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Sex reassignment surgery or gender transformation is an important step for transgender people who want to be recognized for their identified gender identity. Gender reassignment surgery is also a big decision, so it is important to be aware of the steps involved in each type of procedure.
Chest feminization is another name for top surgery performed on transgender women. Chest feminization is similar to breast augmentation in which the breasts or augmented or enlarged with breast implants or fat grafting. For chest feminization with breast implants, Dr. Rau will help you choose the right sized and shaped implant to create a natural look that is proportionate to your body type. Fat grafting is a two-step procedure that first uses liposuction to harvest fat cells from other areas of the body like the abdomen, hips, or buttocks. These harvested fat cells are purified and injected into the breast area to add volume and augment the breasts.
For chest masculinization, breast tissue is removed, and the chest is contoured for a defined, masculine appearance. This procedure is similar to gynecomastia surgery and involves surgical excision and liposuction to create a smooth contour and a newly flattened chest. Nipple grafting can also done as part of this procedure to reposition the nipple-areolar complex and make it smaller, but this isn’t always necessary. This procedure takes about 3-5 hours and is completed under general anesthesia.
After top surgery, a chest binder or surgical bra will be worn to support your chest while it heals. If necessary, drains will also be in place to prevent fluid buildup, and these will be left in place for a few days. Recovery takes about 4 weeks and during this time, you should not lift, pull, or push anything that weighs more than five pounds. This is recommended so that the incision site and your scars heal smoothly.
Gender-affirming procedures are life-changing for transgender and nonbinary people with gender dysphoria. Hormone therapy is often used to start the gender transition and it is recommended that patients wait at least a year after starting hormones before having transgender surgery. Dr. Rau follows the WPATH guidelines for top surgery and will discuss these guidelines with you at your consultation.