Top Surgery vs. Gynecomastia Procedures

[zombieinc]

One of my biggest issues (if not THE biggest issue for me) is my chest. Over the years, my chest has caused me a lot of mindscrewing bad times. I am overweight and come from a family of big chested women. I myself do not have a big chest. On a good day, I'm a large B/small C. However, as I've looked at top surgery pics online, I have yet to find any FTM who has a chest that is similar to mine. I've found that my chest looks masculine and that my breasts resemble those of men with severe gynecomastia more than anything else.

My breasts are pointed and sit lower on my chest. I can feel and see the tops of pecs over my breasts. I also have some underarm fat that resembles what a lot of overweight guys have. It isn't bra-bulge or post-binding tissue redistribution.

When I see the pictures of guys who have had gynecomastia procedures done, they look much nicer than those of FTMs. Some FTMs have great results, but the only way to avoid the scars is peri and that is only an option for those who have small breasts to begin with.  Peri is not a guarantee that you'll end up with a great looking chest either. Many guys get peris and have to have revisions.

So what's the difference between male gynecomastia surgery and FTM top surgery? How come FTM's usually end up with scars and most of the gynecomastia guys don't? Why can't/don't FTMs get the same procedures as guys with gynecomastia?

My last question is about underarm fat. Has anyone had this removed along with a top surgery procedure?

Thanks in advance for any answers or help.

[aleon515]

I'm going to guess that most guys with gynecomastia just have some lip done perhaps similar to a keyhole.
There is little scarring with that. It is pretty unusual for guys with this condition to need something as radical as a DI. I imagine you might see better jobs, as what you might pull from google images is work that looks better (say what doctors want to put on their websites). I have seen extreme cases of gynecomastia, but not what is done about it. So I don't believe doctors who do top surgery are somehow "worse" at it. If you have a more masculine chest, you probably are going to look better than average.

As for fat under the arms. They will do lipo if you need it and probably if you ask for it.

--Jay

[Adam (birkin)]

I think Jay is right, most guys with gyne only need to have the equivalent of keyhole or peri. I personally am bigger chested and I have a consult with a gyne surgeon in March. I plan to ask him about things like nipple placement, scar placement, etc and see how it compares to the procedures done by those who specifically do FTM procedures. I heard he has worked with at least one FTM before and the guy was pretty happy with his results.

[Bimmer Guy]

I agree with Jay and Caleb.  I believe it is mostly just liposuction.  The other thing is that you will not get the opportunity for free nipple grafts like you would with double incision.  If you have a low hanging chest/nipples, you may not be satistied.  That is one of the reasons/determinations for doing keyhole/peri.

I know that in some cases of what people describe as "underarm fat", physicians consider to be connected to your back (therefore, "back fat"), which requires a second surgery.  Make sure you ask your doc, as Jay says.

There is certainly no downside to having a consult with a physician who does a lot of gyne work.  If you can't someone who does a lot of these surgeries (I don't think it is a speciality), look for a surgeon whose specialty is breast reductions; this way you will have a surgeon who is used to working with this part of the body regularly.

[zombieinc]

Here are some photos of Dr. Blau's patients: http://www.gynecomastiausa.com/photos/severe_cases/

Some of these guys have pretty noticeable chesticles. Some of them have had extra revisions to move nipples, get rid of excess skin, etc.

I think that my underarm fat probably does qualify as back fat. I am concerned that perhaps some it is breast tissue though. It breaks out frequently, so if I were going to have chest work done, I would want to get that taken care of as well.

Where I am currently living, there are a few surgeons who specialize in gynecomastia and breast reductions, but none who specialize in FTM tops. Not that top surgery is a realistic possibility at the moment. I've got to get my finances in order before I can consider it and even then, I am unsure that I will be able to obtain it.

Has anyone gotten top surgery before or w/o hormones and therapy?

[aleon515]

Here are some photos of Dr. Blau's patients: http://www.gynecomastiausa.com/photos/severe_cases/

Some of these guys have pretty noticeable chesticles. Some of them have had extra revisions to move nipples, get rid of excess skin, etc.

I think that my underarm fat probably does qualify as back fat. I am concerned that perhaps some it is breast tissue though. It breaks out frequently, so if I were going to have chest work done, I would want to get that taken care of as well.

Where I am currently living, there are a few surgeons who specialize in gynecomastia and breast reductions, but none who specialize in FTM tops. Not that top surgery is a realistic possibility at the moment. I've got to get my finances in order before I can consider it and even then, I am unsure that I will be able to obtain it.

Has anyone gotten top surgery before or w/o hormones and therapy?

I don't know but I was not so impressed with the guys who would (if they wore bras) have to wear a c cup. I thought he left a LOT of tissue. Patient 2, looks like a lot of us might look. But I thought there was a lot of chesticle left and I wouldn't be so happy to be at the beach, though it is an improvement, obviously. The guy was 63, so I am sure he is pretty delighted. But most of them had a LOT smaller areolas than what we would have with the same size. For instance, patient 6 has maybe a B-C cup but very tiny areolas. The other thing is a lot of us have larger nipples as well. IF all you need is a keyhole they can cut around the areola and nipple and they can cut the size down. Sometimes they do that in two surgeries. But if you have that done, it will look like the guy's better work without a lot of scarring, if you go to a doctor who is good at the keyhole procedure, which is not at all cheaper btw. You should not look for a bargain deal for keyhole. I agree though that consulting with a surgeon who does these is a good idea. At least not a negative, most plastic surgeons do free consults.

Well if it is in the back then that is really a separate thing but as breast tissue they can remove that, but some might charge more. It will also make your healing less comfortable. I was very happy not to need lipo, as I have heard it can ache like crazy.

Obviously if you need the DI procedure, there is a scar. Esp if you are a  younger guy, the scar is going to fade a lot. Even with me, and I am not younger, it has still faded in about two months. Also if you have normal hair growth (like I do NOT), you are going to grow chest hair and it is going to hide the scars a lot. I suggest you look at youtube videos of one year post op and look at someone with a better surgeon like Dr G or Medalie or... there are a lot of other names.

--Jay

[zombieinc]

I am not impressed with Dr. Blau's work myself. I linked to his gallery though because it includes a wide sample of men with gynecomastia. It's a decent reference for that, I believe. And it also gives some idea of what an individual like myself with a midsized and more masculinized chest could realistically expect. Or so I'd like to think, fwiw.

I am in my late 20s. Aiming at having top surgery within the next 3 years, depending on finances. Right now, I have not been on T. I have an intersex condition and I also took DHEA for a long time when I was younger. Both of these things have led me down the path to Hair City, so to speak. Pretty sure that if I did take T, I would be hairy. However, I scar easily. I already have some acne scarring on my chest and in my armpit areas to contend with.

The nipple thing concerns me. I do have larger nipples that are not masculine at all. I would definitely need some sort of reduction in that area. Right now, I need to get into better shape. I don't want to have liposuction, or massive amounts of extra work done to my chest due to my weight.

Thanks for all the advice.

[Alexthecat]

You don't need to be on T. I just had top surgery with no T.

[Declan.]

I may be alone in this, but I like his results. We live in an area with a lot of beaches, and I've seen thousands of shirtless guys of all shapes and sizes. The only truly flat-chested men I've seen are thin/lean. I'm not a skinny guy and have no desire for the chest of someone 50 pounds less than me, lol. I don't know, just my perspective I guess.

[Bimmer Guy]

I'm another person who is not on T, but had top surgery (10/2013).

[Sir Wafflinton]

I may be alone in this, but I like his results. We live in an area with a lot of beaches, and I've seen thousands of shirtless guys of all shapes and sizes. The only truly flat-chested men I've seen are thin/lean. I'm not a skinny guy and have no desire for the chest of someone 50 pounds less than me, lol. I don't know, just my perspective I guess.

I second this. These men have been given chests that look normal for someone of their body weights. Patient 15, for example, looks very much like an ftm guy, however an ftm guy with c cups wouldn't have a chance of getting a peri. I mean, the guy hasn't ended up with the chest of a male model, but given his body weight it looks entirely normal post op (and would raise much fewer eyebrows shirtless than someone with big DI scars).

[Declan.]

I second this. These men have been given chests that look normal for someone of their body weights. Patient 15, for example, looks very much like an ftm guy, however an ftm guy with c cups wouldn't have a chance of getting a peri. I mean, the guy hasn't ended up with the chest of a male model, but given his body weight it looks entirely normal post op (and would raise much fewer eyebrows shirtless than someone with big DI scars).

Agreed... I don't personally see any that don't look right to me (as long as you take weight into account). DI scars could be an issue in the future with more and more trans men coming out. Chaz, for example, is shirtless fairly frequently and has obvious DI scars. People catch on fast, and the last thing I want is to stick out if I go out without a shirt. I'm going to consider this procedure instead of "traditional" top surgery, I think.

[zombieinc]

In my case, I have a hunch that I would be a slow healer and would most likely get serious and gnarly scars. I also don't want to have all of these questions about my scars. I want to be able to pass with no questions asked. Right now, it isn't a huge deal, but I agree with DCQ that as more FTM and genderqueer persons opt to have top surgeries, it may make being stealth more difficult.

There is a great deal of variance between body types. I think that tumblr and youtube lead a lot FTM guys thinking that we are all going to look like skinny prepubescent twink twigs or muscled beefcakes after top surgery. Truth is, not all guys look great without their shirts on. Some guys have moobs, others have back fat and some have so much fur that you can't tell what's underneath. So I think it is important to keep a realistic perspective on things. If you're a bigger guy, a perfectly flat chest may look odd on you. If you have bigger breasts, you probably aren't going to be able to avoid evasive top surgery procedures. Them's the facts, it seems.

Further research into top surgery and gynecomastia procedures has yielded some other fruit. Apparently, bioguys with gynecomastia also get DIs when the case is severe enough. It is pretty rare for this to happen though.

[Adam (birkin)]

I agree with the comment on people showing off scars making it harder to be stealth. I personally will not show anyone my scars unless I really believe that for whatever reason, my case is exceptionally different and could provide education. That being said though, people are only going to see the scars and make the *assumption* that it means someone is FTM. I have seen pictures of cis men who had severe gynecomastia and have scars that are like FTM scars. Other surgeries can create similar scars as well.

[LordKAT]

I have so many scars on my gut and chest that 2 more shouldn't make much difference.

[aleon515]

I personally don't think that the average person is all that aware of what scars different surgeries cause. Sure Chaz Bono might go shirtless, but not sure everybody understands all this on the level that you might think. People are just not that into YOU, they are more concerned with their own stuff and in their own little world.

I can see it is as a reason I guess, but not all of us are heavy enough that we could like the looks of having obvious moobs like that .It would have looked quite odd on me. But yet again, I think it's more for ME because not sure other people even care that much.

--Jay

[Declan.]

Which ones have obvious moobs to you, if I might ask? To me, they just look like guys. I don't know any guys that have perfectly flat, shapely pecs unless the rest of their bodies are like that. The ones with some extra fat on their chests have extra fat everywhere, and it looks like building muscle would eliminate that.

[aleon515]

There were a few 2,6,8 for instance, where an overweight guy or very large guy could get away with this, but I couldn't. It's okay for them, but I wouldn't like it for myself. I'm not a large guy it would stand out. I looked like 6 maybe before.

BTW, I don't particularly like getting in an argument about this sort of thing. It's your body and whatever it is that would make you happy, well that's okay by me. Cis guys aren't flat necessarily so if it works it's fine. I should say that for ME, I wouldn't like it and I don't think it works .That's a real picture of me and you can see I'm small and have a very small frame.

--Jay

[Sir Wafflinton]

I have seen pictures of cis men who had severe gynecomastia and have scars that are like FTM scars. Other surgeries can create similar scars as well.

For me I don't worry so much about being outed by my scars, because I really don't think that would be likely in my case. It is more that I want to be able to go to the beach or the pool with my mates and not have a chest that is so obviously different. I don't want to get dressed in the morning 30 years from now and still be reminded of a time when that part of my body caused me so much discomfort. For me, not wanting the scars is as deeply personal as wanting top surgery in the first place (although obviously less important, if DI was my only option I'd take it in a heartbeat). Funnily enough the though of minor puckering or slight loose skin doesn't really bother me that much at all. Maybe it is because I am young and have plenty of time for revisions if I feel they are nessaccary, but once you have DI scars they are there for good  I don't really know

I think it is good to keep an open mind. I contacted a gynecomastia surgeon yesterday asking whether he had operated on severely affected patients before and am still waiting on a reply. Ideally I'd have something like this done:
http://sacramentogynecomastia.blogspot.com.au/2013/09/severe-gynecomastia-male-breast-and-two.html
My case is less severe than that man's but too severe to qualify for a simple peri w purse string.

"Many surgeons would advise to perform a mastectomy for the removal of this vast amount of skin and breast tissue. The treatment would be a successful  but would result in large scars across his chest.  This would defeat the purpose of the this young man wanting to take of his shirt and go swimming or other events with his family." Sounds about right 

[zombieinc]

Ideally I'd have something like this done:
http://sacramentogynecomastia.blogspot.com.au/2013/09/severe-gynecomastia-male-breast-and-two.html
My case is less severe than that man's but too severe to qualify for a simple peri w purse string.

"Many surgeons would advise to perform a mastectomy for the removal of this vast amount of skin and breast tissue. The treatment would be a successful  but would result in large scars across his chest.  This would defeat the purpose of the this young man wanting to take of his shirt and go swimming or other events with his family." Sounds about right 

That's what I'm talking about. Thing is, it's done in multiple procedures, which may not be up everyone's ally. The results are much better than what you get with most DI or keyholes, imho. That guys nipples make mine look like child's play, for real. I think his chest is probably about the same size as mine as well. Nice find, Sir Wafflinton.