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Top surgery, whether FTM (female to male) or FTN (female to nonbinary), is most often life changing.

At a minimum, it is gender affirming – finally allowing your physical anatomy to align with your identified gender. It well addresses gender dysphoria. Consequently, top surgery can markedly improve or even alleviate the anxiety and depression that is closely associated with this anatomical mismatch.

Not everyone seeking top surgery have the same goals, desires, stressors or issues. That is, a one size fits all will not be an appropriate solution for everyone.

Fortunately, top surgery is NOT a one size fits all procedure.

There are many options that can be selected and even further modified so that the outcome can better match what you are seeking. Among these are general technique, incision lengths, incision contours, nipple-areola complex size, shape and location and even whether or not to have the nipple areola complex at all.

Yes, you can select to be nippleless if that is what you want.

No nipple or areola whatsoever. Just a chest contoured to your liking.

This actually is not a rare choice, especially with gender nonbinary individuals.

If you choose to go nippleless and, for whatever reason, you change your mind in the future and want to have nipple-areola complexes adorning your chest, realistic 3D tattooing can be performed to simulate them. Though the appearance is 3D, there is no actual anatomic projection.

An example of the results from selecting to not have nipple-areola complexes is this gender nonbinary patient of mine, in their 30’s, who had dysphoria that involved both their breasts and nipples (photos A, C and E). They underwent a gender affirming mastectomy without replacing the nipple-areola complexes. Results seen are at 8 months following their procedure (photos B, D and F).

A. Before FTN Top Surgery

B. 8 months after FTN Top Surgery

C. Before Top Surgery

D. After Top Surgery

E. Before Top Surgery

F. After Top Surgery

They are very happy with their results as well as their decision not to have any nipples.

For more information on FTM or FTN top surgery or to schedule your consultation with me, please 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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