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How Much Is Top Surgery Going To Impact Your FTM Transition?

Sep 20, 2018 | Body

No surgery comes without some risk. Like any other medical procedure, the weight of the benefits must be measured against the negative possibilities.

When it comes to the topic of top surgery the question that needs to be addressed is, "how much is top surgery going to impact positive change?"

People going through a transition know how these arguments go. Nothing up to this point has been easy and second guesses from within and without both seem omnipresent.

Fortunately, this guide will provide robust information on key impacts of a top surgery. This way a patient can answer and justify their answer to all comers.


TThe risks associated with a top surgery fall in physical areas. These are no different than any other surgery. Complications can arise from the procedure itself, anesthesia, and recovery.

TThe benefits, however, come in a variety of categories. Any single one of these benefits may be enough for a person to decide on a top surgery route, but together they can be a bit overwhelming.

Categories include emotional, mental, physical, and social impacts.


Arguments exist within and without the community the overall need to 'pass' for the identified gender. The important part of that argument hinges on the personal perspective of the person dealing with their own transition. No consensus will ever matter when personal choice is the whole point.

A key emotional impact comes from self-acceptance and the confidence it brings. No more looking in the mirror and thinking that the internal image and the external image are at odds.

Just like binders, top surgery has its share of emotional uplifts and some physical risks. Unlike binders, though, a top surgery gets past the physical risks shortly after the procedure.

Risk of depression and depression-related side effects, such as substance abuse and self-harm, drop. Various types of escapism and avoidance behavior drop when a person no longer feels like they need to hide from themselves inside themselves.

A person gains the ability to face the world without previous worries and embrace a higher standard of life.


The further along the path a person goes, the more certain that path becomes. So it is with undergoing top surgery.

The constant nagging in the back of the mind that a person is an imposter fades when there is less evidence to point to that. Studies have shown that top surgery improves mental health across several categories. Included in these aspects are improvements in body image and lower incidents of self-monitoring and avoidance.

The feeling of standing out or being noticed in some abject but intangible fashion fades for many after a top surgery. This may be related to an internal adjustment of feeling right in the right skin. It may also come from the lowered amount of preparation and self-checks associated with wearing a binder.

Top surgery often comes as a final step for a transitioning individual. This end-of-the-road milestone brings more significance by virtue of ritual thinking.

For those in which it is another step in a transition, it is a significant commitment of time and resources. Surgery often comes after 18 months to two years of HRT beforehand.


The most noticeable impact of a top surgery FTM is physical. A person doesn't just end up finding a chest to match their personal vision. They also gain from hormonal benefits.

Adipose tissue around the breast is responsible for generating an amount of estrogen and progesterone. By reducing the size of these areas, or removing them entirely, the manufacturing of these hormones shuts down.

This gives a stronger boost to HRT and testosterone supplements that no longer have to counteract these opposing hormones.

A top surgery gives a visible benefit but also this internal benefit. The synergistic effect of these things happening at the same time can be more dramatic than people expect.

The recovery process also does a good job of getting a person used to their new body shape. Much like going through puberty, the pain and the awkward adjustments (and sometimes questions) create a firm signpost for a person.

Like any metamorphosis, the pathway to the final form provides a lot of meaning.


Fear and embarrassment powerfully motivate many social interactions. When working with a binder, many find themselves working through public spaces ever cautious of letting their binder be seen.

Locker rooms, bathrooms, and beaches all have risks of being seen as something other than as a person wants to be seen.

These fears go away after a top surgery and recovery time fades the minimal markings from the procedure.

Finally, a person can go where they want and not be worried that someone will spot a tell-tale sign that something is different or out of place.

The removal of these fears also allows a person to engage more fully in social activities. This, in turn, makes being social a stronger pull. This self-feeding cycle helps to put a person's identity out there and be accepted.

Moving bast avoidance and depersonalization helps patients to feel less keenly. That is to say, a person becomes less aware of their body as a vessel and simply starts living.

For people who don't live their lives feeling like the body is a suit that doesn't fit or a machine you pilot, often reluctantly, this can seem nonsensical. Among the social impacts of a top surgery, no longer feeling like you just lost the answer to a question or can't find an object makes living more colorful.


With so many positive impacts associated with a top surgery for FTM transitions, it is easy to see why they are so popular. When asked how much is top surgery going to change life for a transitioning person the answers become abundant.

Facts alone don't motivate though. Looking at an issue from multiple lenses is always a good idea. Check out what others say about their journeys to get a personal vector on this question.

If you'd like to schedule a consultation with Board-Certified surgeon Dr. Schwartz, contact our office today!



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240 South La Cienega Boulevard
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Beverly Hills, CA 90211

Phone: 310-882-5454