Top Surgery
Chest masculinization surgery, also known as top surgery, is a gender-affirming procedure aimed at removing breast tissue and creating a flatter, more masculine or neutral chest appearance.
This surgery is a key step for many transmasculine or non-binary individuals, and it can have a profoundly positive impact on emotional well-being, body image, and overall quality of life.
At our clinic in Mataró (Barcelona), we offer this procedure in a fully personalized way, adapting the surgical technique to each patient’s physical characteristics and personal goals. We are committed to providing a safe, respectful, and professional environment where you’ll feel supported throughout the entire process.
Surgical Techniques for Chest Masculinization
At our clinic in Mataró (Barcelona), we offer personalized chest masculinization procedures, tailored to each patient’s anatomy and goals. There are several surgical techniques available depending on breast size, skin elasticity, and nipple anatomy.
- Double Incision Mastectomy
This technique is recommended for patients with larger chest volume or reduced skin elasticity. It involves two incisions: one along the inframammary fold and another above the nipple line. During surgery, glandular breast tissue and excess skin are removed. The nipples and areolas are resized and repositioned as free grafts on the chest wall.
After surgery, the grafted nipples typically lose erotic sensitivity but may regain basic touch sensation over time.
Advantages:
-
Best contouring results for larger chests
-
Allows for full chest reshaping and optimal nipple positioning
Considerations:
-
Loss of nipple sensation is common
-
Longer scars, though they tend to heal well
- Subcutaneous Mastectomy with Nipple Preservation
Best suited for patients with small to moderate chest size and good skin tone. The procedure involves a single incision under the breast to remove breast tissue, while preserving the overlying skin and nipple-areolar complex. Nipple reshaping may be done to achieve a more masculine appearance.
Advantages:
-
Shorter scar
-
Preserves nipple attachment and potentially some sensation
Considerations:
-
Less effective for larger chests
-
Slightly higher chance of residual tissue
- Periareolar Mastectomy
Ideal for individuals with small breasts and minimal skin excess. A circular incision is made around the areola to access and remove breast tissue. The skin is then tightened, and the areola remains attached.
Advantages:
-
Minimal scarring (hidden around the areola)
-
Nipple and areola sensitivity often preserved
Considerations:
-
Limited effectiveness for larger or sagging breasts
-
May require revisions to improve contour
- Postoperative Information
-
Duration: Surgery usually takes 2 to 4 hours and is performed under general anesthesia.
-
Hospital Stay: An overnight stay may be recommended in some cases.
-
Compression Garment: A compression vest must be worn for 3 to 4 weeks.
-
Activity Restrictions: Avoid lifting heavy objects or upper body exercise for 4 to 6 weeks.
- Oncological Screening
Regardless of the surgical technique, a small amount of residual breast tissue may remain. Therefore, regular breast cancer screenings should continue as advised by your medical team.
-
What does facial lipofiling consist of?Lipofilling / facial lipostructure or facial filler surgery with fat grafting allows us to recover the lost volume in different areas of our faces (cheeks, cheekbones, lips, chin) due to the passage of time, trauma scars or asymmetries. During surgery, fat is extracted by liposuction from a donor area (usually the abdomen), it is processed to purify the fat graft and it is injected in the desired location.
-
Who is a candidate for facial lipofilling?Any patient with a facial contour defect, either due to atrophy of fatty tissues due to age, facial trauma or previous surgeries.
-
Are there any contraindications to perform this intervention?Tobacco may be a relative contraindication, since tobacco decreases the survival of the fat graft in the recipient area.
-
Can facial lipofilling be performed in conjunction with another procedure?Facial lipofilling can be combined with other facial procedures, such as eyelid surgery (blepharoplasty) or facelift. It could also be associated with body surgeries.
-
What can you expect in the postoperative period?After a facial lipofilling surgery we can wait: - Edema / swelling of the infiltrated area (face) and the donor area (abdomen / flanks / thighs), which usually lasts 7 - 10 days, and which will be mitigated with physical measures (elevated head, local cold, girdle compression abdomen) along with analgesic (pain) and anti-inflammatory medication. - Hematoma / "purple" in the treated areas, which usually disappear after 2 weeks. - Pain / discomfort in the treated areas for the first 5 - 7 days, for which you will receive analgesics.