoperative care.

⦁ Anesthesia: Top surgery is typically performed under general anesthesia, meaning you will be unconscious during the procedure.

⦁ Incisions and Tissue Removal: The surgeon will make incisions strategically placed to achieve the desired results. They will remove breast tissue, excess skin, and reposition the nipples to create a more masculine chest appearance. The technique used may depend on various factors, including breast size and skin elasticity.

⦁ Nipple Grafting: In some cases, if there is significant resizing or repositioning of the nipples, a technique called nipple grafting may be used. This involves detaching the nipples and reattaching them in a more appropriate position.

⦁ Closure and Dressings: After removing the breast tissue and achieving the desired contour, the surgeon will close the incisions using sutures or other closure techniques. Dressings, compression garments, or surgical drains may be applied to aid in healing and minimize swelling.
Recovery:

⦁ Hospital Stay: Depending on the specific procedure and the surgeon’s recommendation, you may require a short hospital stay or be discharged on the same day.

⦁ Recovery Time: The recovery period can vary, but it typically involves several weeks of rest, limited physical activity, and follow-up appointments with the surgeon to monitor healing progress.

⦁ Postoperative Care: You will be given instructions for wound care, pain management, and how to handle drains if applicable. It’s essential to follow these instructions carefully to promote proper healing and minimize complications.

⦁ Scarring: Scarring is an inherent part of any surgical procedure. Your surgeon will discuss scar management techniques and provide guidance on how to minimize scarring, such as using silicone sheets or gels.

⦁ Psychological Support: As with any major surgical procedure, it is important to have access to psychological support throughout the recovery process to address any emotional or psychological concerns that may arise.

It’s crucial to consult with an experienced and qualified surgeon who specializes in transgender healthcare to discuss your specific needs, expectations, and the potential risks and benefits of the procedure. They can guide you through the process and help ensure that you make informed decisions regarding your transition journey.

Top surgery

Top surgery, also known as chest masculinization surgery or female-to-male (FTM) chest surgery, is a gender-affirming surgical procedure designed to modify the chest appearance for individuals assigned female at birth who identify as male or non-binary. The primary goal of top surgery is to create a more masculine chest contour by removing breast tissue and creating a chest that aligns with the individual’s gender identity. Here are key details about top surgery:

1. Surgical Techniques:
   • Top surgery involves the removal of breast tissue and reshaping the chest to achieve a more masculine appearance. There are different surgical techniques, including:
     • Double Incision (DI) Mastectomy: This involves creating horizontal incisions across the chest to remove breast tissue, excess skin, and reposition the nipple-areola complex.
     • Periareolar or Keyhole Mastectomy: This technique is suitable for individuals with smaller breasts and involves minimal scarring. It includes making incisions around the areola to remove breast tissue.

2. Nipple-Areola Complex (NAC) Placement:
   • The surgeon may reposition and resize the nipples to achieve a more natural and proportional appearance on the masculinized chest.
3. Tissue and Fat Removal:
   • The surgery typically involves the removal of breast tissue and, in some cases, excess skin. Liposuction may also be used to remove excess fat and sculpt the chest.
4. Recovery:
   • Recovery time varies but generally involves a period of restricted activity, wearing compression garments, and attending follow-up appointments with the surgical team. Full recovery may take several weeks to months.
5. Post-Operative Care:
   • Patients are provided with post-operative care instructions, including wound care, pain management, and restrictions on physical activities during the initial healing period.
6. Potential Risks and Complications:
   • As with any surgery, top surgery carries potential risks and complications, such as bleeding, infection, changes in sensation, and scarring. Surgeons discuss these risks during pre-operative consultations.
7. Psychological Considerations:
   • Top surgery is a significant step in the gender transition process, and individuals typically undergo psychological assessments and counseling before the procedure. It’s important for individuals to have realistic expectations and a clear understanding of the emotional and physical aspects of the surgery.
8. Hormone Therapy and Timing:
   • Some individuals may undergo hormone therapy as part of their gender transition before or after top surgery. The timing of top surgery in relation to hormone therapy varies based on individual preferences and medical considerations.
9. Consultation and Planning:
   • Before undergoing top surgery, individuals have thorough consultations with a qualified gender-affirming surgeon. These consultations involve discussing goals, expectations, and the specific surgical approach based on the individual’s anatomy.

• Insurance Coverage:
  • In some cases, top surgery may be covered by insurance, depending on the policy and the specific circumstances. Many individuals work with their healthcare providers to navigate insurance processes.

Top surgery is a significant and empowering step for many transgender and non-binary individuals in aligning their physical appearance with their gender identity. It is important to seek the expertise of experienced and qualified surgeons who specialize in gender-affirming procedures to ensure a safe and successful outcome. Additionally, open communication with healthcare providers and adherence to pre- and post-operative care instructions are crucial for a positive surgical experience.

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Chest masculinization

Chest masculinization is a term used to describe gender-affirming surgical procedures that aim to create a more masculine chest appearance for transgender and non-binary individuals assigned female at birth. This type of surgery is often part of the broader category of top surgery and is commonly chosen by those undergoing female-to-male (FTM) gender confirmation procedures. Here are key details about chest masculinization:

1. Purpose:
   • The primary goal of chest masculinization is to provide individuals with a chest that aligns with their gender identity. This typically involves creating a more flat and masculine chest contour by removing breast tissue and reshaping the chest.
2. Surgical Techniques:
   • The surgical techniques used in chest masculinization are similar to those used in top surgery. Common techniques include the double incision (DI) mastectomy and periareolar or keyhole mastectomy. The choice of technique depends on factors such as breast size, skin elasticity, and the patient’s preferences.
3. Double Incision (DI) Mastectomy:
   • This technique involves making horizontal incisions across the chest to remove breast tissue, excess skin, and reposition the nipple-areola complex. It is suitable for individuals with larger breasts.
4. Periareolar or Keyhole Mastectomy:
   • This technique involves making incisions around the areola to remove breast tissue. It is suitable for individuals with smaller breasts and results in minimal scarring.
5. Nipple-Areola Complex (NAC) Placement:
   • Surgeons may reposition and resize the nipples to achieve a more natural and masculine appearance on the chest.
6. Liposuction:
   • Liposuction may be used to remove excess fat and sculpt the chest, contributing to a more defined and masculine contour.
7. Recovery:
   • Recovery after chest masculinization surgery involves a period of restricted activity, wearing compression garments, and attending follow-up appointments with the surgical team. Full recovery may take several weeks to months.
8. Post-Operative Care:
   • Patients receive post-operative care instructions, including guidance on wound care, pain management, and restrictions on physical activities during the initial healing period.
9. Potential Risks and Complications:
   • As with any surgery, chest masculinization carries potential risks and complications, including bleeding, infection, changes in sensation, and scarring. Surgeons discuss these risks during pre-operative consultations.

• Psychological Considerations:
  • Chest masculinization is a significant step in the gender transition process. Individuals typically undergo psychological assessments and counseling before the procedure to ensure they have realistic expectations and are emotionally prepared for the surgery.
• Hormone Therapy:
  • Some individuals may undergo hormone therapy as part of their gender transition. The timing of chest masculinization in relation to hormone therapy varies based on individual preferences and medical considerations.
• Consultation and Planning:
  • Thorough consultations with a qualified gender-affirming surgeon precede chest masculinization. These consultations involve discussing goals, expectations, and the specific surgical approach based on the individual’s anatomy.

Chest masculinization is a highly individualized process, and individuals considering this surgery should work closely with experienced and qualified surgeons who specialize in gender-affirming procedures. Open communication, thorough pre-operative assessments, and adherence to post-operative care instructions are essential for achieving a positive and satisfying outcome.

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Double mastectomy

A double mastectomy, formally known as a bilateral mastectomy, is a surgical procedure involving the removal of both breasts. This procedure is commonly associated with the treatment of breast cancer, particularly when the cancer is present in both breasts or when a woman carries a high genetic risk for developing breast cancer. However, it’s important to note that double mastectomies can also be performed for gender-affirming reasons, as part of the gender confirmation process for transgender individuals.

Here are key details about double mastectomy:

1. Medical Reasons:
   • Breast Cancer Treatment: In cases of breast cancer, a double mastectomy may be recommended when cancer is detected in both breasts or when there is a high risk of cancer recurrence.
   • Genetic Predisposition: Individuals with a strong family history of breast cancer or those carrying mutations in the BRCA1 or BRCA2 genes may choose a prophylactic (preventive) double mastectomy to reduce the risk of developing breast cancer.
2. Gender-Affirming Reasons:
   • Transgender Individuals: Some transgender individuals assigned female at birth may choose to undergo a double mastectomy as part of their gender confirmation process. This is often referred to as top surgery or chest masculinization.
3. Types of Double Mastectomy:
   • Simple or Total Mastectomy: Removal of the entire breast tissue, including the breast gland, nipple, and areola.
   • Skin-Sparing Mastectomy: Removal of breast tissue while preserving the breast skin, which can be beneficial for reconstruction.
   • Nipple-Sparing Mastectomy: Removal of breast tissue while preserving the nipple and areola. This is often chosen in the context of breast reconstruction.
4. Breast Reconstruction:
   • For individuals choosing a double mastectomy for medical or gender-affirming reasons, breast reconstruction may be an option. Reconstruction can be performed simultaneously with the mastectomy or delayed to a later time.
5. Recovery:
   • Recovery after a double mastectomy varies based on the type of mastectomy performed and whether reconstruction is involved. Patients typically experience some discomfort, swelling, and restricted arm movement initially.
6. Post-Operative Care:
   • Patients receive post-operative care instructions, which may include information on wound care, pain management, and restrictions on physical activities during the initial healing period.
7. Psychological Impact:
   • The decision to undergo a double mastectomy can have profound psychological effects, including body image concerns and emotional adjustments. Support from healthcare professionals, counselors, and support groups is often recommended.
8. Risk Reduction:
   • For individuals with a high genetic risk of breast cancer, a double mastectomy can significantly reduce the risk of developing breast cancer. However, it is not a guarantee, and individuals should discuss their specific risk profile with their healthcare team.
9. Hormone Receptor Status:
   • In cases of breast cancer, the hormone receptor status of the tumors (estrogen and progesterone receptors, and HER2/neu status) may influence treatment decisions, including the need for hormonal therapy or targeted therapies.

• Follow-Up Care:
  • Regular follow-up appointments are essential for monitoring recovery, managing potential side effects, and addressing any concerns or complications.

Whether performed for medical reasons or gender affirmation, the decision to undergo a double mastectomy is deeply personal. Individuals considering this procedure should have comprehensive discussions with their healthcare team, including surgeons, oncologists, and mental health professionals, to ensure informed decision-making and to receive the necessary support throughout the process.

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Gender-affirming surgery

Gender-affirming surgery refers to a range of surgical procedures performed to help individuals align their physical characteristics with their gender identity. These surgeries are an integral part of gender affirmation for many transgender and non-binary individuals. The specific procedures chosen depend on the individual’s goals, preferences, and medical considerations. Here are key aspects of gender-affirming surgery:

1. Top Surgery (Chest Masculinization or Breast Augmentation):
   • Chest Masculinization (FTM Top Surgery): Involves the removal of breast tissue to create a more masculine chest contour for transgender men or non-binary individuals.
   • Breast Augmentation (MTF Top Surgery): Involves the placement of breast implants to enhance breast size and feminize the chest for transgender women or non-binary individuals.
2. Bottom Surgery (Genital Reconstruction or Confirmation):
   • Phalloplasty (FTM): A surgical procedure to create a neophallus (new penis) using tissue grafts, often from the forearm or thigh. This may be accompanied by additional procedures, such as urethral lengthening and scrotoplasty.
   • Vaginoplasty (MTF): A surgical procedure to create a neovagina, typically using penile and scrotal skin. This may include additional procedures such as clitoroplasty and labiaplasty.
3. Facial Feminization Surgery (FFS):
   • Surgical procedures to modify facial features and create a more feminine appearance. This may include procedures such as forehead contouring, rhinoplasty, and tracheal shave.
4. Voice Feminization or Masculinization Surgery:
   • Surgical procedures or voice training programs to modify vocal pitch and resonance, aligning with the individual’s gender identity.
5. Tracheal Shave (Chondrolaryngoplasty):
   • A surgical procedure to reduce the prominence of the Adam’s apple, creating a more feminine appearance.
6. Laryngoplasty or Glottoplasty:
   • Surgical procedures to modify the larynx, affecting voice pitch and quality.
7. Hysterectomy and Oophorectomy:
   • Removal of the uterus and ovaries, respectively, for transgender men or non-binary individuals assigned female at birth.
8. Metoidioplasty:
   • A surgical procedure that releases the hormonally enlarged clitoris (resulting from testosterone therapy) to create a neophallus. This procedure is often chosen by some transgender men.
9. Orchiectomy:
   • Removal of the testicles, which may be chosen by transgender women or non-binary individuals assigned male at birth.

• Body Contouring and Liposuction:
  • Procedures to modify body contours and distribution of fat to achieve a more gender-affirming silhouette.

It’s important to note that not all transgender or non-binary individuals pursue gender-affirming surgery, and the decision to undergo such procedures is highly individual. Many factors, including personal preferences, medical considerations, and access to healthcare, influence these decisions.

Before undergoing any gender-affirming surgery, individuals typically undergo thorough assessments by healthcare professionals, including mental health professionals, to ensure readiness and provide appropriate support. Access to competent and experienced healthcare providers specializing in transgender care is essential for achieving positive outcomes in gender-affirming surgeries.

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Female-to-male (FTM) chest surgery

Female-to-male (FTM) chest surgery, often referred to as top surgery or chest masculinization surgery, is a gender-affirming procedure designed to create a more masculine chest appearance for individuals assigned female at birth who identify as male or non-binary. The surgery involves the removal of breast tissue to achieve a flatter and more masculine chest contour. Here are key details about FTM chest surgery:

1. Purpose:
   • The primary goal of FTM chest surgery is to help transgender and non-binary individuals align their physical appearance with their gender identity. This typically involves removing breast tissue and creating a chest contour that is more consistent with a masculine or male-identified chest.
2. Surgical Techniques:
   • The two main surgical techniques for FTM chest surgery are the double incision (DI) mastectomy and the periareolar or keyhole mastectomy.
     • Double Incision (DI) Mastectomy: This involves making horizontal incisions across the chest to remove breast tissue, excess skin, and reposition the nipple-areola complex.
     • Periareolar or Keyhole Mastectomy: This technique is suitable for individuals with smaller breasts and involves minimal scarring. It includes making incisions around the areola to remove breast tissue.

3. Nipple-Areola Complex (NAC) Repositioning:
   • Surgeons may reposition and resize the nipples to achieve a more natural and proportional appearance on the masculinized chest.
4. Liposuction:
   • In some cases, liposuction may be used to remove excess fat and sculpt the chest for a more defined contour.
5. Informed Consent:
   • Individuals undergoing FTM chest surgery typically provide informed consent after thorough discussions with their healthcare providers. These discussions cover the surgical process, potential risks, expected outcomes, and post-operative care.
6. Pre-operative Assessments:
   • Before surgery, individuals undergo pre-operative assessments to ensure they are physically and psychologically prepared for the procedure. This may include medical examinations, laboratory tests, and mental health evaluations.
7. Recovery:
   • Recovery after FTM chest surgery involves a period of restricted activity, wearing compression garments, and attending follow-up appointments with the surgical team. Full recovery may take several weeks to months.
8. Post-Operative Care:
   • Patients receive post-operative care instructions, including information on wound care, pain management, and restrictions on physical activities during the initial healing period.
9. Potential Risks and Complications:
   • As with any surgery, FTM chest surgery carries potential risks and complications, including bleeding, infection, changes in sensation, and scarring. Surgeons discuss these risks during pre-operative consultations.

• Psychological Considerations:
  • FTM chest surgery is a significant step in the gender transition process, and individuals typically undergo psychological assessments and counseling before the procedure. It’s important for individuals to have realistic expectations and a clear understanding of the emotional aspects of the surgery.

FTM chest surgery can have a positive impact on the mental health and well-being of transgender and non-binary individuals, helping them feel more aligned with their gender identity. It’s crucial for individuals to work with experienced and qualified gender-affirming surgeons who can provide personalized guidance based on their unique anatomy and medical history. Open communication with healthcare providers and adherence to pre- and post-operative care instructions contribute to a successful surgical experience.

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Chest reconstruction

Chest reconstruction is a term used to describe surgical procedures aimed at altering the appearance of the chest, often as part of gender-affirming surgeries for transgender individuals or as a reconstructive procedure following trauma or surgery. The specific goals and techniques of chest reconstruction can vary depending on the individual’s needs and circumstances. Here are some key aspects of chest reconstruction:

1. Gender-Affirming Chest Reconstruction:
   • Purpose: For transgender individuals seeking gender affirmation, chest reconstruction involves altering the chest to align with their gender identity. It can include masculinizing or feminizing procedures.
   • Masculinizing Chest Reconstruction (MTF): For transgender women or non-binary individuals assigned male at birth, this may involve breast augmentation or chest contouring.
   • Feminizing Chest Reconstruction (FTM): For transgender men or non-binary individuals assigned female at birth, this may involve chest masculinization or top surgery.
2. Post-Mastectomy Reconstruction:
   • Purpose: Following mastectomy procedures, chest reconstruction is often performed to restore the chest’s appearance and contour.
   • Breast Reconstruction (After Breast Cancer Surgery): Women who undergo mastectomy for breast cancer may choose breast reconstruction to restore a more natural breast shape and appearance.
3. Types of Chest Reconstruction Procedures:
   • Double Incision (DI) Mastectomy (MTF): Involves removing breast tissue, excess skin, and repositioning the nipple-areola complex to create a more masculine chest contour.
   • Periareolar or Keyhole Mastectomy (MTF): Involves minimal scarring, with incisions made around the areola to remove breast tissue.
   • Breast Augmentation (MTF): Involves the placement of breast implants to enhance breast size.
   • Chest Masculinization (FTM Top Surgery): Involves removing breast tissue and reshaping the chest to create a more masculine appearance.
   • Breast Reconstruction (Post-Mastectomy): Involves creating a new breast mound using various techniques, including implant-based reconstruction or autologous tissue transfer.
4. Nipple and Areola Reconstruction:
   • Purpose: Following mastectomy or chest reconstruction, individuals may choose nipple and areola reconstruction to restore a natural appearance.
   • Techniques: Nipple and areola reconstruction may involve tattooing, grafting, or surgical techniques to create a realistic appearance.
5. Timing of Reconstruction:
   • Immediate Reconstruction: Some individuals undergo chest reconstruction immediately following mastectomy or gender-affirming surgery.
   • Delayed Reconstruction: Others may choose to delay reconstruction, allowing time for healing or making the decision at a later date.
6. Recovery:
   • Recovery after chest reconstruction varies depending on the specific procedure performed. It may involve a period of restricted activity, wearing compression garments, and attending follow-up appointments with the surgical team.
7. Psychological Considerations:
   • Chest reconstruction can have profound psychological effects, and individuals may undergo psychological assessments and counseling to ensure they are prepared for the procedure. Post-operative support is also crucial for emotional well-being.
8. Consultation and Planning:
   • Before chest reconstruction, individuals typically have thorough consultations with qualified surgeons. These discussions cover goals, expectations, and the specific surgical approach based on the individual’s anatomy and needs.

Chest reconstruction is a highly individualized process, and the choice of procedure depends on various factors, including gender identity, personal preferences, and medical considerations. It is crucial for individuals to work with experienced and qualified surgeons who specialize in the specific type of reconstruction they are seeking. Open communication with healthcare providers and adherence to pre- and post-operative care instructions contribute to a positive and satisfying outcome.

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Mastectomy for transgender individuals

Mastectomy for transgender individuals, often referred to as “top surgery,” is a gender-affirming surgical procedure designed to remove breast tissue and create a chest that aligns with the individual’s gender identity. This procedure is commonly chosen by transgender men or non-binary individuals assigned female at birth as part of their gender transition. Here are key details about mastectomy for transgender individuals:

1. Purpose:
   • The primary goal of mastectomy for transgender individuals is to achieve a more masculine chest appearance, helping individuals align their physical characteristics with their gender identity.
2. Surgical Techniques:
   • There are different surgical techniques for mastectomy in the context of transgender individuals, including:
     • Double Incision (DI) Mastectomy: Involves making horizontal incisions across the chest to remove breast tissue, excess skin, and reposition the nipple-areola complex.
     • Periareolar or Keyhole Mastectomy: Suitable for individuals with smaller breasts, this technique involves making incisions around the areola to remove breast tissue with minimal scarring.

3. Nipple-Areola Complex (NAC) Repositioning:
   • Surgeons may reposition and resize the nipples to achieve a more natural and proportional appearance on the masculinized chest.
4. Liposuction:
   • In some cases, liposuction may be used to remove excess fat and sculpt the chest for a more defined contour.
5. Informed Consent:
   • Individuals undergoing mastectomy for gender affirmation typically provide informed consent after thorough discussions with their healthcare providers. These discussions cover the surgical process, potential risks, expected outcomes, and post-operative care.
6. Pre-operative Assessments:
   • Before surgery, individuals undergo pre-operative assessments to ensure they are physically and psychologically prepared for the procedure. This may include medical examinations, laboratory tests, and mental health evaluations.
7. Recovery:
   • Recovery after mastectomy involves a period of restricted activity, wearing compression garments, and attending follow-up appointments with the surgical team. Full recovery may take several weeks to months.
8. Post-Operative Care:
   • Patients receive post-operative care instructions, including information on wound care, pain management, and restrictions on physical activities during the initial healing period.
9. Potential Risks and Complications:
   • As with any surgery, mastectomy for transgender individuals carries potential risks and complications, including bleeding, infection, changes in sensation, and scarring. Surgeons discuss these risks during pre-operative consultations.

• Psychological Considerations:
  • Mastectomy is a significant step in the gender transition process, and individuals typically undergo psychological assessments and counseling before the procedure. It’s important for individuals to have realistic expectations and a clear understanding of the emotional aspects of the surgery.

Mastectomy for transgender individuals can have a positive impact on mental health and well-being, helping individuals feel more aligned with their gender identity. It’s crucial for individuals to work with experienced and qualified gender-affirming surgeons who can provide personalized guidance based on their unique anatomy and medical history. Open communication with healthcare providers and adherence to pre- and post-operative care instructions contribute to a successful surgical experience.

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Gender confirmation surgery

Gender confirmation surgery, also known as gender-affirming surgery or sex reassignment surgery, refers to a set of medical procedures that individuals may undergo as part of their gender transition. These surgeries are designed to alter physical characteristics to align more closely with an individual’s gender identity. The specific procedures chosen can vary based on the individual’s goals, and not every transgender person pursues gender confirmation surgery. Here are some key aspects:

1. Top Surgery (Chest Masculinization or Breast Augmentation):

1. • Purpose: Depending on the desired outcome, individuals may opt for chest masculinization (removal of breast tissue for transgender men or non-binary individuals) or breast augmentation (implant placement for transgender women or non-binary individuals).
   • Surgical Techniques: Procedures may include double incision mastectomy, periareolar mastectomy, or breast augmentation.

1. Bottom Surgery (Genital Reconstruction or Confirmation):

1. • Purpose: To align the genitals with the individual’s gender identity.
   • MTF Bottom Surgery (Vaginoplasty): Involves creating a neovagina using penile and scrotal skin.
   • FTM Bottom Surgery (Phalloplasty or Metoidioplasty): Involves creating a neophallus using tissue grafts, often from the forearm or thigh.

1. Facial Feminization Surgery (FFS) or Facial Masculinization Surgery (FMS):

1. • Purpose: Altering facial features to create a more feminine or masculine appearance.
   • Procedures: May include forehead contouring, rhinoplasty, jaw reduction, and tracheal shave, among others.

1. Voice Feminization or Masculinization Surgery:

1. • Purpose: Modifying vocal pitch and resonance to align with the individual’s gender identity.
   • Techniques: Surgical procedures or voice training programs.

1. Tracheal Shave (Chondrolaryngoplasty):

1. • Purpose: Reducing the prominence of the Adam’s apple to create a more feminine appearance.

1. Laryngoplasty or Glottoplasty:

1. • Purpose: Surgical procedures to modify the larynx, affecting voice pitch and quality.

1. Hysterectomy and Oophorectomy:

1. • Purpose: Removal of the uterus and ovaries for transgender men or non-binary individuals assigned female at birth.

1. Orchiectomy:

1. • Purpose: Removal of the testicles, typically chosen by transgender women or non-binary individuals assigned male at birth.

1. Body Contouring and Liposuction:

1. • Purpose: Modifying body contours and redistributing fat for a more gender-affirming silhouette.

1. Post-Mastectomy Nipple and Areola Reconstruction:

1. • Purpose: To restore a natural appearance following mastectomy.

1. Nipple and Areola Reconstruction (Post-Mastectomy):

1. • Purpose: Creating realistic nipples and areolas following mastectomy.

1. Timing of Surgery:

1. • Pre-Puberty: Some individuals undergo puberty blockers to delay the onset of puberty until they can make more informed decisions about gender-affirming procedures.
   • Post-Puberty: Surgeries may be performed after an individual has reached a certain age and met the criteria established by healthcare professionals.