Top Surgery 101

General Terms

Top Surgery: a surgical procedure to remove breast tissue and sometimes reshaping and relocating the nipple-areola complex to achieve a flatter chest contour

Gender-Affirming Surgery: any surgical procedure that helps align a person’s physical appearance with their gender identity

Transgender: a term describing someone whose gender identity differs from the gender they were assigned at birth

Non-Binary: a term for people whose gender identity doesn’t fit within the traditional binary of male and female gender identities

Nipple-Areola Complex (NAC): the anatomical structure of both the nipple and surrounding areola and the nerves that innervate it

Pre-Surgery Considerations

Gender Dysphoria: distress or discomfort caused by a discrepancy between a person’s gender identity and their sex assigned at birth

Hormone Replacement Therapy (HRT): the use of hormones to align physical characteristics with gender identity; not required before, during, or after top surgery

Consultation: a meeting with a plastic surgeon to discuss options, procedures, risks, and expectations

Informed Consent: a process ensuring the patient understands the surgery, its risks, and outcomes before proceeding

Mental Health Evaluation: some providers require an evaluation by a mental health professional to ensure readiness for surgery

Support Letter: a letter from a licensed and experienced mental health professional supporting your desire to have top surgery, generally required for insurance approval

Surgical Terms

Anesthesia: medications used to prevent pain during surgery, typically general anesthesia for top surgery which includes IV sedation

Incision: a cut made during surgery to remove or alter tissue

Grafting: the use of skin grafts to reconstruct areas around the nipple-areola complex (NAC) during chest surgery (aka Free Nipple Graft)

Drains: tubes placed in the chest post-surgery to remove excess fluid and reduce swelling

Post-Surgery Care

Recovery Time: the period needed for the body to heal after surgery, usually several weeks to months depending on the individual and surgery type

Compression Vest/Binder: tight fitting garment worn after surgery to minimize swelling and support healing

Follow-Up Appointment: visits to the plastic surgeon post-surgery to monitor healing and address any complications

Scar Management: techniques and treatments to reduce scarring post-surgery, such as silicone sheets, massage, or ointments

Finding a Provider

Board-Certified Surgeon: a surgeon who has received certification from a recognized medical board

Experience: the number of years a surgeon has performed top surgeries and their familiarity with various techniques

Before and After Photos: images of previous patients’ results to assess the surgeon’s work

Patient Reviews/Testimonials: feedback from previous patients about their experiences and satisfaction with the surgeon and the surgery outcomes

Consultation Availability: the ease and accessibility of scheduling an initial consultation with the plastic surgeon

Insurance Coverage: whether the surgeon accepts insurance and if the patient’s insurance plan covers the surgery

Cost Estimates: the total cost of the surgery, including surgeon fees, anesthesia, hospital fees, and post-operative care