Your Guide To Top Surgery in San Francisco
Medically reviewed by Jennifer Richman on September 15, 2024.
What is Top Surgery?
Top Surgery refers to gender-affirming surgical procedures that help patients experience greater gender congruence with their chest. Sometimes referred to as “FTM top surgery,” “MTF top surgery” and “non-binary top surgery,” our board-certified plastic surgeons offer a variety of techniques under the umbrellas of chest reconstruction, breast reduction and breast augmentation or breast implants. Below, you can read more about your options for top surgery in San Francisco and the Bay Area, the costs and resources available for patients traveling from out of town with or wit+hout a support network.
If you have questions about which procedure is right for you, you can schedule a free virtual or in-person consultation with one of our surgeons today.
Cost of Top Surgery in San Francisco and Insurance Coverage
Top surgery with our San Francisco practice can cost $8,500-$11,500 for cash-pay patients. We accept a variety of insurance plans that can help patients drastically lower the cost of surgery. Patients can refer to our trusted list of grant resources for surgery and medical creditors here.
Once you have solicited a consultation with the Gender Confirmation Center (GCC), our free insurance consierge service will guide you through fulfilling the requirements to get your gender-affirming procedure covered. Our team has a 90% success rate in securing insurance coverage for interested patients.
Traveling for Surgery
Many patients travel to San Francisco for top surgery if quality, gender-affirming surgcial care is not available in their area. Not to mention, the Gender Confirmation Center (GCC) is one of the few, premier centers in the United States that offers specialty top surgery techniques for non-binary patients and offers top surgery to patients with BMIs above 30. You can refer to our free, downloadable travel packet for tips on how to reduce the costs of traveling into the San Francisco Bay Area for surgery. It includes in-depth information on travel timelines, supplies, transportation and lodging suggestions.
For patients who undergo top surgery, we recommend that you stay in the San Francisco Bay Area for 8 days after surgery. We require all patients to see their surgeon or Physican’s Assistant in person for their 1 week post-operative appointment so we can monitor your healing, your overall well being and attend to any urgent complications in the rare case that they arise.
Types of Top Surgery
Top surgery is an umbrella term that encompasses a number of different procedures. This guide covers common techniques that address the unique needs and goals of our trans, non-binary and gender non-conforming patients. The following are the most common techniques that the GCC performs:
- Double Incision (DI) Chest Reconstruction: This procedure removes breast tissue, leaving behind one or two horizontal scars at the base of the pectoral muscles. DI top surgery is preferred by patients who desire a flat chest contour and have a large ammount of tissue and/or skin they would like to remove. This procedure offers significant flexibility for nipple resizing, reshaping and placement through nipple grafts, nipple sparing or no nipples. Patients who are interested in mantaining heightened sensation in their nipples can opt for a DI with a nerve reconstruction.
- Periareolar Top Surgery: This technique involves removing unwanted tissue from an incision made around the areola. This procedure is ideal for patients who would like to remove a small to medium ammount of skin and chest tissue. Periareolar patients can have their areolas resized, their scars conceled around their areolas and mantain greater nipple sensation.
- Keyhole Technique: Similar to periareolar, keyhole technique involves making a small incision along the areola and removing chest tissue. This procedure is less common and is ideal for candidates with smaller chest sizes and who do not need excess skin removed.
- Inverted T and Buttonhole Insicions: The inverted T or anchor-T and buttonhole procedures are ideal for patients who wish to mantain some breast/chest tissue and mantain greater nipple sensation. These insicions are chosen by patients who are interested in having some volume in their chest after top surgery.
- Breast Augmentation: Sometimes called “MTF top surgery,” patients can also opt for a breast augmentation. For transfeminine and non-binary patients, fat grafting is less common because of its low success rate when a large amount of volume is needed and the skin is particularly tight. Fat grafting can be used in addition to saline or silicone implants, for example, to increase cleavage.
Non-binary Top Surgery
Non-binary is a label that includes gender identities that transcend the traditional binary of “male” and “female”. For many non-binary folks, top surgery is a medically necessary procedure. While there is no one way to present non-binary, the GCC has compiled a list of procedures that were specially designed to meet the interests of non-binary patients that have been historically excluded from gender-affirming surgical care.
You can find overviews of our chest reconstruction and breast augmentation techniques for non-binary patients in the hyperlinks. Likewise, a number of procedures are available for individuals who wish to retain some breast tissue to allow for a more fluid chest appearance. For more, see our aggressive chest/breast reduction page. Likewise, we offer a variety of techniques to change the appearance of nipples or remove them for top surgery patients.
To design a surgical plan that meets your unique needs and goals, you can request a free virtual or in-person consultation with one of our board-certified surgeons here.
Benefits of Top Surgery
For patients of diverse gender identities, top surgery is a transformative experience. The World Professional Association for Transgender Health has collected multiple, peer reviewed studies that demonstrate the overwhelmingly positive impact of top surgery on patients’ health-related quality of life and a significant decline in their experience of gender dysphoria. Specifically, patients report improved body congruence, self esteem and mental health. Not to mention, there are direct physical benefits, such as relief for patients who do not need to use binders as frequently.
Overall, satisfaction rates for top surgery soar above those of comparable cosmetic and reconstructive surgeries, while rates of regret are quite low and vary from 0-4% of patients.
Choosing the Right Surgeon
In San Francisco, and the larger Bay Area, there are a multitude of options available for individuals. When researching potential surgeons, there are a few important factors to keep in mind.
- Board Certification: It is important to ensure that your surgeon is board-certified by the American Board of Plastic Surgery or a similarly reputable organization. This standard is indicative of their extensive training and expertise in plastic and reconstructive surgery.
- Experience with Gender-Affirming Care: We recommend that individuals not only look for qualified surgeons, but surgeons who are specialized in gender-affirming procedures, especially top surgery. Patients should look for a proven track record of successful outcomes and high competency in working with trans, non-binary and gender non-conforming patients.
- Insurance Coverage: If you would like to use insurance to help you cover the costs of surgery, it is vital to check if your surgeon takes your specific plan. If applicable, check with your insurance company to ensure that coverage extends to your provider.
- Hospital Privileges: Choose a surgeon who has operating privileges at accredited hospitals and surgical centers. This ensures that your surgeon has access to quality facilities and support staff for your operation.
- Before and After Photos: Reviewing the surgeon’s portfolio of before and after photos can provide a visual review of their aesthetic skills. While each patient’s post-op result is different, looking at images can give patients a sense of how their own results may look. This is especially true if a portfolio of diverse body sizes, procedures, results and skin tones is included.
- Patient Reviews: Reviews and testimonials provide insight into a surgeon’s bedside manner, communication skills and patient satisfaction. These may be found directly on a website, on social media and Google My Buisness reviews.
- Consultation Experience: Before scheduling surgery, a virtual or in-person consultation is a useful tool for assessing the surgeon’s professionalism, attention to detail and care for your specific goals and concerns. While the GCC offers free consultations, some practices charge a fee to meet with surgeons.
Recovery Process and Timeline
Recovery from top surgery is variable on the type of procedure(s) a patient undergoes and the pace at which their own body heals. Regardless, the following information is applicable for most top surgery patients:
- Initial recovery period: Patients may experience varying levels of discomfort, swelling and bruising in the days following surgery. Pain medication will be prescribed to manage these symptoms. Those who have had significant tissue removed and/or can expect to wear surgical drains, and those who have received nipple grafts will need to follow specific care instructions.
- Insicion care: Patients will be provided with instructions on dressing changes and protecting the incision site. Protecting your incision site and grafts from water and other contaminants allows for healing and reduces the chances of complications.
- Activity: Strenuous physical activities, lifting above 5 lbs, and lifting arms above the shoulders should all be avoided for 3 weeks. After this period, patients can gradually return to their normal activities. At about 6 weeks most patients can expect to return to normal activities.
- Scar Care: Scar appearance is a common concern for top surgery patients, especially for those who undergo double incision top surgery. Once your incisions have healed, your surgeon may recommend a number of scar care techniques including silicone treatments, scar massage sun protection, non-surgical treatments, and medical tattooing. Ultimately, while reducing scar appearance is a priority for some, many patients view their scars as integral to their identity, aesthetically pleasing and/or as a symbol of their journey towards gender euphoria.
- Additional instructions: It is crucial to follow your surgeon’s post-operative instructions and attend your follow up appointments. You can consult the following links for information on recovering from chest reconstruction top surgery and breast augmentation top surgery.
Facebook
Tweet
Email
