HomeSurgery ArticlesWhat Is Top Surgery - The Complete Guide

What Is Top Surgery – The Complete Guide

Top surgery is the term used for a range of operations done to change the chest. The most frequent type of this procedure is chest masculinization, which transgender males undergo in order to remove their breast tissue, thereby creating a more masculine-looking chest. Other forms of top surgery include breast augmentation done on transgender women, and chest reduction carried out by persons of all genders to reduce their mammary glands. This form of major surgery needs intensive research before settling on one specific surgeon. There are multiple surgeons that specialize in it, with each having different styles as well as techniques at performing the operation. It is important that you decide upon one experienced in the procedure you need and with whom you feel comfortable.

Top surgery can be highly transformative and confidence-boosting for individuals. We’ve collected all the information you need to make an informed decision – from different types of surgeries to eligibility criteria to recovery timeframes. This blog post is ideal for anyone who wants to learn more about their options, no matter their current level of understanding. Read on to discover all the facts about top surgery.

What is Top Surgery?

Top surgery—also known as chest masculinization or “top” surgery—is a gender-affirming procedure that involves removing breast tissue. It is usually performed on transgender men, but cisgender men with Gynecomastia (enlarged breasts) may also opt for this operation. This surgery can be done alone or in combination with other surgeries such as bottom surgery.

There are two main forms of top surgery: bilateral mastectomy and keyhole (or peri-areolar) mastectomy. During the former, all breast tissue is eradicated including the nipple-areola complex (NAC). The latter just refers to removal of the NAC, resulting in a small donut-shaped scar around the areola. Both surgeries generally employ one of two methods: open incision or pedicle flap. With an open incision, the surgeon makes a cut on the chest and extracts all related tissue. For a pedicle flap approach, a piece of skin and underneath muscle is detached from the chest wall and is used to cover where breast tissue was taken away.

Following top surgery, a compression garment is typically worn for 4-6 weeks for post-operative healing and to reduce swelling. To manage any pain or discomfort experienced, medication can usually be prescribed. Generally, the majority of patients report that the recovery period is bearable.

Benefits of Top Surgery

Different individuals may select to have top surgery for a variety of reasons, and the benefits can be numerous. Often, transgender or gender non-conforming individuals feel anxious and uneasy due to their chest not aligning with their gender identity. Top surgery has the potential to give them a sense of liberation from this distress and can have a positive effect on self-esteem and body image. Physically, it may be more comfortable by eliminating excess breast tissue. On top of that, many experience a decrease in gender dysphoria—the intense distress associated with the difference between perceived physical appearance and one’s inner self. Ultimately, undergoing top surgery may be an essential step for some people when taking steps towards leading a life in which they feel authentic and gratified.

Types of Top Surgeries Available

Double incision and “keyhole” surgery are the most common procedures when it comes to top surgery. This technique involves an incision on the chest as well as around the areola, and the nipple is removed and replaced with a new shape. Skin is reshaped and then stitched up to close the incisions.

Periareolar, or “donut” surgery, is a type of top surgery that requires an incision to be made around the areola. Following the removal of the nipple, the chest tissue is reshaped and the skin restitched over it.

The last type of top surgery is called “subcutaneous mastectomy” or “liposuction only” surgery and involves making incisions around the areola and under the arms. A cannula (a small tube) is then inserted through these openings to suction out fat from the chest area, after which stitches are used to seal them.

Your individual anatomy and objectives for surgery will determine the type of top surgery that’s right for you. Your surgeon will help you identify which option works best in your particular case.

Before and After Care Advice

Before undergoing top surgery, it is essential to understand what can be expected. This will help you adequately prepare and maximise the results of your operation.

Prior to your surgery, it is essential to make arrangements for transport home afterwards. You should then take some time out to rest and recuperate during the initial days following the operation, as you may be sore and weary. Refrain from strenuous activity and avoid lifting anything too heavy as it may lead to unwanted bleeding or other risks. Make sure you maintain an adequate level of hydration and a nutritious diet; these will help with the healing process.

Following your procedure, it is essential to wear a compression garment day and night for the first seven days. This will help reduce swelling and ensure your new chest shape is supported. Additionally, be sure to rest on your back to avoid putting strain on the area. Once the initial week elapses, you can gradually start doing activities again; however, be sure to listen to your body and move cautiously at first.

The Cost of the Procedure in Australia

The cost of top surgery in Australia can vary due to various considerations such as the surgeon’s costs, the kind of procedure, and the area of surgical operation.

The cost of top surgery in Australia generally falls between $10,000 and $20,000, although this is only an approximation. The actual price paid could be higher or lower.

Insurance Coverage for Top Surgery

There are various kinds of insurance available for top surgery. NHS cover is the most widespread, covering those whose operation is medically essential. Private insurers may provide cover for top surgery to varying degrees depending on the company, and some people turn to their own funds or credit to pay for it.

Insurance will usually provide coverage for top surgery, if your doctor can explain why, it is medically necessary for you. The insurance company will evaluate your case and make their decision. If the insurance company declines to cover the surgery, you can try appealing this decision.

Private insurers typically have varying criteria when it comes to approving coverage compared to the NHS. Generally, you will need to have been living in your preferred gender for at least 12 months prior to them looking into covering the cost of surgery. Additionally, some insurers require that hormone therapy or other treatments are undertaken before they will consider contributing financially towards top surgery. It’s essential to check with your chosen insurer and discover what their exact demands are.

If you are funding your own procedure, there are several financing possibilities. You can apply for a personal loan, tap into savings, or explore crowdfunding options that are specifically designed for transgender surgeries. As top surgery can be costly, it is essential to prepare in advance and make a budget.


This guide has been a comprehensive and detailed insight into top surgery: what it is, and isn’t. We are glad to have been able to help improve your understanding of the various ways people transition. Should you decide to go ahead with surgery, bear in mind that it requires extensive research, consultation, preparation and recovery; clearly taking some time. Before making any decisions, make sure you have taken all emotions into consideration – it is very important.


1. What is top surgery?

Top surgery is a gender-affirming surgical procedure for those who identify as transgender or non-binary. The most widespread type of top surgery is masculinizing chest reconstruction, involving the excision of breast tissue and the reshaping of the chest to carry a more masculine look.

2. Who can get top surgery?

Anyone with chest dysphoria may benefit from top surgery; however, consulting a doctor to ensure physical health is essential.

3. What is the cost of top surgery?

Top surgery costs vary depending on a variety of factors, such as the type of procedure, the surgeon’s fees, and insurance coverage. Generally speaking, expect to pay between $3,000 and $10,000 out of pocket.

4. What can one expect during the recuperation period?

It usually requires two weeks to recuperate from top surgery. During this period, it is normal to have a bit of discomfort and puffiness. To ensure a satisfactory recovery, be sure to take it slowly and abide by your surgeon’s advice.

5. Can potential risks be associated with top surgery?

Any form of surgery carries a degree of risk, and when it comes to top surgery this includes the possibility of infection, bleeding, and adverse reactions to anesthesia. Generally speaking, though, such complications are rare, and people who have gone through top surgery tend to be very pleased with the results.

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