MTF Bottom Surgery

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MTF Bottom Surgery Basics

Choosing to affirm your gender identity through surgery can be one of the most exciting and critical steps in the transition process. Dr. Stiller's patients describe the experience  as a freedom, as they reach the point where they don't feel as though they are caught in a body that isn't theirs.

GCS is a procedure that will make verifiably ground-breaking changes in a transgender individual's life. For those who are looking for GCS, Dr. Stiller and his team are honored to be apart of your transition process and hope to make this experience the most comfortable and empowering step in your transition. Dr. Stiller is one of the most sought after specialists for gender reassignment surgery and is the only surgeon in Washington state to perform this surgery.

Bilateral Mastectomy with Free Nipple Graft

A double-incision mastectomy is a good choice for patients with a medium to large chest. During the procedure, an incision is made above and below the breast tissue to open the skin. Liposuction will be performed as well to help contour the chest. The breast tissue is removed and the skin is closed, leaving two horizontal scars. Each nipple is removed. The nipple-areolar complex is downsized and placed as a graft in the anatomically correct position. 

Peri-Areolar Subcutaneous Mastectomy

The peri-areolar, or keyhole, incision is ideal for patients with a smaller amount of breast tissue, usually A or small B cup. The procedure consists of removal of breast tissue through a small incision around the nipple-areola complex. The nipple stays intact with the breast and is not repositioned. This technique results in significantly reduced scarring.

Mastectomy with Dermal Pedicle Flap

The dermal pedicle flap consists of the full thickness of the skin and is attached by tissue where it receives its blood supply. An incision is made on each side of the chest along the lower pectoral muscle fold. The nipple areolar complex is then downsized and placed in a new opening. The ideal candidate is a large-breasted, or ptotic, individual. 

Anchor Incision Mastectomy

An incision is made around the areola and continues down the midline of the breast. The incision continues across the inframammary crease. This procedure allows for reshaping and sculpting of the entire breast. The ideal candidate for this procedure is one with overly large or ptotic breast tissue, as other procedures will result in excess skin around the breast. 

Recovery

The recovery for top surgery varies from patient to patient, however, most patients do very well. After your surgery, you will have a drain placed on each side of your chest and have a compression garment on, which we encourage you to wear for 4 more weeks. You will follow up in 1 week to have your drains removed, if fluid is less than 30 ccs in a 24-hour period, and bandages are removed. At this appointment, we will make sure your nipples are alive and healthy if you had free nipple grafts. New bandages will be placed which are to be kept on for 5 days. At the 5-day mark, you can remove them and continue with an antibiotic ointment. Patients can usually begin chest exercises around the 4-week mark but are encouraged not to lift arms above shoulders for about 6 weeks.