Double Incision Top Surgery
The Double Incision Top Surgery procedure is one of the most popular techniques, especially for those with medium to larger chests. During the surgery, two horizontal incisions are made at the top and bottom of the pectoral muscles (the muscle itself isn’t touched). The skin is lifted, and the breast tissue is carefully removed.
To create a more masculine chest shape and reduce the risk of "Dog Ears" (extra skin at the edges of the incisions), surgeons may also perform liposuction. Depending on the surgeon, this male chest contouring might be included in the procedure or offered as a separate male chest contouring service at an additional cost.
There are different approaches to the scar shape with Double Incision surgery, such as straight, curved, or contoured scars, giving you some choice in the final look.
In most cases, Free Nipple Grafts are performed, where the nipples are removed, resized, and grafted back onto the chest. While this technique typically results in limited sensation in the nipple and areola area, some surgeons offer alternatives—like Buttonhole or Inverted-T techniques—that aim to preserve the original nipple/areola complex and its sensation.
Aetna insurance doesn't cover the cost of nipple grafts, and some people choose to not get nipple grafts. Paramedical tattoo artists offer 3D, realistic-looking nipple-areola tattoos that are a popular alternative to nipple grafts.
Double Incision Top Surgery is usually done as an outpatient procedure and takes about 3-4 hours. It’s performed under general anesthesia, but catheterization is rarely needed.
Source: Surgery: A Guide for FTMs
Top Surgery Post-Op Care
After surgery, most patients are left with two medical drains — small tubing that lines the length of the incisions, under the skin, that exit through a small incision under each arm, with a resevoir bulb attached at the ends to collect excess blood and lymphatic fluid. These drains are left in for several days to a week, and need to be emptied by the patient or an assistant a few times a day.
Many surgeons also have patients wear a compression binder after Double Incision surgery, for anywhere from 1-6 weeks. The binder helps prevent fluid build up, aids the skin in adhering back to the chest wall, and also helps with minimizing scars.
Top Surgery Recovery
Healing times vary, but many most patients return to desk jobs and light work after two weeks. There should be no heavy lifting, regular lifting of your arms over your head or weight training for 6-8 weeks. Get more information about recovering from Top Surgery »
What to discuss with your surgeon:
- Incision lines and placement. (Straight, curved?)
- Size and placement of the nipple-areola complex.
Also see:
- Surgeons who perform Double Incision Top Surgery
- Questions to Ask at Your Top Surgery Consult
- Before
& After Photos of Double Incision
- Video of Dr. Daniel Medalie Performing Double Incision Top Surgery
Dr.
Drew Schnitt Explains Double Incision -
Watch Now!
Back to Top Surgery Procedures »
Last updated: 01/23/25
