Gender Surgery

FTM Top Surgery

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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Award Winning Specialist Clinic

We've won 12 top industry awards since 2010 and regularly feature in the national and international press.

Industry Leading Consultants

We've invited only the very best consultants in the country to practice with us.

Care Quality Commission

We're regulated by the independent regulator of health and social care in England.

GMC Registered Surgeons

All of our surgeons are registered with the General Medical Council.

What is FTM Top Surgery?

Female to male (FTM) top surgery is a surgery which is carried out on transgender men to create a flatter, more masculine-looking chest.

This is done by removing the breasts (mastectomy) and any excess skin and fat around the breast area. The nipples and areolas (the dark area surrounding the nipple) are then repositioned. There are a number of different surgical options, depending on the size of the breasts and the elasticity of the skin.

FTM top surgery is a permanent alternative to chest binding, which can sometimes cause issues such as skin irritation and breathing difficulties.

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FTM Top Surgery
At a glance

Surgery Time

2.5 hours

Time off work

2 weeks

Hospital Stay

Day Case


6 days

Reasonable Mobility

Same day


6 weeks

Bras & Garments

6 weeks

45 degrees

2 weeks

Full Recovery

6 weeks

Why do people have it?

Female to male top surgery is used to create a natural-looking male chest. Top surgery helps to alleviate gender dysphoria, a condition that causes great distress and stems from a feeling of disconnect between a person’s biological sex and gender identity.

Female to male gender reassignment helps to treat gender dysphoria and helps to alleviate the mental health issues that can come with this diagnosis, such as depression and anxiety. FTM surgery will help to boost your confidence and self-esteem and have a positive impact on your quality of life. The aim of female to male surgery is to help you feel at ease with your identity.

Who is suitable?

FTM top surgery is for trans men who have been diagnosed as having gender dysphoria. Before you have female to male gender reassignment surgery you should have been living as your preferred gender for at least a year and must have undergone a psychological assessment. You must be over 18 to undergo FTM top surgery.

Ahead of FTM surgery you should stop smoking, make sure any existing medical conditions, such as diabetes, are under control and lose weight if you have a body mass index (BMI) of 25 or more.

Your surgeon must be satisfied that you are in good mental health ahead of surgery.

Any person undergoing female to male gender reassignment must have realistic expectations of what can be achieved through surgery.

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The cost of FTM Top Surgery

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What are the options?

When it comes to FTM top surgery, there are a number of different methods. These are double-incision top surgery, periareolar top surgery and keyhole top surgery. The method used will depend on various factors, including the size of the breasts and skin laxity. We will look at these methods here.

Double-incision top surgery: This is the most common type of FTM top surgery. The surgeon will start by removing the nipples and areolas (the dark area of skin around the nipples) and making them smaller. They will then make long incisions to remove the breasts (mastectomy) and liposuction is used to remove any excess fat. Any excess skin is also removed. Special stitches will be used in order to prevent any puckering of the skin near the incision sites.

Finally the nipples and areolas are reattached in their new position on the flatter chest.

Periareolar top surgery: Also known as donut procedure, periareolar top surgery is best suited to people with smaller chests. Periareolar top surgery involves making one circular incision around the border of the areola, followed by a second, larger incision around the first one. The surgeon will then remove the breast tissue and use liposuction to suck out any excess fat. The edges of the larger incision are then pulled together, resizing the areola.

Keyhole top surgery: This particular method of FTM top surgery is best suited for those with very small chests and tight skin. It is a straightforward procedure that involves making a small incision along the bottom half of the areola, leaving it partially attached to the body. Just like periareolar top surgery, the breast tissue is removed and liposuction carried out. The nipples will be resized if necessary.

Female to male top surgery is performed under a general anaesthetic and the procedure takes around two-and-a-half hours from start to finish.

FTM Top Surgery Surgeons

We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.

What to expect

Below you will find some key information to help you prepare for surgery and make necessary arrangements to ensure you have the support you need and that everything runs smoothly on the day.

The first step for all of our patients is to meet with the surgeon we feel is best placed to perform your procedure for a consultation.

At the consultation you will be able to discuss with your surgeon what your hope to achieve from the procedure, as well as discuss in detail what may or may not be possible.

Finally a comprehensive discussion regarding risks and complications will take place, alongside a discussion regarding the post procedure and recovery phase. Your previous medical history will also be recorded (including previous surgery, medications, allergies etc.) and an assessment of your fitness for surgery.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed for surgery or otherwise following a two week 'cooling off' period.

Within this period you are welcome to come in and discuss your potential surgery with your surgeon as many times as you like.

If you choose to proceed with surgery, the next time you come into the Clinic after your final consultation will be the day of your procedure.

Before admission the following behavioural changes are recommended / required:

  • In the 6 weeks before your procedure we recommend smoking is discontinued as patients who smoke have a higher risk of healing more slowly and complications
  • In the week before your procedure you must cease taking Aspirin or any medication that contains Aspirin
  • In the 6 hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid (e.g. still water, black coffee, black tea) which are allowed up to 2 hours before admission)

Your FTM top surgery will take place under a general anaesthetic as a day case at our Chelsea clinic.

Once you are unconscious, the surgeon will start your mastectomy using double-incision top surgery, periareolar top surgery or keyhole top surgery. The method used depends on various factors and varies from patient to patient.

The top surgery should take around two-and-a-half hours from start to finish. After the procedure is complete, you will need to rest and wait for the effects of the anaesthetic to wear off. You may need pain relief.

When you leave the clinic, you must be accompanied by a responsible friend or family member.

It is important to follow all the aftercare advice issued by your surgeon following your FTM top surgery. Failure to do so may delay healing and impact upon the final result.

You will need to take two weeks off work following your top surgery. Exercise, including any sports and the gym, must be avoided for six weeks after surgery. During these six weeks you must wear a surgical garment in order to keep the shape of your new chest. You should expect a full recovery at around the six week mark.

As part of your treatment with the Cadogan Clinic, you will have access to 24/7 on-call nurse assistance for the duration of your recovery.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

FTM surgery helps to alleviate gender dysphoria by bringing a person’s body in line with their gender identity. Most people who have top surgery will find that they have an improved self-image once the operation is completed and the body has had a chance to heal. By helping trans men to feel happier and more connected with their bodies, this usually has an overwhelmingly positive impact on all areas of their life. FTM surgery helps to restore confidence and improves mental health, alleviating the symptoms of depression and anxiety.

This newfound confidence can help in the workplace, in social situations and aid with forming romantic relationships.

Top surgery results in a more masculine-looking chest, replacing female characteristics. Our surgeons at the Cadogan Clinics are experts in their field and have the knowledge and skills to help you to reach your body goals.

The best surgeon to perform top surgery is an aesthetic surgeon who has specific training in gender-affirming surgeries.

Here at the Cadogan Clinic, all of our surgeons are world-class experts in their field. This expertise means that our surgeons are highly sought after to perform female to male surgery in London.

You should expect a degree of scarring following any type of top surgery. Scarring from surgical incision looks like a thin, raised line on top of the skin. As it heals, it will darken and flatten.

The size, length and exact location of these scars in FTM top surgery depends on the surgical technique used. The keyhole and periareolar methods of top surgery are  less invasive than double incision top surgery. As a result, this generally results in less scarring.

The good news is that any scarring will gradually fade, but the speed of this varies from person to person. Three months after surgery you can start to use bio oil on your scars to help lessen their appearance. You should avoid smoking, tanning, excessive scrubbing and scratching the area during the healing process as these can make scarring worse.

Some people have a condition called keloid that causes excessive tissue growth in the wound area. Keloid scars are thicker and more noticeable than regular scars. In the unlikely event that you acquire an infection of the wound, this can also make scars thicker and it takes longer for them to go.

The Cadogan Clinic provides every patient with access to one of London’s most advanced scar minimisation programmes, led by our scar prevention team here at the clinic.

After the post-surgery swelling subsides, you should expect to have a flatter, contoured, more masculine-looking chest. There may be some scarring, depending on which technique is used in your top surgery. You may also find that you experience a reduction or loss of nipple sensation, depending on which surgical technique is used during the operation.

Once you have recovered from your operation, you can begin to enjoy a new body which helps to heal the feeling of disconnect caused by gender dysphoria. You should notice an overall boost in your mental health and wellbeing, as well as a boost in self-confidence.

You can expect some discomfort for around four or five days after your FTM top surgery. In the event that you do experience any mild to moderate pain or discomfort, this can be controlled with over-the-counter painkillers. The chest area will be swollen and on average this will take two to three weeks to subside. However you may find the area is still swollen for anywhere up to six months after surgery.

As part of your treatment with the Cadogan Clinic, you will have access to 24/7 on-call nurse assistance for the duration of your recovery.

Yes, it is possible to get FTM top surgery on the NHS if you meet the criteria. However the NHS waiting list for female to male gender reassignment is very long.

If you choose the Cadogan Clinic for your FTM top surgery, there are no waiting times and you will get your treatment sooner.

Top surgery is permanent. Your breasts will not grow back after the operation and any reconstructive surgery will not return your chest to the way it looked before. It is therefore of paramount importance that you are 100 percent certain about your goals before taking such major steps to change your body. You must also have realistic expectations about what FTM top surgery can achieve. Book an appointment with one of our expert surgeons here at the Cadogan Clinic who will run through the options with you.

If the milk ducts are removed during top surgery, then you will not be able to breastfeed or chestfeed. If some of these milk-producing ducts are left behind, then it may be possible.

If you are taking testosterone as part of your treatment, then this may affect the production of the hormone needed for lactation.

It is important to note that many factors can affect a person’s ability to breastfeed or chestfeed. A person who has all their milk ducts and is not taking hormones may still find they do not produce enough milk. Formula milk is a perfectly healthy and safe way to feed a baby.

A mastectomy (breast removal) is just part of FTM top surgery. Liposuction is also used to remove excess fatty tissue to create an improved contour and the nipples will also be repositioned to a more natural-looking position.

Depending on the results of your FTM top surgery, the surgeon may feel that further procedures are necessary. This may include more liposuction, dog-ear surgery to remove puckered skin at the end of the scar line, and possible nipple reconstruction if required.

A state of the art, award winning clinic.

Founded in 2004 by world renowned plastic surgeon Mr Bryan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.

About Us

Best in Class Facilities

All of our treatments take place at our beautiful boutique premises in Chelsea. We have six consulting rooms and five operating rooms, as well as a dedicated pre and post-operative suite, and a full team of specialist nursing staff.

Our Clinic

A Strong Tradition of Innovation

We were founded in 2004 by world renown plastic surgeon Mr Bryan Mayou, best known for his pioneering work in the area of liposuction, lasers and microvascular surgery. We continue to collaborate with pioneers in our field.

Our History

At Home in Sloane Street, London

We are proud that our state of the art award-winning clinic is located in one of the best neighbourhoods in the country

Welcome to Sloane Street

Clinics Nationwide

We offer surgical consultations in London, Birmingham, Chelmsford and Bristol, and attract international patients from all corners of the globe such as as the USA, the Middle East and Europe.

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What are the risks?

As with most operations, there are risks attached to FTM top surgery. Risks associated with this type of surgery are:

  • Bruising of the chest or abdomen
  • Loss of nipple graft
  • Infection
  • Fat necrosis (formation of hard lumps under the skin)
  • Skin necrosis (tissue death)
  • Nipple necrosis (nipple death)
  • Asymmetry (when both sides are uneven. This can be corrected with further surgery).
  • Synmastia (when two scar lines merge into one long scar)
  • Scarring
  • Haematoma (blood pooling under the skin at the surgical site)
  • Seroma (build-up of serous fluid between the tissues and the skin)
  • Altered or loss of sensation in the nipples
  • Loss of skin sensation

General complications from any type of surgery include pain, scarring, blood clots (deep vein thrombosis) and an adverse reaction to the anaesthetic.

Gender Surgery

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We believe in the delivery of excellent outcomes and results, and exceptional levels of service. Our outcomes are natural and long-lasting, and we remain the premier choice for cosmetic surgery treatments in the UK.

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