Gender affirmation surgery, or top surgery, is a complex and deeply personal process. Before undergoing any surgery, it’s important to consider all aspects of the procedure and ensure that you have a clear idea of what is typically involved in the process.
Top surgery has specific requirements as to what makes a suitable candidate, which are set out by WPATH (World Professional Association for Transgender Health). Your surgeon will also need to make sure that you meet other requirements that are in place for any surgical procedure.
A consultation with one of the plastic surgeons who operate at Aesthetic Edge in Sydney will provide you with the most important details you will need to know before undergoing the procedure. Taking an empathetic and understanding approach, your surgeon will assess your suitability for top surgery and create a suitable treatment plan.
In this blog, we’ll explain the basics of the procedure, including how it is performed and who is a suitable candidate.
What is top surgery, or gender affirmation surgery?
Top surgery allows patients to match their physical features to their gender identity. It is generally selected by trans and non-binary patients and can be masculinising (female-to-male) or feminising (male-to-female).
The surgery, whether masculinising or feminising, is usually part of a larger therapy plan, which involves other methods to help a person physically transition from one gender to another. The procedure is also often performed alongside Transgender Psychology and Gender Counselling, which is offered by clinics.
At Aesthetic Edge in Sydney, we also offer Facial Feminisation Surgery as another type of gender affirmation surgery.
Who is a suitable candidate for top surgery?
As a complex and very individual procedure, candidates need to be deemed as suitable for surgery by meeting some important requirements.
To undergo surgery, you will need to meet the criteria set out by WPATH (World Professional Association for Transgender Health). The criteria essentially require candidates to be physically and mentally healthy, be able to make an informed decision, and be able to consent to surgery.
Candidates for top surgery are usually suffering from gender identity disorder or gender dysphoria, but the criteria outline that candidates need to be professionally diagnosed with gender dysphoria or have a persistent, clearly documented case of gender dysphoria before undergoing the procedure.
The WPATH criteria also outlines that candidates have any medical or mental health concerns reasonably well-controlled before undergoing surgery. Psychological support is important throughout the process, and an assessment will typically be needed as part of the consultation process.
Most plastic surgeons have a minimum age requirement of 18 years old for top surgery. Surgeons may also need to ensure that the candidate has no severe systemic disorders and does not have serious organ diseases (such as with the heart or kidneys) that can affect the procedure. Your surgeon will also ensure that you aren’t allergic to any materials that may be used during the procedure.
Some surgeons will require you to have taken hormone therapy for a period of time before undergoing top surgery. Normally, a 10 to 12-month period of hormone therapy is required, but this will depend on your individual circumstances.
As well as these specific requirements for gender affirmation surgery, there are also some general requirements that apply to many types of plastic surgery. Firstly, candidates will need to be at a stable body weight, with a BMI under obesity level. A healthy BMI helps to prevent complications from occurring. Smoking is the next key factor that surgeons will most often address. Ideally, candidates for the procedure will be non-smokers, and smokers will be able to quit before and after undergoing the procedure.
Your surgeon may give you preparation instructions that can help your suitability for surgery, particularly quitting smoking, following a healthy diet, and avoiding alcohol. You may also need to stop taking certain medicines, such as blood thinners.
How is masculinising (female-to-male) top surgery performed?
Masculinising (female-to-male, or just FTM) top surgery is performed at a hospital under general anaesthesia and can take about two to three hours. It is a personalised procedure, meaning that the specific steps will vary from person to person.
Essentially, the goal is to make the chest appear more masculine. The procedure involves altering certain muscle attachments, skin and tissue, particularly removing breast tissue and glands. It can also include the repositioning of the nipples and areolae.
Incisions may only be placed around the areola, or your surgeon may place another incision under the pectoralis muscle, depending on the amount of tissue you have. Liposuction may also be used to target fat pockets in the chest.
Once the procedure is complete, you’ll be taken to the recovery room to be observed, normally for a few hours. If you are recovering well and there are no complications, you will typically be able to return home within one to two days.
How is feminising (male-to-female) top surgery performed?
Like with the masculinising procedure, the feminising surgery (male-to-female, or just MTF) will be performed at a hospital with a general anaesthetic and normally takes around two to three hours to perform, depending on the details of the surgery. However, the procedure itself involves creating a more feminine chest, usually with breast implants, and with a highly personalised result.
To achieve a more feminine-looking chest, breast implants are placed beneath the chest muscle (the pectoral muscle). Breast implants are made in different sizes, and can be round or anatomical (teardrop) shaped. You will be able to choose breast implants based on your personal preferences and your unique body frame. Your surgeon will help guide you through the process during your consultation. As well as placing implants, the procedure can also include alterations of the chest contour, by making adjustments to the tissue in the area.
After the procedure, you’ll be observed in the recovery room for up to a few hours, as with the masculinising procedure. Once you are stable and are recovering well, you can return home to complete your recovery.
Aesthetic Edge Clinic for top surgery in Sydney
The process of undergoing top surgery needs to be supported by an experienced, highly qualified plastic surgeon.
Your surgeon will ensure that you are well informed of the procedure process, and are suitable for the surgery as outlined by WPATH (World Professional Association for Transgender Health).
You will also be able to ask any questions you may have, and discuss the possible risks and complications of the surgery, including how they will be prevented throughout the process.
Please contact our team at Aesthetic Edge in Sydney to discuss how to arrange your initial consultation for top surgery.
