Chest recontouring is an important step in the process of gender transformation. Dr. Steven Montante uses his extensive expertise in breast surgery and reconstruction to assist in this transformation process.

Dr. Montante has performed many female to male breast reductions (top surgery) in Richmond, Virginia, helping his transgender patients achieve their true identity.

See Our Top Surgery Results

Purpose of Top Surgery

The goal of Female to Male Top surgery is to masculinize the chest and remove female contour. In Male to Female Top surgery, the goal is to provide a feminine shape to a male chest for transgender patients in Richmond.

Dr. Montante will spend time with you during your initial consultation to hear your concerns and goals, as well as answer your questions. He will review your medical history, followed by an examination of your chest. This will allow him to recommend a surgical plan tailored specifically for you.

Dr. Montante will advise you of all preparations to take prior to your operation. If you are a smoker, for example, you will need to stop for a period of time before surgery.

Transgender Top Surgery Qualification Requirements

Please bring:

  • Documentation showing that you have been on hormones for at least one year (unless non-binary)
  • Letters from a psychologist / psychiatrist stating that you are mentally fit for the surgery and that the surgery is required.

We prefer that all of this information be brought to the consult in order for the practice to insure a quicker reply from your insurance company regarding your coverage. This will enable us to get a surgery date scheduled for you.

Please note that if you smoke, you will be required to stop smoking for 30 days prior to your surgery date and for 30 days after your surgery. We reserve the right to test for nicotine. Our surgeon in Richmond could further explain the requirements for top surgery to a transgender patient

Effects of Top Surgery

This surgery is usually performed using general anesthesia and takes 2-4 hours. Afterward, you can go home, but you must have someone available to drive you. Incisions vary depending upon the amount of excess skin that needs to be removed. In rare cases, liposuction, alone, may be sufficient.

Native breasts with minimal sagging and good skin tone may be amenable to a combination of liposuction and a concentric or “donut” lift. In this procedure, a “donut” incision pattern is designed to remove breast tissue, after liposuction is performed to remove breast fat. The incision is well-concealed in the border of the areola.

In cases of particularly large breasts or breasts with a lot of excess skin, a “double incision” procedure may be necessary. In this procedure, an incision is designed adjacent to the lower border of the pectoral muscle. The original nipple is removed temporarily, and the breast tissue is removed. Once the chest skin is tailored to masculinize the chest, the nipples are then reattached to the chest as a graft.

After your top surgery in Richmond, the incisions are sutured and dressed. All sutures are typically dissolvable and the incisions are covered with a skin glue. In the case of a double incision procedure, a dressing, sewn over the nipples, is removed after approximately one week.

This surgery is usually performed using general anesthesia and takes 2-4 hours. Afterward, you can go home, but you must have someone available to drive you.

Recontouring the chest from male to female typically involves the placement of implants, in a similar way to a breast augmentation. The most common incision used is along the fold on the underside of the breast. The implants can be placed either under the breast tissue or partially under the pectoral muscle and breast tissue. Your starting anatomy will determine which location will provide you with the most natural results. Through his analysis of your native anatomy, Dr. Montante will make recommendations concerning implant size and position to meet your particular needs.

Recovery Process for Transgender Top Surgery

You will wear a postoperative garment for approximately four to six weeks after your surgery, depending on the type of surgery you have. You should sleep on your back during this period of time.

You should be able to return to work and resume normal activities within about 2 weeks, as long as your work does not involve strenuous activity or lifting. You should avoid strenuous exercise for about 6 weeks.

Expect to feel some post-operative discomfort, but this can be managed with oral pain medication. Some bruising and swelling are normal. Swelling will take the longest to resolve, so while your chest will be flatter immediately, you won’t be able to see the final results of your surgery until all of the swelling has resolved. This could take a few months. There are visible scars after Top Surgery, but they will become flatter, smoother, lighter, and less prominent over time.Dr. Montante will monitor your progress carefully in follow-up examinations.

Gynecomastia surgery can give you a masculine-looking chest. Call us today to schedule a consultation to find out more about male breast reduction. If you are looking for transgender top surgery in Richmond, speak with our team today.