Also known as FTM Top Surgery, the procedure involves breast removal (Mastectomy) and male chest contouring and may also include free nipple grafts, or nipple/areola resizing and repositioning. Top Surgery is the most commonly performed gender affirming surgery for trans masculine people. Top Surgery helps one to live more comfortably, improving psychological and social functioning, and it may be the only surgical step that one takes in their transition. There are different types of Top Surgery including the buttonhole technique, double incision mastectomy with free nipple grafts, inverted T / anchor, and keyhole and periareolar. The best choice for you depends on the anatomy of your chest (size of breast gland, amount of excess skin and size and position of the nipple and areolar) and well as your goals and acceptance of size and position of scars. As with all body contouring techniques, correct selection of technique leads to a better shape and overall outcome. Recovery includes an overnight stay in hospital and you will have drains and dressings for at least a week. You will often need a compression vest for 4 weeks to help the tissues settle and use scar tape to improve the final scars for at least 3 months. Light walking is encouraged once you get the drains out but no exercise that gets you hot and sweaty for the first 2 weeks. Getting back to lifting, gym and other work activities by 4-6 weeks is usual, but full healing and settling takes 12 months. In about 1 in 5 trans men minor revision surgery (scar, nipple, volume equalisation) is needed 6 months after surgery – this is more common if you are carrying extra weight as the shaping and tailoring is more complex.
Plastic and reconstructive surgery is a specialised branch of medicine which requires many years of training. Following medical school both Mr Adam Bialostocki and Mr Brandon Adams undertook near 10 years of additional training and were awarded a Fellowship in Plastic and Reconstructive Surgery (FRACS). They both went on to undertake training in aesthetic (cosmetic) surgery and complex reconstructive surgery with leading experts.
If your surgery requires implants or a special post-operative garment then these will have a cost associated with them.
Your follow up at six weeks, including any wound care and appointments, is included in your surgeon's fees. Costs for revision surgery is not included.
To perform safe surgery a high quality operating facility is required. Extensive surgery requires overnight hospital stays with skilled nurses.
Private hospitals charge for time used in the operating theatre, recovery time and day stay or overnight hospital stays. In addition they charge for all equipment used such as sutures, dressings, disposable instruments and drapes.
Mr Adams and Mr Bialostocki only operate at private hospitals with highly trained nursing staff who care for you after your operation in recovery, and on the ward if you stay overnight.
Any surgery requiring a general anaesthetic (going to sleep for surgery) or sedation requires a skilled anaesthetist. Anaesthetists are skilled doctors who require at least seven years training after medical school to achieve the highest standards of skill and safely.
Your comfort and safety is the result of team work between all of the doctors and nurses who will care for you. If you have complex medical conditions you may need additional assessments prior to surgery.
Most of the time surgery goes well and wounds heal without problems. However, no surgical treatment is completely risk free. So, if you are having elective or cosmetic surgery it is especially important that you understand this. The general complications of surgery which occur with some regularity include:
If there is a complication that requires further surgery – you or your insurer will be responsible for any further costs.
The estimates of cost provided are estimates only and are not based on what is needed by any particular patient. If surgery is unexpectedly complex it may take longer then hospital and anaesthetic costs will increase. If a complication occurs and requires surgery there will be costs associated with repeat surgery. Mr Bialostocki and Mr Adams do not control the hospital or anaesthetic costs.