Transgender breast reduction - FTM Top Surgery

Gynaecomastia surgery – a subtle procedure for small breasts.

The keyhole procedure is suitable if you have little breast tissue and your skin is sufficiently elastic. With this technique, the surgeon makes a small incision at the lower edge of the areola, through which the breast tissue is removed.

Sometimes liposuction is added to make the contour around the nipple area extra smooth. The nipple remains in its original place and the areola is not reduced in size. The procedure is performed under general anaesthesia. This procedure is also called gynaecomastia surgery.

Peri-areolar technique: a subtle chest mastectomy with minimal scarring.

With this method, the breast tissue is removed through a circular incision around the areola. The nipple remains partially in place, which helps to minimise scarring.

The medical name for the Donut procedure is the peri-areolar concentric circle technique. This procedure is suitable if you have a small to medium breast size (e.g. a small B cup) and elastic skin.

An incision is made around the areola, followed by a second, larger circle just outside it. The skin between the two circles is removed, and the breast tissue is removed. The surgeon then brings the skin together using a purse-string technique so that the incision fits nicely around the areola. The nipple stalk remains intact, which often preserves (some of) the nerve sensation.

In some cases, the nipple is reduced in size and repositioned, although this is done with caution so as not to disrupt the blood supply. Additional liposuction can help to smooth the contour around the nipple. Please note that some wrinkling may occur along the circular scar due to the difference in skin diameter. The procedure is performed under general anaesthesia.

Batwing procedure (fishmouth incision): for a firm chest and moderate breast formation.

The batwing technique combines an incision around the areola with additional skin removal in the form of two “wings”. This provides more space for contour improvement in cases of moderate breast size.

The Batwing procedure, also known as the Fishmouth incision, is suitable if you have moderate breast size and a cup size no larger than B, with some slight skin sagging (ptosis) and reduced skin elasticity.

The procedure begins with an incision around the areola, followed by a larger circular incision. Extra skin is removed in a triangular shape on the inside and outside of this circle. This creates a skin pattern reminiscent of wings – hence the name “Batwing”. This skin is removed and the scar is neatly placed horizontally, in line with the areola.

The nipple stalk is preserved, which often leaves nerve sensation partially intact. In most cases, the nipple is not reduced in size to limit the risk of blood flow problems. Liposuction can be added for a tighter contour finish. The operation is performed under general anaesthesia.

Double incision: a commonly used mastectomy technique for larger chests with moderate to fuller breasts.

The breast tissue and excess skin are removed via two horizontal incisions, and the nipples are repositioned as free grafts.

The double incision technique is a commonly used procedure for people with medium to larger, fuller breasts. This procedure gives the surgeon plenty of room to accurately remove breast tissue and skin and to create a tight, masculine chest.

Two horizontal incisions are made: one above and one below the breast, usually in or just above the breast fold. The breast tissue is removed, and if necessary, liposuction is used to further refine the contours. The scars are positioned so that they will eventually blend subtly into the breast fold.

The nipples are completely removed, reduced in size and repositioned in a natural, masculine position on the chest. This is done using a technique known as free nipple transplantation. The nipples are secured with special dressings (“sponges”), which are removed at the outpatient clinic five to seven days after the procedure.

After this technique, sensation in the nipples and areolas is usually limited. In rare cases, the nipple stalk can be preserved, allowing some sensation and blood flow to remain. The procedure is performed under general anaesthesia.

Reverse T technique for heavier or thicker breasts.

The reverse T technique combines a horizontal and vertical incision, resulting in a (reverse) T-shaped scar. This method is necessary for larger or heavier breasts.

The reverse T procedure may be a good choice if you have thicker breasts (cup size C or larger) and your skin is less elastic. This technique is similar to the double incision, but adds a vertical skin excision, allowing the surgeon to better redistribute the skin and avoid skin folds.

The additional vertical incision creates an inverted T-shaped scar. This allows more skin to be removed, resulting in a tighter, more masculine chest contour. The breast tissue is completely removed and, if necessary, liposuction is performed to refine the result.

The nipples are detached, reduced in size and repositioned on the chest for a natural result. They are attached as free grafts. Sensation in the nipples and areola is usually limited afterwards. In exceptional cases, the nipple stalk can be preserved, allowing partial sensation and blood flow to be retained. This procedure is performed under general anaesthesia.

Yes. A trans man is someone who was assigned female at birth but identifies as male. Synonyms for trans man are transgender man, transmasculine person (somewhat broader), and the abbreviations FtM or F2M (female-to-male). These terms describe a person's gender identity, regardless of medical procedures. A trans man differs from a cis man, who was assigned male at birth and also identifies as such. The term transsexual is still sometimes used, but it is outdated and less common in contemporary language. Transman breast enhancement (breast removal) is the most requested aesthetic procedure among transmasculine individuals.

Wellness Kliniek specialises in all aspects of aesthetic surgery to enhance the appearance of breasts or the chest. A surgeon must treat every person – whether trans or not – equally and optimally, because this is the core of medical ethics and professional care. Every patient has the right to respect, dignity and equal access to quality healthcare, regardless of gender identity. Discrimination or biased behaviour not only harms the patient's health, but also undermines trust in the healthcare sector. Surgeons take an oath and have a responsibility to act in the best interests of all people, with compassion and without judgement. Medical care is not a privilege, but a right – and that applies to everyone.

Top Surgery or FTM breast surgery for trans men, in which breast tissue is removed to create a male chest, is not medically reversible. During the operation, mammary gland tissue, skin and often the nipples are permanently altered.

Although reconstructive options – with breast implants – exist in cases of regret or detransitioning, these cannot fully restore your original appearance and feel. For this reason, this procedure is preceded by psychological analysis to ensure that the surgeon is convinced that the person requesting this procedure has made a well-considered choice for this physical change.

Any adult trans man who has carefully considered taking the step towards a more masculine chest is a good candidate for a transgender breast reduction. A trans breast reduction operation creates a masculine chest.

The procedure is performed on individuals aged 18 and above. It is recommended to wait until at least 25 years of age, as the body and brain are fully developed by that time. Do you believe you are ready sooner? Schedule a no-obligation consultation.

This surgery is ideal for trans men, non-binary individuals, or others who desire a flat, masculine chest. Removing the breasts (FTM mastectomy) helps bring the body more in line with the person's gender identity.

During a no-obligation consultation, the options will be discussed with you in detail. This way, you will know in advance what to expect from the transgender breast reduction results. We welcome patients from all over the world. For an initial consultation, it is possible to schedule a telephone consultation/video call so that you can learn more about the options for your body remotely.

Transgender breast reduction surgery is also known as Top Surgery in the trans community. It is a respectful term for the procedure in which people who were assigned female at birth undergo the transformation to male. This breast surgery is also referred to as breast amputation, breast removal or breast reduction for trans men. The aim of this procedure is to make the chest more masculine.

Other names include FTM chest reconstruction (Female-to-Male surgery), gender-affirming chest surgery, and trans surgery breasts. In scientific terms, this is also referred to as masculinising chest surgery, subcutaneous mastectomy, or double incision mastectomy, depending on the specific technique used.

FTM stands for Female-to-Male. It refers to individuals who were registered as female at birth but identify as male. FTM surgery is a medical procedure to achieve an appearance that matches one's identity. At Wellness Kliniek, in addition to FTM breast reduction surgery, we also offer other FTM procedures, including body liposuction for a more masculine body profile.

Top Surgery is a commonly used term in the LGBTQIA+ community, referring to the surgical procedure in which the breasts are removed or shaped to match a person's gender identity. Top Surgery is common among transgender people as part of their transition. It is therefore another name for transgender breast surgery, but it is actually much broader than that. It is not only about the external result of the procedure, but also about the positive emotional consequences.

Top Surgery has a positive impact on transgender people. It gives them a flatter chest that matches their gender identity. It is one of the most requested gender-affirming surgeries among transgender men, and for good reason. The procedure often has a profound impact on daily life and well-being. Here are some of the benefits of Top Surgery:

• Improved quality of life: Many trans men experience severe gender dysphoria because of their breasts. A flat chest helps you to finally experience your body as “your body” – both physically and mentally.
• More confidence and freedom: After the procedure, you often feel more confident in your clothes, while exercising or at the beach. You no longer have to hide yourself or constantly adjust.
• No more binders: Top Surgery makes wearing chest binders unnecessary. That means more breathing space – literally and figuratively – and fewer physical complaints in the long term.

Female-to-male breast reduction (Top Surgery) is gender-affirming surgery in which the breasts (skin, glandular tissue and fat) are removed to create a more masculine chest profile. The nipple and areola can also be adjusted to give the chest a masculine appearance. There are various techniques to make this procedure successful. The surgeon at Wellness Kliniek will determine the best technique for your body and wishes.

The medical term for a transgender procedure is a total mastectomy or subcutaneous mastectomy. This means that the breast tissue is removed and the chest is shaped to a masculine appearance. This is often done in conjunction with adjusting the size of the nipples and areola and repositioning them for a natural result.

The goal of the surgery goes beyond just a flat chest. You want a chest that looks masculine and fits your body. With as few visible scars as possible. Because it's not just about the outside, but also about how you feel inside.

In summary, a chest masculinisation (mastectomy) operation at the Wellness Kliniek in Belgium or Barcelona usually involves the following steps:

• You start with a no-obligation, personal consultation with a specialist surgeon, so that you know what to expect from the surgery, recovery and results. If you then decide that you want to undergo a mastectomy, we proceed to the next steps:
• The surgeon removes most of your breast tissue to create a flat chest.
• Excess skin will remain. This is removed to achieve a tight, masculine contour.
• The natural breast fold is now removed for a smoother and more masculine profile.
• The nipple and areola are customised and, if necessary, moved to a position that suits a male chest.

Each step is performed with care and attention to your physique, so that you not only notice the difference in appearance, but also feel truly different.

Aesthetic breast surgery is not covered or reimbursed by health insurance funds or insurance companies. If you are looking for breast enhancement surgery (at your own expense), you do not need a referral from a doctor. However, the surgeon may ask you for an additional psychological report. A referral is not required at our clinic.

What's more, with us you can expect short waiting lists. During a personal consultation, your doctor will assess whether you are a suitable candidate and whether you have made a well-considered decision to undergo the operation. The doctor will let you know if any further steps are necessary before you can undergo transgender breast reduction surgery. If a consultation with a psychologist is advisable, we offer options through the clinic. If the doctor is convinced that you are a good candidate, we can almost always help you!

In principle, the procedure can be performed from the age of 18. During a personal consultation, we will determine whether you are a suitable candidate for transgender breast reduction surgery. However, in most people, breasts are only fully developed at the end of puberty (18 years of age), but in exceptional cases, breasts can continue to develop for several more years. In terms of aesthetic results, it is preferable that your breasts are fully developed in order to maintain the results of the procedure in the long term.

At Wellness Kliniek, we recommend waiting until at least the age of 25 before considering transgender surgery. This is important because your body and, in particular, your brain – including areas responsible for impulse control and self-awareness – are only fully developed around that age. Identity and gender identity can still change during puberty and young adulthood. Waiting reduces the risk of someone later regretting irreversible procedures. At the age of 25, a person is also often better able, legally and emotionally, to make well-considered, independent decisions about such a radical choice.

At Wellness Kliniek, we believe that providing transparent information is of the utmost importance. It is essential that you are well informed about the procedure. Choosing to undergo transgender breast reduction surgery is not a decision to be taken lightly; it is a carefully considered step in your transition process and a significant phase in your life. During a no-obligation consultation, the doctor will ask the right questions to find out what you want and determine whether you are eligible for surgery. Every person and every journey is unique, so let the gender surgery experts guide you at your own pace and according to your wishes.

The surgeons at Wellness Kliniek have experience with transgender breast reduction and are happy to help you achieve the chest that really suits you. We also use transparent prices (all-inclusive), so you know what to expect in that area as well. We are also there for you after your trans breast reduction with aftercare.

As mentioned, there are various types of surgical techniques for transgender breast reduction, such as the keyhole technique, double incision and the donut procedure. The best technique is tailored to your body shape. This depends on factors such as the size of your current breasts and nipples, and skin elasticity.

You can rest assured that the doctor at Wellness Kliniek will always choose the technique that will give your body the most beautiful/desired result.

Depending on the type of procedure, you may be able to go home the same day or you may need to stay in the clinic overnight. Your surgeon will discuss this with you in advance and draw up a personal aftercare plan.

Immediately after the operation, two drains are sometimes inserted – one on each side of your chest. These drains run through a small incision under your armpits and collect blood and lymph fluid in a small reservoir. In most cases, the drains are removed the next morning, after which you can return home or to your hotel.

Sometimes it is necessary to go home with the drains in place. You will then return to the clinic once the production of fluid has decreased sufficiently, or you can have the drains removed by your own GP or nurse in your area.

When you wake up from the anaesthetic, you will already be wearing a chest band or compression bandage. This pressure bandage helps to prevent fluid accumulation and supports recovery by allowing the skin to adhere to the chest wall. You will wear this bandage according to your doctor's advice, usually for several weeks.

On average, you will wear a tight chest band or compression binder for 6 weeks after the operation. Depending on the specific procedure, this may be longer or shorter. The doctor will inform you personally about this. The necessary chest band or compression binder is included in the all-inclusive price at Wellness Kliniek.

The doctors always operate in a way that achieves the desired result with as few incisions as possible. However, incisions (and therefore scars) are unavoidable in transgender breast reduction surgery. You will be given detailed information in advance about what to expect in your situation. Where possible, we will make the incisions in folds or around the areola. You will also receive detailed instructions on scar care to ensure that the incision heals as well as possible. Over time, the scar will fade and become less visible.

Sometimes yes, sometimes (partially) no. It depends on the technique chosen for the FTM breast reduction surgery. Of course, the doctor will take your wishes into account and choose a technique that preserves the surrounding nerves as much as possible. Sometimes sensation may be temporarily lost, but it will return over time. This will, of course, be discussed with you in detail during the consultation.

Fortunately, the chance of necrosis (complete death of the nipple) is extremely rare, but it can occur. This is more common in smokers (smoking reduces blood flow). We therefore recommend that you stop smoking at least 6 weeks before the procedure.

At Wellness Kliniek, we believe it is extremely important that you are well informed about all possible disadvantages, risks and complications. No operation is 100% risk-free, but by applying strict safety measures and good monitoring, we keep the chance of complications as small as possible. Some possible risks of mastectomy are:

• Infections and bleeding: with proper aftercare and by following the aftercare instructions, the risk of bleeding and infections in the wound area is small, but possible.
• Loss of nipple sensation: sensation in the nipple may be temporarily or permanently reduced or lost. This depends on the technique used to perform the operation, and the doctor can often give you an indication of this in advance.
• Scarring: depending on the exact procedure, a scar may be more or less visible (you will be informed of this in advance). We will provide you with specific aftercare instructions so that you can properly care for the incision. This reduces the risk of scarring. Scars heal differently in everyone due to a combination of genetic, physical and environmental factors. Some people produce more connective tissue than others, which can lead to more noticeable or abnormal scars, such as keloids.
• Dissatisfaction with the result: if you have an FTM breast reduction, the result may not be what you expected.
• No complete reversibility: with various procedures, the external result can be partially reversed, but it will never be exactly as it was before.

The doctor will discuss all possible risks and complications during the consultation because, as a patient, you are entitled to complete, honest and understandable information in order to make an informed decision. Surgical procedures – especially in trans care – are often invasive and sometimes irreversible, so it is crucial that you know what to expect, both positive and negative.

In addition, discussing risks is an important part of medical ethics and is also required by law (informed consent). This prevents misunderstandings, increases trust between you and the doctor, and allows you to better assess whether the procedure is really the right choice for you at this time.

If you would like to lose weight, it is recommended that you do so before undergoing FTM breast reduction surgery. Breasts consist of fat and breast tissue, and breasts can become smaller as you lose weight. By losing the desired weight first, the doctor can tailor the result to your body more effectively.

Immediately after FTM breast reduction, you will already see a clear difference in breast contour, but the area will often still be swollen and covered with bandages or drains. After a few weeks, the bandages are usually removed and you can assess the result more accurately. Most of the swelling subsides within 6 weeks, but the final result is only clearly visible after a few months, usually around 3 to 6 months. Scars fade gradually and can take up to a year to a year and a half to settle.

No. Transgender procedures at Wellness Kliniek are not covered by health insurance, mutual health insurance funds or other insurance providers. However, operations that are medically indicated may be exempt from VAT. This saves you 21%. Transgender breast reduction is usually medically indicated. Discuss this with your doctor.

No. Going through a (reimbursed health insurance) medical process for transgender surgery is often considered complicated and undesirable. This involves an extensive psychological evaluation, which requires approval from a gender team (for medical necessity due to established gender dysphoria) in order to be eligible for reimbursement or refund from health insurance.

At Wellness Kliniek, patients pay for their own treatment. A referral letter is not required. Often, patients have already made the transition years ago and breast surgery is the final step. If a psychological evaluation is deemed necessary, the doctor will discuss this with you.

Yes. At Wellness Kliniek, you can set up a savings account free of charge, into which you can deposit a monthly amount of your choice. Once you have saved up the amount for the procedure, we will contact you.

Would you like to undergo your transition as soon as possible, but do you currently lack sufficient financial resources? Through instalment payments and medical financing, you may be able to obtain credit for your transgender breast reduction. Please note that borrowing money costs money. Wellness Kliniek is not a credit organisation itself, but we are happy to provide you with information about a number of options on the page about financing.

A transgender breast reduction can be performed in both a hospital and a private clinic. There are advantages to both options.

The advantage of FTM breast surgery in a hospital is that the costs may be covered by insurance, provided you undergo certain psychological tests and build up a medical file that covers the surgery. However, such a medical process is often perceived as complicated and stressful, which may be a reason to choose a different path to the chest that suits you.

The advantages of choosing Wellness Kliniek for FTM breast surgery are that you do not have to go through the medical process prescribed by hospitals and health insurers. You will be put in direct contact with a surgeon who specialises in breast aesthetics and has experience with breast reduction surgery for this target group. Do you want to have the procedure done for aesthetic reasons and because it better suits your identity? Then a private clinic such as Wellness Kliniek often offers short waiting lists without you having to go through complicated procedures.

Aesthetic breast surgery is one of Wellness Kliniek's core specialisations. Thanks to our many years of experience and focus on quality, we welcome many international patients every day, from Europe and other continents. Our plastic surgery clinics in Genk (Belgium) and Barcelona (Spain) are fully equipped to provide safe and accessible care for trans men and trans women from home and abroad. Through our Medical Travel and Next-Day-Surgery services, we make it easy to plan cosmetic surgery with us, regardless of your nationality or gender. Comfort, discretion and expertise are our top priorities.

Yes, gynaecomastia is a form of FTM breast reduction in which fat is removed from the breasts using liposuction. The procedure is mainly performed on men with man boobs, but in exceptional cases it can also be used in female-to-male surgery. It is usually only effective if the breasts are relatively small to begin with. The surgeon will be happy to discuss the options with you personally.

Yes, an FTM breast reduction is essentially permanent, because the breast tissue is surgically removed. Hormonal changes or weight gain could cause the results to change slightly. Would you like to have breasts again at a later date? Then you can opt for breast augmentation with implants. Please note that you will not regain the same effect and feeling in your breasts. The doctors will be happy to discuss the options for your body.

Yes, you can! Viewing before and after photos of transgender breast reduction surgery will help you get a better idea of the possibilities. Keep in mind that results may vary from person to person, depending on your body. You will be informed about this in detail during a consultation. Of course, you can rest assured that the plastic surgeon will always strive for the best possible result for you. You are also welcome to bring FTM photos to the consultation to clarify your wishes.

There are numerous clinics that perform breast reduction surgery (mastectomy), some of which also perform Top Surgery (transgender breast reduction). It is wise to choose a clinic that specialises in this procedure and performs it on a weekly basis, such as Wellness Kliniek Belgium and Spain.

It is also a good idea to choose a clinic with proven quality. ISO 9001 quality assurance is an international standard for quality management, and when a clinic has this label, it meets high standards in the field of safety. Plastic surgeons who have proven experience with Top Surgery know how to achieve a beautiful result based on your body.

Furthermore, patient reviews for Top Surgery can help you get a good idea of the clinic. Wellness Kliniek has won the WhatClinic Award for excellent patient experiences several times, and we are proud of that. From consultation to aftercare, the entire process is important. You can also come to us for a second opinion.

Finally, transparent information and personal advice are very important. Feeling comfortable with the clinic and the doctor, as well as having all the information you need, will help you decide whether the procedure is right for you. You will get a good idea of what to expect, including in terms of recovery and scarring. Top Surgery is tailor-made and must be tailored to your body, wishes and pace. That is what the doctors at Wellness Kliniek strive for.

Wellness Kliniek has expert surgeons who are experienced in top-level surgery. This is a specialism that requires the necessary knowledge and skills. We not only receive patients from Belgium, the Netherlands, France and Spain, but also many international people from the transgender community (for both female-to-male and male-to-female operations). They come to Wellness Kliniek specifically because of its good reputation in the field of gender operations and transformations.

We are equipped to handle this, with services such as Next Day Surgery Service and doctors who specialise in this field. We are happy to guide you through the entire process, from pre-operative care to surgery and excellent aftercare – remotely if necessary. In addition, we offer short waiting times, transparent prices and guidance in various languages.