Top surgery is a type of gender-affirming surgery that involves modifying the breast tissue to reflect a patient’s gender identity. At Cultura Dermatology and Plastic Surgery in Washington, DC, Dr. Kelly Bolden, FACS, specializes in FTM (female-to-male) and MTF (male-to-female) top surgery, or chest surgery. Our approach is welcoming and customized, focusing on helping our patients look and feel more like their true selves.
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Who is a Good Candidate for Top Surgery?
Good candidates for top surgery are transgender patients looking to make their physical appearance more congruent with their gender identity. In accordance with the World Professional Association, candidates should be in good overall health, have a stable weight, and clearly understand their goals and what the surgery entails. An initial consultation with Dr. Bolden includes an evaluation and discussion of goals and expectations of gender affirmation surgery, ensuring transgender health concerns are prioritized, and patients are prepared for this life-affirming step.
Top Surgery Benefits
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Gender Affirmation
Helps patients live more comfortably in their gender identity, combatting negative feelings and poor mental health caused by a misperception of a person's gender identity, called gender dysphoria.
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Improved Self-Esteem and Confidence
Creates significant psychological and emotional relief after surgical procedures.
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Permanent Results
Provides enduring changes that support the patient's gender expression.
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Customized Procedures
Offers customization for the patient's unique body and transition goals.
Preparing for Top Surgery
Preparation for top surgery with Dr. Bolden includes a thorough consultation planning stage. Patients may need to undergo medical evaluations and adjust or cease certain medications. Patients will need to stop smoking, along with other specific steps provided by their health care providers.
Top Surgery Procedure
Top surgery requires informed consent to ensure patients are aware of the risks and are fully prepared for their top reassignment surgery. It can help align physical appearance with gender identity but can also significantly improve self-confidence and comfort in one’s body.
Dr. Bolden performs top surgery using techniques that are best suited to each individual’s needs:
- FTM Top Surgery: FTM (Female-to-Male) top surgery is a gender-affirming procedure designed to create a more masculine chest by removing breast tissue and reshaping the chest contour. The masculinizing chest surgery typically involves a double incision technique with free nipple grafts or a periareolar (keyhole) method, depending on the patient’s anatomy and desired outcome. During the procedure, excess skin and fat are removed, and the nipples may be resized or repositioned to achieve a natural, masculine appearance.
- MTF Top Surgery: MTF (Male-to-Female) top surgery is a gender-affirming procedure designed to create a more feminine chest by enhancing breast size and shape through breast augmentation. The surgery typically involves the placement of silicone or saline implants, though some patients may opt for fat transfer to achieve a more natural look. During the procedure, an incision is made either along the inframammary fold, around the areola, or in the armpit, depending on the patient’s anatomy and aesthetic goals. The implants are then positioned to create a fuller, more feminine chest.
Results of Top Surgery
The final results of top surgery are designed to enhance comfort in one’s body and to affirm gender identity. Patients often see immediate changes, with final results developing as swelling decreases.
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The cost of top surgery at Cultura Plastic Surgery varies depending on the specific procedures chosen and the complexity of the surgery. During the initial consultation, Dr. Bolden provides a detailed pricing breakdown, discussing all options and associated costs.
Recovery from top surgery varies but generally involves rest and closely following post-operative care instructions. At Cultura, we understand the importance of support during this time. Dr. Bolden and our team offer ongoing assistance, ensuring patients are comfortable and well-informed throughout the healing process.
As with any surgical procedure, top surgery carries potential risks, including infection, adverse reactions to anesthesia, and dissatisfaction with the aesthetic results. Dr. Bolden discusses all possible risks and ensures patients feel confident in moving forward with surgery.
What to Expect From a Top Surgery Consultation
During the consultation, Dr. Bolden conducts a thorough assessment, discusses each patient’s transition goals, and outlines the best surgical options. This session is designed to answer any questions, ensuring that patients feel fully prepared and confident in their decision to proceed with top surgery. We understand fully realized gender identity looks different for every patient, and are open to discussing resources for transgender health including trusted mental health professionals and primary care providers. We can also help you understand the benefits and risks of other gender affirming surgeries and treatments, such as facial surgery, bottom surgery, hormone replacement therapy, or genital surgery.
Dr. Kelly Bolden
In the world of plastic surgery, few names shine as brightly as Dr. Kelly M. Bolden's. A double board-certified plastic surgeon, she has earned a reputation as a compassionate healer, an innovative mind, a dedicated educator, and a tireless advocate for the underserved.
