FTM Top Surgery (Transgender Mastectomy)

Are you looking for a skilled and experienced surgeon to perform your transgender breast surgery? Increasingly, patients with gender changes seek Dr. Mark Mandell-Brown’s expertise with FTM breast reduction (top surgery). The Mandell-Brown Plastic Surgery Center caters to chest procedures and facial surgery for both males transitioning to females or females transitioning to males. Dr. Mandell-Brown is dedicated to providing our patients with personalized and natural-looking results from their transgender breast surgery in Cincinnati.

More patients with identity changes are seeking gender-affirming surgery. In several recent studies, gender-affirming surgery has increased 20% over the past several years. Currently, 0.6% of US adults identify as transgender. Dr. Mandell-Brown offers masculinizing top surgery for the transgender female patient desiring a male chest.

Dr. Mandell-Brown & Dr. Maccarone

Dr. Mark Mandell-Brown and Dr. Gina Maccarone strive to offer Natural Look™ cosmetic surgery results in an educational, supportive environment. Each holds multiple board certifications, so you can rest assured that your surgeon has the credentials and aesthetic eye to precisely tailor your surgical plan for safe, aesthetically sound outcomes.

Portrait of Dr. Mandell-Brown and Dr. Maccarone smiling

Options for Chest Masculinization

There are two types of masculine chest surgery—mastectomy, or ablative, procedures or gynecomastia-type procedures. Chest masculinization has been shown to improve body image and decrease emotional anguish.

For most patients, this protocol is followed by many physicians.

Chest Wall Masculinization in FTMT Morselli et al Annals of Plastic Surgery Vol 83. 6, Dec 2019

However, Dr. Mandell-Brown emphasizes liposuction and less incisions when possible. He performs aggressive breast liposuction as the breast is often 70 to 80% adipose or fatty tissue.

For patients who have excess skin, a circumareolar or incision around the areola is required. An outer circular incision is made and the skin between the two circles is removed thus tightening the breast and flattening the appearance.

Dr. Mandell-Brown aims to provide the least invasive option possible for achieving your desired result.

Some patients with large pendulous breasts require a vertical mastopexy, also known as the “lollipop” incision often with an anchor incision. Rarely will Dr Mandell-Brown perform a free nipple graft as the patient has a 100% chance of no sensation in this area.

Determining masculine nipple placement

Three step technique for optimal nipple placement in transgender chest masculinization
Three-Step Technique for Optimal Nipple Position in Transgender Chest Masculinization – Ayyala et al Aesthetic Surg J. 40 (11) 2020

The male NAC (Nipple Areola Complex) is 36% size of female, among other differences:

  • Male nipple is located inferiorly and laterally
  • Horizontal component determined at 4th rib near lateral border of Pectoralis Muscle.
  • Vertical component of NAC is confirmed at junction of middle and lateral third
  • Symmetry confirmed by creating a triangle

Recovery from FTM Chest Surgery

During your consultation, Dr. Mandell-Brown can let you know what to expect during your recovery. Our team will also provide you with post-operative instructions following your female to male chest surgery in Cincinnati. Most of our patients return to work in two weeks.

How painful is a breast reduction?

Female to Male top surgery protocols - Dr. Mark Mandell-Brown

We find that patients actually have less pain or discomfort than a from a breast augmentation with implants. Typically, pain pills are used for a few days.

In the Media

Dr. Mark Mandell-Brown authored the article “Female to Male Top Surgery Protocols,” which was published in Aesthetic Authority (Summer 2021).

In the article, Dr. Mandell-Brown details his treatment protocol for addressing female to male breast reduction surgically and through minimally invasive procedures.

Related Procedures

Areas Served


Medically reviewed by Dr. Mandell-Brown — Updated on Mar 11, 2024