What does chest masculinization mean?
Chest masculinization, also known as transmastectomy, means reshaping the chest surgically to create a more masculine appearance. The purpose of the procedure is to ease the psychosocial burden and support living as a man.
Masculinizing surgery is also known as gender-affirming surgery. Its goal is to align the body with the person’s gender identity.
Who does chest masculinization suit?
The person seeking the procedure must be of legal age and able to understand the procedure, as well as its benefits and disadvantages.
It is advisable to have a diagnosis of transgender identity before the procedure. A diagnosis is not required in order to perform the procedure, but it supports the decision to proceed with surgery. With a diagnosis, the procedure can be performed tax-free (VAT 0%).
Hormone therapy (testosterone treatment) is also not a requirement for the procedure, but using testosterone before the procedure enables a better result.
How is the surgical technique for chest masculinization chosen?
Periareolar Mastectomy
This surgical technique is suitable when the breasts are not large to begin with.
An incision is made around the areola of each breast, through which the breast tissue is removed. A small amount of skin can be removed around the areola in a “donut-like” shape. However, skin is usually not removed.
The nipples remain connected to the surrounding tissue, so nipple sensation is often preserved.
With this technique, the position of the nipple on the chest cannot be significantly changed.
Subcutaneous Mastectomy
This procedure may be recommended for people with larger breasts.
In the procedure, breast tissue and part of the breast skin are removed through a transverse skin incision. The areola is moved to the desired position on the chest either as an island flap or as a free graft. The shape of the areola is often changed at the same time.
When the nipple is moved, reduced sensation is likely.
The surgical scars are located around the areola and horizontally across the chest, at the level of the lower edge of the pectoral muscle.
More Information
Chest Masculinization – The Procedure
Before surgery, you must not eat or drink for six hours. You arrive for the procedure at the agreed time, and before surgery, the surgeon makes the necessary markings on the skin with a marker while the client is standing upright.
Chest masculinization is almost always done under general anesthesia. The procedure usually takes 2–3 hours.
The goal of surgery is always to achieve the most symmetrical result possible. At the end of the surgery, a compression garment is applied in the operating room.
The procedure can almost always be performed as day surgery, meaning you can return home on the same day. However, when you are discharged after surgery, you must have someone to accompany you, and this person must also stay with you for the first night.
Chest Masculinization – Recovery After Surgery
After chest masculinization, pain is not severe. However, pain medication may be needed during the first few days after surgery.
As the tissues recover, occasional sharp pains inside the chest are typical even for a few months after surgery.
The length of sick leave is typically approximately 1–4 weeks. The length is decided individually.
Using Compression Garments
Exercise
After surgery, heavy lifting, strong use of the pectoral muscles, and extreme arm movements should be avoided for the first week. Heavy straining and jumping should be avoided for the first month.
Exercise can be started gradually approximately one month after surgery.
Stitches and Supportive Taping
The wounds are mainly closed with dissolvable stitches that do not need to be removed.
Removable stitches may also be used in a free areola graft. The stitches are removed approximately one week after surgery.
Supportive taping of the wounds should be continued for 2–3 months after surgery so that the scars become as thin and unnoticeable as possible. We will provide instructions for the best scar care after supportive taping.
Possible Complications of Chest Masculinization
Surgical procedures always involve risks. After chest masculinization, the greatest risks of complications are related to tissue hematomas and blood circulation, as well as possible infections.
Hematomas and Blood Circulation
Bruising occurs on the skin as a result of surgery. Sometimes hematomas can be larger.
If blood leaks into the breast after surgery, it may cause pressure symptoms and may even need to be removed in a new surgery. This does not affect the final aesthetic result of the breast, but it does slow down recovery from surgery slightly.
After nipple repositioning, the development of new blood circulation in the areola is monitored. Sometimes the areola may have insufficient blood circulation, either completely or partially, in which case the areola may even peel away. In this case, tattooing, among other methods, is used to recreate the areola.
Infections
Although surgery is performed under sterile conditions, bacteria on the skin can enter through the surgical wound and cause infection in the tissues even after surgery.
Minor infections can often be treated with medication. In rare cases, a more severe infection may even lead to repeat surgery, in which the tissues are cleaned in the operating room.
