Double Incision Top Surgery
aka. Bilateral mastectomy, Mastopexy
The Double Incision Top Surgery procedure is the most widely-used technique and is ideal for those who are medium to large chested. During this procedure, the skin on the chest is opened along two horizontal incisions, at the top and bottom of the pectoral muscle. (The muscle itself is not touched.) The skin is pulled back and the breast tissue is then removed.
Additional liposuction may be performed to provide a more masculine contour and/or help prevent Dog Ears. Depending on the surgeon, this liposuction is either done as part of the Top Surgery procedure and included in the cost, or performed as a separate "cosmetic" Male Chest Contouring procedure with added expense.
With Double Incision Top Surgery, there are various approaches that can be taken that result in different scar shapes: straight, curved, contoured, connected and more.
Free Nipple Grafts: Nipples are removed, re-sized and grafted on the chest. Patients have limited sensation through the nipple/areola complex.
Though less common, some surgeons will maintain the original nipple/areola complex instead of grafting, which usually preserves nerve sensation. (See: Buttonhole Top Surgery and Inverted-T Top Surgery.)
Double Incision Top Surgery is typically an outpatient surgery that lasts 3-4 hours. General anesthesia is used, but patients are rarely catheterized.
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.
What to discuss with your surgeon: Incision lines and placement (straight, curved?); Size and placement of the nipple-areola complex. Also see: Questions to Ask at Your Top Surgery Consult
- Surgeons who perform Double Incision Top Surgery
- View Photos of Double Incision Results
- Video of Dr. Daniel Medalie Performing Double Incision Top Surgery
Dr. Drew Schnitt Explains Double Incision - Watch Now!
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Last updated: 11/14/2022
