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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.

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

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.

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.

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

Quote from: zombieinc on January 15, 2014, 12:44:03 PM
Here are some photos of Dr. Blau's patients: http://www.gynecomastiausa.com/photos/severe_cases/ (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

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.

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

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

Quote from: DCQ on January 15, 2014, 06:35:49 PM
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).

Quote from: Sir Wafflinton on January 15, 2014, 11:36:13 PM
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.

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.

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.

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

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

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.

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

Quote from: caleb. on January 16, 2014, 09:05:02 AM
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  ;)

QuoteIdeally 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.  :)

Quote from: zombieinc on January 16, 2014, 09:28:54 PM
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

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

Quote from: LordKAT on January 17, 2014, 12:27:01 AM
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

Quote from: aleon515 on January 16, 2014, 11:36:48 PM
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  :D

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.

QuoteUnfortunately 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  :D

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.

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

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.

Quote from: Sir Wafflinton on January 18, 2014, 04:49:51 AM
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.

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?

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.

Quote from: lxndr on January 18, 2014, 06:02:56 AM
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.

Quote from: CursedFireDean on January 18, 2014, 09:26:19 AM
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

Quote from: Sir Wafflinton on January 18, 2014, 04:49:51 AM
A quick check of the blog says Sacramento, California. If this were in Aus I'd already have a booking :P

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.

Quote from: lxndr on January 18, 2014, 06:02:56 AM
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.

Quote from: lxndr on January 18, 2014, 09:56:37 AM
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.

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

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

Quote from: JLT1 on January 18, 2014, 09:40:30 PM
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

Quote from: Brett on January 18, 2014, 09:59:26 AM
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.

Quote from: aleon515 on January 18, 2014, 11:42:37 PM

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 

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.

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.

Quote from: Sir Wafflinton on January 19, 2014, 12:20:03 AM
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.

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

QuoteGynecomastia 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.

QuoteDid 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.

Quote from: JLT1 on January 19, 2014, 12:33:47 AM
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

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