FTM Top Surgery » Surgeons

Dr. Katherine Gast

Gender-Affirming Top Surgery in Wisconsin

Dr. Katherine Gast, MD is a fellowship-trained plastic surgeon who specializes in Gender-Affirming Top Surgery. Dr. Gast is the Medical Director of the UW Health Comprehensive Gender Services Program in Madison, Wisconsin.

Dr. Gast received her medical degree from the University of Michigan Medical School in 2010 and completed her plastic surgery residency also at U of MI in 2016. Dr. Gast completed the Subspecialty Fellowship in Gender Affirming Surgery and Microsurgical Breast Reconstruction in Ghent, Belgium in 2017.

Dr. Gast is experienced with a variety of Top Surgery methods, including Peri-Areolar, Circumareolar and Double Incision with free nipple grafting. The surgery takes about 3 hours and you can go home the same day. Drains may or may not be used.

There are a number of factors to consider when choosing a surgical approach. Dr. Gast is an author of an academic paper on Top Surgery that addresses this:

Age, breast size, breast ptosis, skin quality, and overall body habitus are the most important factors influencing procedural selection. Age is associated with reduced skin elasticity, and patients with higher BMI may have excess skin and decreased skin elasticity, as well as an increased risk of complications requiring secondary corrections. Weight loss before and after surgery can improve outcome.

Breast volume, grade of breast ptosis, degree of skin excess, and position of the nipple-areola complex (NAC) in relation to the inframammary fold will determine the procedure of choice in most patients.
The patient's skin must be accurately assessed to avoid undue tension in closure, to predict the ability of any redundant skin to remodel, and to prevent scar lines more prominent in movement, such as raising one's arm above shoulder height. Patients must demonstrate good skin quality, smaller breasts, and lesser degrees of ptosis to be candidates for less-invasive, short-scar procedures.

A significant proportion of FtM patients also utilize breast binders to conceal the appearance of their breasts in public. Even in small-breasted patients, this has a deleterious effect on the elasticity of the skin and can result in a higher degree of breast ptosis, which may require a more invasive approach.

Finally, the patients' desired aesthetic outcome should be considered carefully, because some patients want to be more involved in deciding the size, the position of the scars, and the new NAC, according to some retrospective studies.
Source: Female-to-Male Gender-Affirming Chest Reconstruction Surgery.

Dr. Gast also performs Body Masculinization and Phalloplasty.

Surgery Requirements
Dr. Gast is a member of WPATH and follows WPATH guidelines for surgery. You will need to provide one referral for Top Surgery unless otherwise specified by insurance.

Paying for Top Surgery
Dr. Gast accepts cash, credit cards and insurance, including but not limited to: Title 19, BadgerCare Plus, Wisconsin Medicaid, Medicare, private insurance.

Booking a Consultation
Dr. Gast is available for in-person and phone consultations.

More information about Dr. Katherine Gast »

Gender-Affirming Top Surgery in Wisconsin