Chest masculinization

Mastectomy in transmen includes the removal of the breasts and the shaping of a male contoured chest. The procedure includes the removal of mammary tissue, removal of excess skin, and reduction, proper repositioning and reconstruction of the nipple and areola complex. The selection of operative procedure depends on the transman’s breast volume and the degree of ptosis. Transmen with moderate to large breasts usually require a radical bilateral mastectomy with grafting and reconstruction of the nipple-areola. This will result in two horizontal scars on the lower edge of the pectoral muscle, but allows for easier resizing of the nipple and placement in a typically male position. For persons with smaller breasts, a transareolar procedure may be done where the mastectomy is performed through an incision made around the areola. This avoids the larger scars of a traditional radical mastectomy, but the nipples may be larger and may not be in a perfectly male position on the chest wall. In addition, there is less denervation (damage to the nerves supplying the skin) of the chest wall with a transareolar mastectomy and less time is required for sensation to return.