Chest masculinization

Female to male sex reassignment surgery includes a variety of surgical procedures, including removal of the breasts and chest contouring (bilateral mastectomy), as well as removal of internal female genitalia (hysterectomy, adnexectomy and vaginectomy).

Mastectomy presents 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 patients’ breast volume and the degree of ptosis. Patients 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 patients 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.

CASE 1

Transareolar approach

Appearance before surgery

Appearance before surgery

Outcome one month after surgery

Outcome one month after surgery


CASE 2

Radical mastectomy

Preoperative appearance – frontal view

Preoperative appearance – lateral view

Outcome 3 weeks after surgery

Outcome 3 weeks after surgery

Outcome 3 weeks after surgery


CASE 3

Before surgery

After surgery


CASE 4

Before surgery

After surgery


CASE 5

Before surgery

After surgery


CASE 6

Before surgery

After surgery


CASE 7

Before surgery

After surgery


CASE 8

Before surgery

After surgery



CASE 9

Result three months after transareolar mastectomy



Mastectomy