Top Surgery vs. Gynecomastia Procedures

[Sir Wafflinton]

Did you actually look at the link I posted? It was an incision (around the areola) not lipo, so the type of tissue shouldn't matter. Even if it did the site specifically says there was a "vast amount of skin and breast tissue." And the guy had the biggest areolae I have ever seen man, woman, cis or trans and the surgeon got them down to a male size and put them in a male position.

I don't know if you were responding to me or not (sorry if you weren't) but I did write up the reasons why I wasn't happy with the scarring and stated it had nothing to do with fear of being outed by my scars.

I don't see anything wrong with trying different things in the hope of making progress.

[Bimmer Guy]

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.

Got it.

As an aside, I think that Jack was probably speaking to the ZombieInc, the OP.

[zombieinc]

Wow, there's been a lot of activity...

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.

Originally, I was just pondering the idea. I am not opposed to scars, but in my case, I fear that the healing process won't be as smooth as some. I also know that I will have to undergo lipo under my arms and on my upper back at some point due to weight issues.

I am trying to lose weight now so that when I am ready for top surgery, I will have a chance at having better results.

As for nipple placement, that's a bridge I'd cross when I came to it.

Did you actually look at the link I posted? It was an incision (around the areola) not lipo, so the type of tissue shouldn't matter. Even if it did the site specifically says there was a "vast amount of skin and breast tissue." And the guy had the biggest areolae I have ever seen man, woman, cis or trans and the surgeon got them down to a male size and put them in a male position.

I think that the procedure shown in the link produced an excellent result for that patient. And the guy did have huge areolae and decent sized nips as well, bigger than mine and some have said that I am "blessed" in that department. I'm not a surgeon though and maybe there are concerns that a layperson can't discern from pics on the internet. Maybe this surgery would not be feasible for an FTM person.

If this procedure could be performed on FTM transpersons, I would vastly prefer to have it done vs. a DI. Not just for aesthetic reasons, but because I think that risks of infection and delayed healing (a reality for someone like me with diabetes and a kidney condition) would be greatly reduced by not having the open wounds on my chest for a prolonged period of time.

Thanks to all for the info and discussion.

[aleon515]

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

It sounds like what might happen for a reduction. I can't imagine that working for a C or larger actually, without retaining a lot of tissue. Of course, it wouldn't matter if you were actually large enough. Dropping the areolas down wouldn't actually work for a lot of us, as the nipple placement is already too low in most female bodied people, compared to males. Mine might have ended up on my belly button. I also needed the nipple itself cut down substantially, which I don't know how you do with this sort of thing (why they can't do peris in larger chested people).

I had an acquaintance whose surgeon (it was very early on, maybe about then) who did a similar procedure to the above. Both of his nipples basically caved in and his chest is very sunken in. He has a very hairy chest and is very muscular and could have easily hid a DI at this point.  He's had so many revisions he looks like a roadmap. Another guy I know had a peri performed and he was about a B cup. He's had many revisions and I think one of them was to actually get a DI!
So there are definite benefits of starting out with one and not starting with one and ending up with another.

There is no doubt reasons that more surgeons didn't go to this kind of surgery, as it doesn't sound "harder". Actually I think nipple grafting is more complicated than cutting it down. So I don't know that something recommended in 1998 is some kind of standard. Most of the people I know who had early chest surgeries look a LOT worse than people having them today. Also revisions are less common now than the were in the late 90s too.

I can't recall the OP here, but I did see the link. It's an interesting procedure, but I gather this is a procedure invented by the doctor who posted it, and probably only performed by him. YOu would have to contact him. (I gather you are not in the US, but I imagine this doctor does take patients from all over the world.) I wouldn't want a two step surgery like this but I do see the appeal. The dude that he shows was definitely bigger than I was. However, in body size not so much.

I think though the incidence of complication for top surgery is pretty low. I think the only common one is hematoma which is still at less than 5% (bad if you are in that 5%)--with some surgeons having complication rates of 1%. There are other possibilities, but one I have NOT heard of a lot is infection. This is a surgery they perform outpatient all over the US, letting you out the same day. Most of us heal pretty darn well. I am much older than most of the guys here and never even took a tylenol.
I gather that diabetes is an added burden, but I am pretty sure that many videos on youtube have guys with diabetes and multiple health issues.


--Jay

[Bimmer Guy]

Hi, all.  I just wanted to point out this thread to the people who want to try to stay away from the double incision method.  It looks (from the pictures), as though these surgeons are open to doing something different with people who are larger than a A/very small B

https://www.susans.org/forums/index.php/topic,158932.0.html