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The techniques used for gender affirming top surgery procedures for both transmen (FTM) and gender non-binary individuals (FTN or FTNB) are the same ones. Both involve the removal of the breast tissue (mastectomy), contouring of the chest and addressing the nipple-areola complex in some fashion so as to facilitate the transformation.

When differences exist, they are in the details – and there are several.

The overarching goal for FTM top surgery is to produce as masculine a chest as possible. Aside from resecting the breast tissue to obtain the desired contour, the nipple-areola complexes are reduced in size to more male appearing ones. With the double incision free nipple areola graft approach, the nipples are also relocated laterally and lower to a more masculine location.

With gender non-binary individuals, there is not the same “one size fits all” approach (slight exaggeration here). Some seeking top surgery (FTN or FTNB) want a masculine chest whereas others want to be somewhere in between. Then there are others who want to be between these two – they lean more masculine but don’t want to go all the way there.

Finally, there are a number of gender non-binary individuals who don’t want any nipple-areola complexes at all.

They just want a flat chest. No breasts. No nipples.

Consequently, the procedures and specifics must be precisely customized for each patient’s desires and goals.

The most common considerations include whether or not a nipple-areola complex is wanted and, if so, the areola size and its location on the chest.

This creates almost countless possibilities for customization of the chest.

Sort of!

The following patient of mine is a good example of the differences that can be selected in FTNB top surgery employing the double incision free nipple areola graft approach.

At the time of their consultation, this non-binary individual was 21 years old and was seeking female to non-binary (FTNB/FTN) top surgery results where the appearance of their chest was neither male nor female but somewhere in between. They wanted their nipple-areola complexes to be intermediate in size and in a non-masculine location.

Gender Non-Binary
Before Top Surgery

Gender Non-Binary
After Top Surgery

Gender Non-Binary
Before Top Surgery

Gender Non-Binary
After Top Surgery

Gender Non-Binary
Before Top Surgery

Gender Non-Binary
After Top Surgery

Photos are prior to surgery and one year and five months postoperatively.

They got exactly what they wanted and were extremely happy with the results.

For more information on female to non-binary (FTN/FTNB) or female to male (FTM) top surgery, you can contact us at the Arizona Center for Aesthetic Plastic Surgery at (480) 451-3000 or by email.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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