Top Surgery vs. Gynecomastia Procedures

[aleon515]

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. 

It's definitely an interesting procedure. Obviously it is kind of something that is not typically done. And a multiple procedure might not be my cup of tea, still might be worth pursuing if your concern is really the scars. Seems like it does a good job of dealing with that. You can always contact him about being a trans guy, and find out what he charges.

--Jay

[LordKAT]

I like this possibility. Long as you don't need the nipple itself resized.

[aleon515]

I like this possibility. Long as you don't need the nipple itself resized.

Perhaps he could do this a little with this. My nipple size was decreased a LOT. But there are surgeons that don't do this so much. I am not as happy with how this looks. It does look like though the guy's areolas are very large, the nipples themselves are quite small.

--Jay

[Sir Wafflinton]

It's definitely an interesting procedure. Obviously it is kind of something that is not typically done. And a multiple procedure might not be my cup of tea, still might be worth pursuing if your concern is really the scars. Seems like it does a good job of dealing with that. You can always contact him about being a trans guy, and find out what he charges.

--Jay

Unfortunately I am on the other side of the planet so I'll have to do a bit more hunting around, but it could be an idea for the OP (if you do contact him, can you keep me updated because I would be very interesting to see how things would turn out). I can completely understand not wanting a multi stage procedure, just wanting them gone and it finished with, but for me it would be worth it.

All the actual tissue is removed in the first stage so all you have is saggy skin. This would mean you wouldn't have to bind, and if you were worried about any bulging an undershirt would do fine which would be such a massive relief for me. I'm not comfortable enough with my fat redistribution (it hasn't really started yet) to be walking around shirtless even with full top surgery yet anyway, and I have a feeling as long as I don't have a "female" chest my dysphoria will be much better anyway so there wouldn't be much to lose 

[Sir Wafflinton]

oh, and I read somewhere (citation needed) the nipple can be resized later under local even if it isn't done in the original op, but I see no reason why the dr wouldn't do it on one of the stages.

[zombieinc]

Unfortunately I am on the other side of the planet so I'll have to do a bit more hunting around, but it could be an idea for the OP (if you do contact him, can you keep me updated because I would be very interesting to see how things would turn out). I can completely understand not wanting a multi stage procedure, just wanting them gone and it finished with, but for me it would be worth it.

All the actual tissue is removed in the first stage so all you have is saggy skin. This would mean you wouldn't have to bind, and if you were worried about any bulging an undershirt would do fine which would be such a massive relief for me. I'm not comfortable enough with my fat redistribution (it hasn't really started yet) to be walking around shirtless even with full top surgery yet anyway, and I have a feeling as long as I don't have a "female" chest my dysphoria will be much better anyway so there wouldn't be much to lose 

Perhaps I will contact him next week for heck of it and let you all know what he says. Wasn't that surgeon in another country though, like Australia? I'm in the US, so if that's the case...

The extra skin would be akin to what a lot of overweight guys have after they begin to lose weight. My father had gastric bypass surgery a few months ago and now he has some excess skin in his chest and upper back area.

I think that if you wanted/needed any nipple or areola work done, that could be addressed during the second stage of skin removal. Another possible advantage to having this sort of procedure done might be the retention of more nerve tissue and sensation in the nipple area. I liked the end result in the picture and imagine that is what most guys 'round here are aiming for: as little scarring as possible with realistic results.

[Sir Wafflinton]

A quick check of the blog says Sacramento, California. If this were in Aus I'd already have a booking

I agree that the result of stage one looks like dramatic weight loss. I am pretty skinny and young enough that people wouldn't expect that but I think with a regular t shirt on people (at worst) would just assume I had minor gyneocomastia which is really common in teenage guys anyway.

I think the thing to remember is "realistic" isn't always "perfectly aesthetic." With a well done DI people get chests of a very fit, healthy and genetically gifted man (small, perfectly positioned nipples and a well sculpted chest) with the downside of it being obvious an operation has taken place. Most surgeons who do DI make the nipples smaller than most cis guys because that is considered more attractive. Comparing this (or keyhole ftm surgery) to DI is a false standard because most cis guys carry a bit of fat in their chest or don't have tiny areolae or have nipples in a weird position or any of the other bodily quirks of humanity. I can absolutely see the appeal of the DI but I'd choose looking like the majority of men and not have obvious surgery scars any day.

[Adam (birkin)]

I think the thing to remember is "realistic" isn't always "perfectly aesthetic." With a well done DI people get chests of a very fit, healthy and genetically gifted man (small, perfectly positioned nipples and a well sculpted chest) with the downside of it being obvious an operation has taken place. Most surgeons who do DI make the nipples smaller than most cis guys because that is considered more attractive. Comparing this (or keyhole ftm surgery) to DI is a false standard because most cis guys carry a bit of fat in their chest or don't have tiny areolae or have nipples in a weird position or any of the other bodily quirks of humanity. I can absolutely see the appeal of the DI but I'd choose looking like the majority of men and not have obvious surgery scars any day.

This is exactly what it comes down to for me. I hope that one day I can take my shirt off, and look like a dude with a less-than-model like chest than a transsexual. People are starting to recognize the scars because they're all over the place now.

[AdamMLP]

I'm kind of wondering where everyone's always seeing scars from DI.  Aside from looking for them intentionally online I've never seen one, so I can't imagine where a cis person would see one.  Even on programs like "My Transsexual Summer" I can't remember them showing top surgery results, although I might be wrong as it was a long time ago that I watched it.  I've only ever heard of one case where someone was recognised by their scars, and that was because they were topless in a bar and happened to get talking to a medical professional.  I think that happened anyway, I might be making the entire thing up.

At the end of the day it's down to you what you want, providing you can access it.  I think I've heard of some people going to gynecomastica doctors for their surgery when there hadn't been much else available, but they've always had basically DI results, or the one which looks like an inverted T.  Wouldn't the presence of more breast tissue cause a problem here?

[Alexthecat]

I thought the major difference was in a DI they scoop out the breast cap that makes the milk. In just a Gyn they don't have that milk parts to worry about.

[CursedFireDean]

I've only ever heard of one case where someone was recognised by their scars, and that was because they were topless in a bar and happened to get talking to a medical professional.  I think that happened anyway, I might be making the entire thing up.

It was a guy on youtube, I remember watching his video. I tried finding it again just now, but I can't remember what the main part of the video was about.

[AdamMLP]

It was a guy on youtube, I remember watching his video. I tried finding it again just now, but I can't remember what the main part of the video was about.

The memories come back to me now, I was wrong about the doctor part, he was just a person who knew a lot about various surgeries.  By some miracle our work wifi allowed me to watch a video (normally it blocks the videos but not the webpage) so I could check I was posting the right video.

http://youtu.be/7OpmjY0XgA8?t=4m

[Bimmer Guy]

A quick check of the blog says Sacramento, California. If this were in Aus I'd already have a booking

I agree that the result of stage one looks like dramatic weight loss. I am pretty skinny and young enough that people wouldn't expect that but I think with a regular t shirt on people (at worst) would just assume I had minor gyneocomastia which is really common in teenage guys anyway.

I think the thing to remember is "realistic" isn't always "perfectly aesthetic." With a well done DI people get chests of a very fit, healthy and genetically gifted man (small, perfectly positioned nipples and a well sculpted chest) with the downside of it being obvious an operation has taken place. Most surgeons who do DI make the nipples smaller than most cis guys because that is considered more attractive. Comparing this (or keyhole ftm surgery) to DI is a false standard because most cis guys carry a bit of fat in their chest or don't have tiny areolae or have nipples in a weird position or any of the other bodily quirks of humanity. I can absolutely see the appeal of the DI but I'd choose looking like the majority of men and not have obvious surgery scars any day.

I don't know of any other surgeon who says that he/she makes the areolas smaller than "average", other than Garramone (of course their size is still within the norm of bio males).  Most use a tool to cut out the correct size.  What surgeons are you referring to?  Additionally, your top surgeon can easily adjust where you would like your areolas placed (if you want them placed in a "weird position" for some reason?) and I am sure they will cut them down to the size you would like, as well.

I saw one genderqueer person who had Garramone keep them much larger than the average cis male as this person  identifies as being in the "middle" on gender and wanted their chest to reflect this.  Moreover, I am sure your top surgeon would be willing to leave excess tissue if you would like he/she to do so (if you are overweight).  I do understand why this would make sense.  I remember in the past (8 years ago?), reading that this was something the surgeons paid attention to, but I agree I don't see it out there. 

The other thing you might want to consider is contacting a top surgeon and asking them if they would do the gyne surgery on you. 

I would be interested to know why top surgeons have discarded the gyne surgery approach for FTMs.  Obviously, a top surgeon's goal would be to create female to male chests with the least scars possible.  I don't really think surgeons decided years ago that they didn't give a flip and the DIs were easier, so they just went with them.  I'm sure they discarded the gyne approach for a reason.

If the bottom line for you is about scars I get that, but it doesn't make sense to me that you would see any negatives to the areolas being placed in the correct position for a male chest and having your areolas cut down to the average bio male's size.  I guess I don't understand why your argument against DI would include correct areola size and positioning.

[Adam (birkin)]

I'm kind of wondering where everyone's always seeing scars from DI.

I've seen a lot of reblogs on Facebook, Tumblr, and a lot of guys on YouTube - which have considerable amounts of likes (like I'm talking more than 10K in some cases), so a lot of people are able to see if their friends liked them and so on. So, I suppose in a way, someone would only be familiar with them if they went looking for trans stuff online in the first place. Still though, it makes me pretty uncomfortable, because not everyone who knows a lot about trans stuff has the best intentions.

The memories come back to me now, I was wrong about the doctor part, he was just a person who knew a lot about various surgeries.  By some miracle our work wifi allowed me to watch a video (normally it blocks the videos but not the webpage) so I could check I was posting the right video.

Interesting. The guy did make a good point, which is that people don't know it's from a transsexual surgery. They could assume or have a hunch but they don't actually know.

[aleon515]

I would gather that if you have large sized chesticles the average gynecomastia would be close to what a DI is. I am pretty sure that's where the FTM docs got the idea from, because it clearly is not what is done in a typical mastectomy, so they didn't get teh idea there. It seems like there could be other possible surgeries. That one doctor shows-- I don't know as he looks like a sort of gynecomastia doctor that people go to from all over. And if you are already a plus size guy, heck you could go get a peri. I imagine most docs would tell you realistically what you might look like. I'm sure there are doctors in Australia though, so, why not just ask.

My understanding is that there is something they can do for nipple and areola size during a peri but that there are limitations. If that's what you want, fine. But I understand there is only so much and they'd have to resize at a second surgery. I don't know at all what those limitations are so you'd have to talk to a surgeon. Since revisions are typical....

Someone like Dr G doesn't do a random tiny areola. It's probably an average of size and position for a cis guy. If you wanted them somewhere else, as Brett talks about, I'm sure that a doctor would be happy to oblige, if it's doable. (Someone I know asked if he could have a oval areolas, and he said no, because they tend to pull that way in a lot of cases-- so he felt it wouldn't work).

Unless you corrected an earlier post, the video is correct. And is very true and funny. I have known few people having problems with scars or discussion. But I do understand some people could have some degree of dysphoria over having to have the surgery. Fortunately hasn't been the case for me. In fact, almost can't remember ever having chesticles. Strange considering how long I had them.

The video of Jonathan, oh hilarious "Noooo!"  "Yesss"  "Nooooh" "Yeesss".

--Jay

[JLT1]

Gentlemen,

I had gynecomastia throughout most of my life.  It was during a consultation on my hormone difficulties and having my breasts removed that I gave into my own gender issues.  So, I am coming at this from the other side of this question: gynecomastia.

A young man who has gyno has a small quantity of mammary tissue. Typically, a little below and just outside the nipple. I suspect that many men here have or had quite a bit of that tissue and it is much more diffuse.  The surgery is therefore different because it is perceived by doctors that every last bit of that tissue must be removed to prevent the future possibility of breast cancer.  Therefore, top surgery is similar to a double mastectomy, where there is quite a bit of scaring.  In a gyno surgery, it's get rid of the small amount of breast tissue and the fat.  Because of the quantity and location of all the mammary tissue, there will be larger scars for top surgery.

Having said all of that, I cannot, in any way understand the level of scaring I have seen in some men.  To me, that is just poor technique.  I believe that if more men would rightly express their problem with the current level of scarring, the level of scarring would decrease.

I wish you all well.

Jen

[aleon515]

Gentlemen,
...of breast cancer.  Therefore, top surgery is similar to a double mastectomy, where there is quite a bit of scaring.  In a gyno surgery, it's get rid of the small amount of breast tissue and the fat.  Because of the quantity and location of all the mammary tissue, there will be larger scars for top surgery.

Having said all of that, I cannot, in any way understand the level of scaring I have seen in some men.  To me, that is just poor technique.  I believe that if more men would rightly express their problem with the current level of scarring, the level of scarring would decrease.

I wish you all well.
qu
Jen

I don't actually know what kind of scarring you are talking about above. But the one or two long thin scars running along the chest are typical of the double incision procedure. It's not bad technique. They are essentially removing two organs. There is fat, tissue, duct work, etc.

I am pretty sure the technique is taken from treating very severe gynecomastia.  There are lesser procedures if there is not so much tissue there, but maybe for 90% of us that's the technique. A simple procedure of lipo or whatever will not work. There might be other things to try (that two phase technique might work for some of us, for instance, not all). There is also the problem that in very severe gynecomastia there is a lot of times obesity. But with us that is not the case at all.

I feel a lot better about the scars than I did having the chesticles. I feel that they will get lighter (already have), but that even if they didn't I already feel more comfortable in my body. Not every guy worries about that the same things, or has the same sorts of dysphorias.


--Jay

[Sir Wafflinton]

If the bottom line for you is about scars I get that, but it doesn't make sense to me that you would see any negatives to the areolas being placed in the correct position for a male chest and having your areolas cut down to the average bio male's size.  I guess I don't understand why your argument against DI would include correct areola size and positioning.

It doesn't, and I wanted to clarify that I don't think the DI produces a bad result, it just isn't for me. Obviously a surgeon would aim for the best looking chest possible. I was just stating that a large chunk of cis-guys don't have "correct areola size and positioning" so for me as long as it within a normal male range things like scars are a bigger priority.

[JLT1]

I don't actually know what kind of scarring you are talking about above. But the one or two long thin scars running along the chest are typical of the double incision procedure. It's not bad technique. They are essentially removing two organs. There is fat, tissue, duct work, etc.

I am pretty sure the technique is taken from treating very severe gynecomastia.  There are lesser procedures if there is not so much tissue there, but maybe for 90% of us that's the technique. A simple procedure of lipo or whatever will not work. There might be other things to try (that two phase technique might work for some of us, for instance, not all). There is also the problem that in very severe gynecomastia there is a lot of times obesity. But with us that is not the case at all.

I feel a lot better about the scars than I did having the chesticles. I feel that they will get lighter (already have), but that even if they didn't I already feel more comfortable in my body. Not every guy worries about that the same things, or has the same sorts of dysphorias.


--Jay

In 1998, the first time I went to a surgeon to discuss removing my breasts, I was a 42C and the incision would have started 2" from the center of the nipple, ran horizontally to the nipple, encircled ½ nipple (around the bottom) and then 2" out the other side.  It would have looked kind like a distorted up right horse-shoe with the open part of the shoe going under the nipple and the top of the shoe on each side being 2" long.  It would have dropped the nipple down to nearer the bottom of my pecks and at least part of the scar would have been hidden.  What remained would have been much thinner than I have seen in pictures of top surgery.  (Comparison with pictures from Dr Garramone's web site.)  In 2011, I was a 46C and I went to a different surgeon but had the same description.  My nipples were small female or large male. 

Lipo does not work when mammary tissue is present. 

I can understand geting rid of parts that don't match one's gender. 


Jen 

[Jack_M]

Honestly, IMO I think you're clutching at straws at your size. I also think you're likely looking at too many pics of either recent scars or just scars from people that haven't bothered much with minimising the scars. Also, cameras do tend to make them redder than they really are. I'm only 1 month post op and despite complications, my scars are looking fantastic. They're a little pink but they're very fine and fading nicely. I can only imagine how great they'll look in a year's time. Also, incidentally, my friend was changing in the same room as me for Taekwon-do and he has no idea I'm trans and never questioned the scars.  Just asked how I was with regards to range of motion.  Not everyone is nosey or jumps straight to thinking you're trans. There's some procedures independent of top surgery, like ops for lungs or tumours that could result in the same scars.  Also with them being on your chest and you being a bloke and all, you can easy say, "I'd rather not talk about it, mate!" In a way that implies you don't want to talk about a possible weak spot. I've had folks at work ask what surgery I had having seen my new drain (harder to hide) and I just said it was some surgery on my right chest, nothing major. And no one pushes me for information. And even if they did, so what? You don't have to answer anything you don't want to. I think far too many people assume they have to give people an explanation all the time. We all know top surgery and top surgery scars, but regardless of how much it's out there now well over 90% of everyday folks are 100% ignorant of what those scars mean. And anyway, put yourself in their shoes, how many people are going to push people to reveal more about a surgery after they've answered the first question about it?  It's like someone asking what flavour of ice cream you like and you say vanilla. That's your answer. You don't expect that person to start asking why you like vanilla, or what specific brand of vanilla you like, and even if they did, you wouldn't HAVE to say!

Even with all that said and done, if you take care of the scars early on, a lot of people have fine pale lines, easily covered by hair or pec muscles, but barely noticed even without. And most people stop posting pics after the beginning stages of healing. I've seen many top surgery results in person from a year or so on, and you can't tell.

Gynecomastia and top surgery are just entirely different procedures. And very few guys get the type of surgery you're taking about at your size. Nipple placement alone would be a major issue for anything over a B, even more so for a female chest where they'll likely be much lower than a male chest with gynecomastia. Only small Bs at a push qualify for peri for a reason. You're talking fat VS breast tissue.

Get in touch with the doc before you get too excited.  I'd be extremely dubious going to anyone who isn't specific to top surgery though. At your size you're also more likely to end up with a DI approach being recommended. I've seen small Bs end up with poor results from peris and several revisions down the line just resigned to having less than perfect results. I couldn't imagine going with someone not specialising in top surgery, at your size, and expecting decent results. It honestly sounds like a disaster waiting to happen so I say tread carefully before you jump into the idea of a multi stage procedure from someone not specialised in that area. In fact I'd go as far to say that just that alone might well be a reason for them to say no.