Subcutaneous Mastectomy
Top surgery for transmale individuals is a procedure to remove breast tissue (subcutaneous mastectomy). It is also called masculinizing chest surgery. The surgery can help nonbinary individuals transition physically to their self-affirmed gender and can help reduce gender dysphoria.
If your breast size is small, you might be able to have surgery that spares your skin, nipple, and areola. This type of surgery is called nipple-sparing subcutaneous mastectomy. If you have larger breasts, you might need to have your nipples and areolas taken off, resized, and placed back into position.
The techniques Dr Kanhai uses for the subcutaneous mastectomy:
- donut procedures
- inverted-T
- vertical technique
- free nipple transfer
- wise pattern
- liposuction
What to expect
Pre-operative:
- Bring a list of your questions and concerns to your pre-operative visits. Understanding the expectation for recovery, based on your plan, is essential.
- You will need surgery referral letters from two qualified mental health professionals.
- You will be given guidelines on eating, drinking and adjusting current medications before the surgery can take place.
- Smoking is a relative contra-indication to subcutaneous mastectomy. Because of the increased risk of infection i.a., you are advised to stop smoking as soon as possible.
- After you have discussed which surgery technique is best for you, Dr Kanhai will draw up a plan for the operation.
- The anaesthesiologist will provide information on the anaesthesia, and doctor Kanhai about the type of the operation, and the follow-up procedures that might be necessary.
- Dr Kanhai will also ask about any risk factors for blood clotting issues (past deep vein thrombosis or pulmonary embolism), bleeding problems (like haemophilia), or family/personal history of issues with anaesthesia.
- You will undergo a physical examination to ensure readiness for the operation.
Peri-operative:
- We will give you general anaesthesia through a vein in your arm. You will be asleep throughout the procedure and won’t feel any pain during surgery.
- After marking the surgical site, Dr Kanhai will make an incision depending on the chosen technique.
- Then the breast tissue will be removed.
- Dr Kanhai places drainage tubes inside the breast before closing the incision with sutures. The tubes will help to remove any fluids accumulating in the surgical site, to prevent complications.
- Dr Kanhai stitches up the incision and covers the site with a bandage that wraps around your chest.
Post-operative:
- After the subcutaneous mastectomy, post-operative discomfort can be moderate to mild. We will provide pain medication to relieve some of the discomfort.
- If all goes well, you will be discharged 1 day after the surgery. Sometimes the drains need to stay in for longer.
- Bruising and swelling in the chest area may persist for 2 to 3 weeks. That is why it is important to wear your bandage for at least 2 weeks.
- During the first 2 weeks following the surgery, you should avoid using your arms as much as possible.
- After 2 weeks, you may resume your daily activities. Vigorous exercise and weight lifting can be resumed at 6 to 8 weeks post-surgery. You should consult Dr Kanhai for care and guidance to cater to your specific situation.
- Do not tan or expose the scars from the subcutaneous mastectomy to prolonged sunlight for 1 year.
- Scars from the surgery are permanent, but should fade over time. This can take up to 1 year.
