Gender-affirming chest surgery changes the shape of the chest to match your gender identity: for FTM, removing breast tissue and shaping a masculine chest contour; for MTF, creating volume with implants or fat grafting.
Gender-affirming chest surgery creates a chest shape that matches your gender identity. For trans men (FTM), the goal is to remove breast tissue and create a masculine chest contour; for trans women (MTF), it is to create feminine volume with implants or autologous fat. The two surgeries go in different directions, but they share the same principle: the shape is designed around what you want to see.
In FTM surgery, the incision approach and the way the nipple is handled depend on breast size, sagging and skin elasticity, and adjusting the size and position of the nipple and areola to a masculine pattern decides the result. In MTF surgery, the chest is often wide with widely spaced nipples, so implant size, position and pocket plane must be chosen accordingly, and the plan changes with how much breast tissue has developed under hormone therapy.
At Atelier Plastic Surgery, Dr. Go personally handles everything from consultation to surgery and follow-up, and consults in a manner that respects your identity and the direction you want to take. Dr. Juyoung Go chaired the gender-affirming surgery session at Aesthetic Plastic Surgery Korea (APS Korea) 2023. Before surgery, we go through the required diagnostic and consultation steps and review your hormone therapy status together.
Breast tissue is removed through an incision around the areola, and the areola is reduced if needed. The scar sits at the border of the areola and the blood supply and sensation of the nipple can be preserved, but the amount of skin that can be removed is limited.
Through a horizontal incision along the lower chest, breast tissue and excess skin are removed; the nipple and areola are detached, reduced in size and grafted in a masculine position. Because sagging skin can also be removed, a flat chest contour can be created, but a horizontal scar remains and nipple sensation is reduced.
Fat on the sides of the chest and the front of the armpit is suctioned to smooth the chest contour and reduce the skin excess that forms at the ends of the incision. It is often combined regardless of the excision method.
Implants are placed to create feminine volume. The chest is often wide with widely spaced nipples, so the width and position of the implant are matched to this, and when breast tissue is scant, the implant is placed under the muscle or under the fascia so that its outline does not show. The type, surface and shape of the implant are decided at consultation.
Autologous fat is harvested from the abdomen or thighs and grafted into the breasts. It is used to create gentle volume without an implant, or to blend the outline of an implant naturally into the breast. Because fat survival varies by individual, it may be carried out in several sessions.
These may vary depending on your condition; we will give you precise details at your consultation.
Even within FTM surgery, people think differently about the chest shape they want, the size of the nipple and where the scar should be. We listen with respect for how you express yourself and what you want to see, and decide the method together.
We choose between a periareolar and a double incision according to breast size, sagging and skin elasticity, and adjust the nipple and areola to a masculine size and position. At consultation we explain the balance between reducing scarring and creating a flat contour.
Assuming a wide chest, widely spaced nipples and little breast tissue, we decide the width, size and position of the implant and the pocket plane. We check the expected shape with 3D simulation and, if needed, refine the contour with fat grafting.
Gender-affirming surgery involves required steps such as psychiatric diagnosis and consultation, and if you are on hormone therapy, adjustments before and after surgery may be needed, which we coordinate with your prescribing clinician. Preoperative tests and consultation with an anesthesiologist follow.
After general anesthesia, your condition is monitored in the recovery room and you rest in a private recovery room. Drains may be kept in place, and depending on your condition you go home the same day or stay one night.
This is the period of swelling, pain and a pulling sensation. You wear a compression garment or binder, take the prescribed medication and avoid raising your arms widely.
At your visit we check the wound and drain output and remove the drains. If the nipples were grafted, we check that they are taking, and showering becomes possible depending on the wound.
Stitches are removed. Much of the swelling has subsided and you return to light daily activities. Compression is continued for several more weeks depending on your condition.
Scar care begins. We check your condition with ultrasound, and light exercise can begin. Upper-body strength training starts after this point, depending on how you are recovering.
The shape settles and the redness of the scars fades. We check symmetry and contour and, if needed, discuss aftercare such as scar laser treatment or further adjustment.
After gender-affirming chest surgery, bleeding, infection, hematoma and seroma, and delayed wound healing may occur. In FTM surgery, reduced or lost sensation in the nipple and areola is common; in particular, when the nipple has been grafted, sensation may barely recover, and if the graft takes poorly, part or all of the nipple may be lost. The scar from a horizontal incision may widen or become red and thickened, skin excess may remain at the ends of the incision, the chest contour may become uneven, and asymmetry or differences in nipple position and size may occur. In MTF surgery, capsular contracture, implant malposition, rippling, changes in shape with movement of the chest muscle and visible implant outlines may occur, and because fat survival varies by individual, fat grafting may lead to absorption and calcification. Hormone therapy may be associated with a risk of blood clots and may need adjusting before and after surgery, and smoking affects wound healing and nipple graft survival. Revision surgery may be needed depending on the result, outcomes vary by individual, and all of this is explained fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
Implant breast augmentation with size and pocket plane chosen by body type and tissue thickness
Learn more Related Non-implant breast augmentationNon-implant breast augmentation with the material chosen by the enlargement needed and your body fat
Learn more Related Breast reductionBreast reduction that takes away weight while keeping your proportions
Learn more Related Breast liftA breast lift with the incision pattern chosen by the degree of sagging
Learn moreConsultations are conducted by the Director herself. Schedule one by phone or KakaoTalk, or leave an online consultation request.
