For most transgender males (transmen), living with a physical body that does not match one’s actual gender identity is a very difficult and uncomfortable way to exist, function and interact. Transgender identity and the related issues often create a dysphoria associated with anxiety, depression, substance abuse and other negative issues. Fortunately, advancements in transgender plastic surgery and medicine have made female to male (FTM) gender transition easier, real and natural and with results that are far more satisfying.
At the Arizona Center for Aesthetic Plastic Surgery, board-certified plastic surgeon Steven H. Turkeltaub, MD offers female to male (FTM) breast surgery in order to help his patients transition in their appearance to match their gender identity. When you visit his practice for your consultation and postoperative care, you can expect to receive non-judgmental professionalism, understanding, attention and support. He will strive to understand your unique desires and perspectives, develop a customized treatment plan with you based on your anatomical needs and lifestyle goals and then help you achieve the life-changing transformation that you deserve.
Dr. Turkeltaub is a member of the “World Professional Association for Transgender Health” (WPATH).
For those individuals who are non-binary, the term “FTM” transgender top surgery is not accurately descriptive. Nevertheless, the concepts are similar but there are often variations that must be addressed such as the desire not to have any nipple-areola complexes at all. Again, the treatment plan is aligned based on each person’s desires and goals.
We have found that our FTM breast surgery patients are at the top among our happiest, most satisfied and appreciative patients. Following this procedure, their experiences have universally been overwhelmingly positive. But don’t just take it from us—read the letter below that was written by one of Dr. Turkeltaub’s patients to get an idea of just how life changing FTM top surgery can be.
I have been wanting to write you for some time now, as I have wanted to share with you the overwhelming positive impact having top surgery has had a my life.
To begin, I first want to say thank you for all that you do and am so grateful that you and your team were part of my journey. I cannot even begin to describe the terror, the dreaded fear, of announcing to someone that I want to top surgery. You may remember that I could barely speak and shook like a leaf. Being the professional that you are, you treated me with dignity and respect. Despite having just unloaded a lifelong secret, I was treated with kindness and respect. I knew that when the time was right, you were going to be the one I would entrust to do the procedure.
So, after working with an equally wonderful counselor, I was finally ready. You generously saw me for another consult and again, you treated me with dignity and respect. You answered all my questions, as well as my friend’s long list of questions. Your patience and kindness made what normally be abnormal feel totally normal.
The long awaited day of surgery came and I will never forget the overwhelming relief as I awoke in the recovery room and knew that 45 plus years of living with the wrong body parts was finally over….forever!
There are no words that can ever begin to describe that feeling…. that level of happiness transcends anything I had ever experienced. From that day on, I have had an entirely new outlook on myself, my body and my life.
It is not something that everyone will understand, but for those individuals struggling with body dysmorphia/gender identity, I think that top surgery is the best decision I have ever made. It has dramatically improved my life and I cannot thank you enough for the work that you do. I could not ask for better results and have to say, I think my chest looks perfect. Not a day will go by that I do not reflect on or think about this experience. I am much happier, confident and feel as if my body matches my mind.
I will close by saying again, thank you, from the bottom for my heart. I couldn’t be happier and owe it to you and your credible staff for making this dream my reality.
I will leave off my name for privacy reasons
Female to male breast surgery entails masculinizing the appearance of the female breast and chest wall. The standard procedure is usually accomplished by the thorough removal of breast tissue with either a nipple sparing mastectomy (“keyhole”) or subcutaneous mastectomy with a free nipple graft (“double incision”). Liposuction may need to be employed in order to obtain a more thorough transformation. In addition, the large female nipple-areola complex typically needs to be substantially reduced in size and repositioned on the breast to create a more masculine appearance. Not addressing this can compromise the results. When excess skin is present with the nipple sparing mastectomy, a concentric circle (peri-areolar) mastopexy can be performed.
Just like all surgical procedures, there are certain risks associated with FTM breast surgery. Depending on the procedure selected, these are similar to the ones that can occur with breast reduction or gynecomastia surgery. Dr. Turkeltaub does everything in his power to avoid and minimize the risk of experiencing these complications.
I am a transgender male and Dr. Turkeltaub did my top surgery. I am very pleased with my results and everyone that I show my chest to is very impressed. My scarring is minimal, my nipples are very well shaped, and Dr. Turkeltaub did an amazing job at keeping everything symmetrical. I was really large chested and a bit nervous as to how the final result would look, but from the very first day I was really pleased! My results just keep getting better and better. He is also very gentle handed so I only bruised in one very small area and I probably only bruised because I was a bit more active than I should have been 1 week after surgery. The office staff are very knowledgeable, friendly, and answer all questions without issue. I called many, many times with all kinds of questions and the staff always put my concerns or questions to rest with spot on answers. They were also very quick at getting my surgery scheduled and took on all communication with my insurance. I recommend Dr. Turkeltaub to everyone interested in getting any type of surgery with him but I really, really recommend him for transgender surgeries. The whole office and Dr. Turkeltaub are extremely LGBT+ friendly and they are dedicating a portion of their practice to transgender procedures. Both my partner and I felt very comfortable with every interaction with the entire office. I recommend Dr. Turkeltaub 100% and I am very grateful that I came across his practice!
The incision pattern utilized to perform female to male breast surgery depends several factors that include the pre-existing breast size, configuration, degree of skin laxity and excess, and the size and location of the nipple areola complex. Dr. Turkeltaub offers the following FTM breast surgical approaches:
During your consultation with Dr. Turkeltaub, the techniques that would be most relevant and appropriate for your particular situation will be discussed with you in great detail.
To help minimize any post-operative bruising, swelling and discomfort, a snug form-fitting dressing is placed around the chest following surgery and kept on for a few days. This is then replaced with a form-fitting garment that is worn for at least two to three weeks thereafter.Drains, which are tubes coming out through the skin on the sides of the chest and which serve to remove unwanted fluid in the surgical field, usually stay in on average for one to two weeks. Those individuals who have had their top surgery using the double incision free nipple graft technique will have a special dressing on around their “new” nipples for two weeks in order to protect them and allow them to be revascularized (get a new blood supply). See photo here.
The majority of patients experience only a mild degree of discomfort that can typically be alleviated with oral medication. Most individuals feel well enough to return to school and/or non-strenuous office jobs within a few days of surgery but any vigorous physical activity or heavy lifting will need to be avoided for a minimum of three to four weeks.
Results of the transgender surgery are evident immediately though it can take up to a year for all the swelling to fully resolve and the incision lines to mature and largely fade. You actually may see some increased swelling for the first two months which then gradually subsides. For all practical purposes, though, the final results are close to being realized at about six to nine months.
The final outcome of FTM breast surgery can be truly life-changing for individuals transitioning from female to male.
Due to social media policies, the following images have been censored. Please click on the button below to view the image.
*Individual Results May Vary
At only three and a half weeks, the early results can be seen and are significant (post-op photos). No pain medication is being taken. Swelling is present though not overwhelming and no bruising is present. The incisions with areas of redness seen on the side views are where the drains exited the skin.
Swelling can take up to two months to maximize then start to resolve. It can take up to a year for maximal resolution of the swelling in order to see the long-term results. The drain exit sites should ultimately heal as fine lines.
The results should be a masculine appearing chest with virtually invisible, very short scars.
I initially chose to see Dr. Turkeltaub because he was one of the very few local surgeons who could perform a bilateral mastectomy. But BOY did I make the right decision. I’m currently 5 weeks post op. Dr. Turkeltaub and those in his office have made this experience so smooth. From the moment I scheduled my consultation they have been highly attentive, kind, reassuring and have been willing to answer the gazillion questions I’ve had along the way.
From a technical standpoint, my procedure and recovery have been so clean and accurate to the timeline they originally estimated. My scars are razor thin and looking more even and natural every day. The followup care I’ve experienced has been reassuring and they’ve allowed me to schedule unexpected followup appointments just because I wanted to make sure everything was okay. They’ve been incredibly patient and professional and I couldn’t recommend a better or more qualified surgeon.
January 10, 2020
This is a relatively typical example of the results that can be seen at two months post FTM top surgery using the double incision free nipple graft technique. His nipple-areola complexes were covered by an “immobilization” dressing for two weeks and protected overall for four weeks to allow them to be revascularized (get a good blood supply back) and properly heal.
Due to social media policies, the following images have been censored. Please click on the button below to view the image.
*Individual Results May Vary
Scar gel was started at three weeks for the incision at the lower part of his breasts and then added around the areolas a week later. Full scar maturation will take a year or even longer for maximal improvement.
At four weeks, he was able to resume virtually all activities except for a few chest related workouts that he had to wait for one more month in order to fully resume.
A majority of insurance companies do offer at least some insurance benefits for FTM top surgery but, like many other medically related issues, coverage is dependent on your specific policy. In order to be eligible for this coverage, however, you must comply with the delineated guidelines which do vary by company and the particular policy
The following are generally required by most insurance plans:
Since 2014, Medicare has been authorized to provide coverage for FTM breast surgery but only on a case by case basis. There is no blanket guarantee.
If you want to pursue FTM/FTN top surgery but don’t have insurance or insurance coverage, we do have “cosmetic” pricing available to help make this both more affordable and a reality. There are several financing options available, if needed, including through CareCredit and Alphaeon.
According to data shared on RealSelf, the cost of FTM top surgery is generally between $4,900 and $12,000 in the Scottsdale area, with the average expense reported as $8,475. Although these numbers can provide a good point of reference, the exact pricing for your FTM breast procedure will depend on a variety of different elements that include:
Typically, medications and post-operative garments are not included in the pricing.
In order to provide a custom quote, Dr. Turkeltaub will need to meet with you for an in-person consultation at our practice. At this time, he can perform a thorough evaluation and give you a detailed breakdown of all associated costs based on an individualized treatment plan. If you wish, a team member can also introduce you to various financing and payment plan options that help to make FTM breast surgery expenses manageable for almost any budget.
Top surgery is, by far, the most important and requested gender affirming procedure that transmen with gender dysphoria pursue. The desire is even greater and the need more acute for those with more than an “A” size cup.
The results from the mastectomies are truly life changing. In fact, those individuals on whom we have performed the gender confirming mastectomies are among the happiest of all our patients.
For a variety of reasons, most transmen do not pursue bottom surgery or the extensive facial masculinization procedures. Some, however, are interested in seeking out less “radical” refinements of their body contours to reflect a more male appearance. Though long term usage of testosterone can assist in this transformation, the effects are often limited or incomplete.
A common path chosen is liposuction in order to reduce persistent feminine type fat deposits such as of the hips, thighs, abdomen and buttocks. This surgery, which we offer, is done as an outpatient with relatively minor and brief discomfort and minimal down time as relates to work or school.
Dermal fillers such as Juvederm® Ultra Plus and Voluma™ can be injected into various areas of the face to create more masculine angles and contours. BOTOX® can also be employed to precisely reshape the brows and affect their position as relates to the forehead and eyes to be more consistent with the male gender.
These same procedures are available to our non-binary patients though consideration would need to be given to their individualized goals as relates to masculine and feminine characteristics.
Yes, a letter documenting your gender dysphoria is required before you can have your top surgery. No insurance company will approve your request for coverage without having this letter and an additional one. Before we can authorize your surgery, we will need these two letters to submit to your insurance company in order to obtain authorization.
In addition, whether you have insurance coverage or are paying for the surgery out of pocket, the surgery centers require this letter before your top surgery can be scheduled.
For more information about these letters, read What Letters Do You Need For Scheduling Your FTM/FTN Top Surgery?
If you are considering FTM/FTN breast surgery, Dr. Turkeltaub would be happy to assist you in your gender transformation. Please contact our practice online or by phone today to schedule a consultation.
In light of the coronavirus/COVID-19 pandemic, we would like to let you know of some of the major precautions we are taking in our office to maximize cleanliness and keep the environment as sanitary and safe as possible. Our highest priority is always to ensure the safety of every individual who sees us and we are taking extreme infection-control measures to maintain cleanliness and “sterility” of surfaces and the overall environment.
We will be limiting dates and times for office appointments and consultations due to safety and other issues. Consequently, if you have already made an office appointment or consultation prior to March 18, 2020 to occur at a later time, this may need to be changed.
For anyone considering plastic surgery, we are now offering Virtual Consultations and Telemedicine through Skype. A great number of aesthetic or insurance-related issues can be evaluated via pictures and online video conferencing, making this an excellent way to find out more about particular procedures, determine candidacy for treatment, receive answers to questions and facilitate being able to move forward with care once the government lifts all restrictions.
In an abundance of caution, we are asking all current patients who are experiencing a fever, cough, chills, fatigue or any type of respiratory illness to please delay any upcoming appointments at our practice. We can talk with you by phone or email to establish a new date and time for the appointment.
We are all in this together. Our team urges everyone to follow the guidelines recommended by local health authorities and the Centers for Disease Control and Prevention, which include frequent handwashing for a minimum of 20 seconds, social distancing, staying home if you are feeling sick, and contacting your healthcare provider if you feel you are experiencing symptoms.
For more information, please read our blog – Coronavirus and You: Important Information
For further updates, please check our blog.
If you have any questions or concerns, please contact us by phone or email.