Mastectomy, or top surgery for toms, is a procedure that can boost confidence and improve how you present yourself. It has become very popular among transgender men. For anyone researching mastectomy, the most important factor in deciding is the surgeon’s experience, skill and expertise, because the breast area contains many nerves, which can lead to problems later on. At SLC Hospital, we recognise what matters most to our patients. Besides our surgeons’ experience, skill and expertise, we have special techniques that shape the chest to look as close to a male chest as possible. It can also be done for people with drooping or sagging breasts, whether due to genetics or age, or for people with very large breasts that affect daily life. And for those concerned about breasts that are too large or have a lot of breast tissue,  breast reduction surgery can also be done together with nipple and areola reduction to achieve the most suitable size and shape, depending on the surgeon’s assessment. Mastectomy can be performed with several techniques, depending on each person’s breast size, degree of sagging and skin elasticity. Mastectomy, breast reduction

Who is mastectomy suitable for?

1. People who have passed a physical or mental health check and been diagnosed by a psychiatrist as having a gender identity that does not match their sex (Gender Identity Disorder), and who want to change their body to match who they are

2. People who have lived as men for at least 1 year

3. People aged 20 or over *Those under 20 need permission from a legal guardian

4. People with a lot of breast tissue or sagging breast tissue (suitable for both women and transgender men)

What to know before deciding on mastectomy

1. Post-surgical scars: The scars after mastectomy may be small or large, depending on the technique and method the surgeon chooses for each person’s concerns and suitability. For some people, scars start to heal and fade within 3-6 months, but others may develop raised scars or keloids.
2. Numbness in the chest: After mastectomy, there may be numbness in the chest at first, because the surgery affects internal nerves. This numbness will resolve and return to normal in about 3-6 months.
3. Partial loss of sensation: The surgeon performs the mastectomy together with nipple reduction and nipple reshaping to achieve a suitable size and shape. After surgery, the nipples lose some sensation, because the chest contains many nerves, so sensation around the nipples may be reduced. It will gradually return to normal, depending on the individual.

Methods and techniques used in mastectomy

Technique 1

The surgeon makes an incision below the areola and removes fat and breast tissue. This suits people with small breasts and good skin elasticity. The scar sits below the areola.

Technique 2

The surgeon makes an incision on the breast while leaving the nipple area intact, then removes breast tissue and reduces the nipple size. This suits people with small breasts, good skin elasticity and large nipples. This method gives good scars after surgery, and mastectomy and nipple reduction can be done at the same time.

Technique 3

The surgeon makes an incision around the areola. This suits people with fairly large breasts and more skin than usual, and it is also suitable for those who want areola reduction.

Technique 4

The surgeon makes incisions around the areola and to the side of the areola. This suits people with large breasts but less elastic skin, who need excess skin at the side of the areola trimmed away. This method reduces areola size well.

Technique 5

The surgeon makes an incision at the base of the breast, so there is no scar around the areola. This suits people with large breasts that sag slightly. Only the skin between the areola and the lower edge of the breast is removed, without moving the nipple and areola. This method suits people whose areolas are already small and who do not want areola or nipple reduction. The advantage of this method is that there is no scar around the areola. Instead, there is a long scar along the lower edge of the breast, which follows the shape of the edge of the male chest muscle.

Technique 6

In this method, the surgeon makes an incision around the areola that extends outward to both the outer and inner sides, without gathering the skin around the areola. This method suits people with large, very saggy breasts.

Technique 7

The surgeon makes a long straight incision and moves the areola and nipple above the scar. This suits people with large breasts but less elastic skin, who want excess skin trimmed away.

Technique 8

The surgeon removes breast tissue and skin and repositions the areola and nipple. This suits people with large, sagging breasts and more excess skin than usual.

Technique 9

For people with very large breasts who do not want all breast tissue removed, breast reduction surgery is another way to solve this problem. Using the T-shaped technique, there is no risk of a scar around the areola, and loss of nipple tissue is reduced.

Each method depends on the surgeon’s assessment and each person’s concerns.

Why choose mastectomy at SLC Hospital?

• A Thai surgical hospital meeting Boutique Hospital standards
• Care from an anaesthesiologist, a doctor specialising in local and general anaesthesia, on a strictly 1:1 basis throughout surgery
• Operating rooms with advanced medical technology to international standards, with a Positive sterile air room system, PPM particle control, a monitor control system for air conditioning and humidity, a sterilisation system and emergency backup power during surgery, well above the standard of typical operating rooms
• Recovery rooms designed with special care, so you can relax in a calm, elegant, airy and clean atmosphere with extra privacy
• Customized service with extra privacy and close care, plus beauty consultations with accurate information tailored to each patient’s needs
• Trusted by SLC patients and well regarded by international patients for many years
• SLC Holiday Surgery: patients who would like a change of scene for their post-surgery stay can choose a service package with luxury accommodation at a well-known hotel in central Bangkok’s Thonglor area, certified to SHA Plus+ standards. It is clean, safe, comfortable and private, while keeping premium luxury, with a full range of facilities such as a swimming pool, fitness centre, onsen, spa, fine-dining restaurant, co-working space and more.

Preparing for surgery

• Have a health check to make sure you are ready for surgery
• Stop all vitamins, supplements and blood thinners at least 4 weeks before surgery
• Stop smoking and drinking alcohol 4 weeks before surgery
• If you take gender-affirming hormones regularly, tell your surgeon during your pre-surgery consultation. Ideally, stop taking them at least 4 weeks beforehand.
• If you will have general anaesthesia, do not eat or drink for 8 hours before surgery. SLC Hospital may give you antibiotics to take 1-2 days before surgery.
• On the day of surgery, arrive at the hospital 1-2 hours early
• Prepare yourself mentally and try not to get too anxious. Be aware that after surgery there may be bruising and changes,  and it takes time for things to settle and to get used to your new look.
• Avoid surgery during your period and in the few days right after it (hormone levels at that time make the body swell and increase the risk of blood loss).
• On the day of surgery, wear loose, comfortable clothes that are not too tight
• Bring a friend with you, and leave valuables at home; do not wear them on the day of surgery unless necessary
• Driving yourself on the day of surgery is not recommended, as anxiety after surgery can affect your concentration and lead to accidents. Public transport is the best option.

Preparation on the day of surgery

• Shower and wash your hair on the day of surgery. Do not wear contact lenses, makeup, nail polish, lotion, perfume or jewellery on the day of surgery. Please leave valuables at home.
• Wear loose clothing with a zip or buttons at the front. Do not wear tight clothes or trousers, and do not drive yourself alone; a companion or relative must come with you on the day of surgery.
• Arrive 1-2 hours before your surgery time to prepare

Surgical procedure

• The surgeon assesses the chest and marks the incision points, the tissue to be removed and the new nipple position. Each method depends on the surgeon’s assessment and each person’s concerns.
• Surgery is performed under general anaesthesia. The anaesthesiologist puts the patient to sleep and monitors them throughout surgery.
• The surgeon makes the incisions, removes the marked breast tissue, reshapes and reduces the nipples, and moves them to a suitable position.
• The incisions are stitched closed and the chest is wrapped in a compression bandage.

Treatment time

• Surgery takes about 2-3 hours *depending on each person’s concerns

Aftercare

• For the first 2-3 days after surgery, avoid moving around too much to prevent the wounds from tearing or becoming inflamed
• Follow the nurses’ instructions strictly
• Sponge-bathe to keep your body clean. After 1 week, the wounds will be dry and you can shower as normal. You do not need to dress the wounds yourself until your follow-up appointment with the doctor.
• Avoid heavy lifting, driving and exercise for the first month
• Keep the bandage on as the doctor wrapped it, at a tightness that still lets you breathe out, for 2 weeks
• Avoid fermented and pickled foods, smoking and alcohol for at least 1 month after surgery
• Wear a chest compression binder strictly as your doctor advises, to help your chest take shape faster
• Attend your doctor’s appointments. If you notice anything unusual, tell your doctor immediately.

Review & Reality Live: mastectomy at SLC Hospital

Update: 6 months after mastectomy! #รีวิวหมอกัมSLC #รีวิวตัดหน้าอกSLC

When a tom comes in for chest removal: “Just take them off!” Let’s see how it turns out #รีวิวหมออ้นSLC #รีวิวตัดหน้าอกSLC

Stitch removal after top surgery: a transgender man’s case, a new technique that hides the scars, from her to him #รีวิวหมอกัมSLC #รีวิวตัดหน้าอกSLC

Stunning! A new mastectomy technique, top surgery for toms, from her to him. Anyone who wants to reshape their chest has to watch this live #รีวิวหมอกัมSLC #รีวิวตัดหน้าอกSLC

[ Eng-Thai ] Chest removal for a handsome tomboy with Dr. Gam’s technique, 6 months on: forgot there were ever breasts #รีวิวหมอกัมSLC #รีวิวตัดหน้าอกSLC #SLCeng

Chest removal!!! A transgender patient’s mastectomy consultation #รีวิวหมออ้นSLC #รีวิวตัดหน้าอกSLC

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in Breast Surgery