What is FTM Top Surgery?

Top Surgery is a general term for any surgical procedure to alter the size, shape, and general appearance of the chest. Specifically, FTM Top Surgery is the removal of breast tissue and contouring of the chest by a qualified plastic surgeon to make a transgender or nonbinary person appear more masculine.

Who is Eligible for FTM Top Surgery?

People who experience gender dysphoria or who want their body to appear more masculine may want to undergo FTM Top Surgery. Healthy nonsmokers are likely good candidates for the procedure, but scheduling a consultation with Dr. Howland is the best way to know whether FTM surgery is right for you and what your options are.

FTM Top Surgery Options

There are several different types of FTM Top Surgery procedures available depending on your original and desired appearance. The procedures use different incision patterns that will cause different outcomes after recovery, and take an average of 3 hours to perform. The most common three techniques used are double incision, periareolar, and keyhole, although there are other incisions that may be used in certain circumstances.

Double Incision

This FTM Top Surgery is typically recommended for people with larger chests and bodies. This technique uses a horizontal incision at the top of the breast from which chest tissue is removed, and a second incision to remove the nipples, which will need to be resized and replaced in a different location for a more masculine appearance.

This procedure typically reduces nipple sensitivity and results in more significant scarring than other techniques.


Patients with small- to medium-sized chests and healthy skin may qualify for periareolar, or circumareolar, FTM surgery. Periareolar surgery requires one incision to be made around the areola, and another slightly smaller circular incision within that area. Tissue is removed and the skin is reattached around the now smaller nipple.

In around half of cases, a follow-up surgery is required to achieve a completely flat chest. Most patients report little to no reduction in nipple sensitivity after periareolar surgery, and the procedure results in minimal scarring.


Only people with small chests and good skin elasticity are eligible for keyhole top surgery. This procedure only removes excess tissue, not excess skin. As a result, scarring is barely noticeable, and nipple sensitivity is not affected. Again, because no skin is removed, this procedure cannot change nipple placement or size.


No matter which incision type Dr. Howland chooses, undergoing FTM Top Surgery will flatten your chest and make it look more masculine. Recovery from these procedures will likely take at least 2-3 weeks, following Dr. Howland’s specific instructions for a quick and full recovery.

Begin your journey toward your fully expressed identity by scheduling a consultation today. Dr. Howland is a board-certified plastic surgeon serving patients in Salt Lake City and Draper, UT.