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How Much is Top Surgery: A Detailed Guide

Medically reviewed by Paul Gonzales on March 13, 2024.

Costs of surgery can be one of the most confusing or even overwhelming parts of a patient’s journey. We have created this detailed guide on top surgery pricing–sometimes called ftm top surgery, chest reconstruction or breast removal surgery–to bring greater transparency to our patients. The costs outlined below are specifically for cash-pay patients: those who are paying for the entire surgery without insurance coverage.

Top surgery is estimated to cost between $14,000 and $17,000 for cash-pay patients. The total price varies due to several factors such as doctors’ fees, facility fees, additional tests/imaging, prescription medications, or post-op related care. Most major insurance plans we work with can significantly reduce these costs. You can read more about the insurance coverage approval process here.

We understand that it can be daunting to realize how much the price of top surgery can vary. We can give you a specific quote for your case after your free, virtual consultation with one of our board-certified surgeons.

Please note that these estimations do not include any travel expenses, like flights or lodging. You can find our recommendations for out of state and international patients in our free, travel packet resource, here.

When do I need to pay for top surgery?

Please note that all patients are expected to cover their financial responsibility for their procedures 6 weeks prior to their surgery date. Failing to do so will risk the cancellation of your procedure. For cash-pay patients, you will be asked to pay the total cost by this date. For patients with insurance coverage, you will only need to pay your out-of-pocket expenses by this deadline.

To lower the barriers to access, we offer patients the ability to make multiple payments before this deadline. Additionally, the Gender Confirmation Center (GCC) finances a variety of scholarship opportunities for gender-affirming procedures and has accepted payments made by trusted medical creditors like CareCredit.

Understanding Top Surgery Costs at The Gender Confirmation Center

The GCC is committed to providing medically necessary gender-affirming care. We aim to minimize barriers to accessing surgery through our insurance advocacy efforts and community financing partnerships. Our goal is to provide transparent information about the costs associated with top surgery to ensure patients fully understand the financial considerations of undergoing surgery.

Cost Considerations

• Consultation/Office Visit Fees: Our office provides virtual and in-person consultations that are free of cost to all patients. All follow-up office visits are also complementary after initial surgery at GCC. Patients with insurance will have their insurance billed for in-person consultations alongside the overall cost of the procedure. Consultation and office visit fees will also be billed to insurance for those with insurance coverage.
• Procedure-Specific Costs: Top surgery costs may vary based on the type of top surgery performed. For example, a double incision top surgery without nipple reconstruction typically involves less technical skill and time compared to a keyhole procedure. Although keyhole surgery is less invasive, it demands greater technical skill to achieve the same goal through a smaller incision. In addition, adding other procedures such as liposuction of the chest or other areas of the body would incur a separate cost. Below is a list of estimated costs for each procedure without other associated costs (i.e. facility fees). These price ranges represent the least and most expensive cases we have
  

  Procedure Costs	Price Range*
  Chest reconstruction top surgery	$8,500 – $11,500
  Revision top surgery (scar revision, dog ears)	$1,500 – $3,000
  Breast augmentation (w/ implants)	$8,500 – $10,000
  Body masculinization (trunk, thigh, buttocks liposuction)	$8,500 – $14,000
  Body feminization (trunk, thigh, buttocks liposuction and/or fat grafting)	$15,000 – $19,500

  * These price ranges are for cash pay rates only; insurance rates may differ

• Facility/Anesthesiology Fees:  Facility and anesthesiology fees are separate costs and are calculated based on the duration of your procedure and where the surgery will be performed (i.e., hospital, surgery center). Hospital ORs may typically charge more than an ambulatory surgery center for facility fees. Since there are a variety of factors that go into calculating facility and anesthesia fees, we give these quotes to patients on a case-by-case basis.
• Additional Tests: Some patients may require additional tests for top surgery which may incur separate costs or may be covered through insurance.
  
  • Medical clearance (i.e., labs with PCP) may be required for patients with specific medical conditions.
  • Mammograms are required for patients aged 40 and above.
  • Pathology testing is required for all top surgery procedures (excluding revisions) to ensure chest tissue removed poses no risk for malignancy. This cost is estimated at $600.
• Post-Surgery Costs: Post-surgery care will vary between patients and may depend on the type of top surgery procedures involved. Longer incisions will require more scar management
  • Prescription medications – These are prescribed to manage pain and nausea w/in the first week of surgery. Using health insurance or GoodRx can help minimize costs. 
  • Post-op supplies – A compression binder and wound care items (i.e., non-adhesive pads, ointments, medical tape, etc) are free and will be provided at your post-op appointment.
  • Scar management – Silicone tape or gel can range between $15-$150. Steroid injections may be used for specific types of scars and cost $150 per treatment. The first 3 injections are free for GCC patients. You can read more about these treatments here.
  • After-surgery care – For patients requiring immediate surgical post-operative care with nursing staff, there are professional services that charge on an hourly or daily basis. Cost may include accommodations, transportation, and/or meals and can range anywhere from $250-$2500 per day.
• Travel Costs: For out-of-town patients, travel expenses may include flights, transportation as well as accommodations and meals for 6-7 days. We created a Travel Packet for patients which includes resources and a list of affordable options to minimize these costs.

Insurance Coverage for Top Surgery at Gender Confirmation Center

Navigating insurance for top surgery can be challenging. Our insurance advocacy team works directly with your insurance to determine if your health plan has coverage top surgery. This service is complimentary for all our patients to ensure the best chance of getting their top surgery covered by insurance. Once you have requested a free consultation, our patient care team will help you secure all of the necessary documentation, like support and/or referral letters, for this process.

You can find a list of insurance providers for which our team has successfully obtained approval for top surgery procedures from here. If you don’t see your insurance listed there, you can schedule a free, virtual or in-person consultation so our team can verify this information for you.

Financing Options Available at Gender Confirmation Center

• Financing Options – At the GCC we understand how significant of a barrier costs can be to accessing gender-affirming care. We do not offer internal payment plans after the surgery has taken place. That said, patients can make multiple payments prior to the 6 weeks before surgery payment deadline. Many patients that we work with are able to meet the payment deadline with the help of trusted medical creditors like Care Credit.
• Surgery Grants: We’ve collaborated with non-profit organizations that offer grants to assist with the expenses of top surgery. Eligible recipients can use these grants to cover part of the procedure’s cost. However, this funding may not apply to other costs associated with top surgery, such as facility and anesthesiology fees.
• Point of Pride
• The Jim Collins Foundation
• Genderbands

Choosing Dr. Mosser, Dr. Facque, Dr. Ley or Dr. Jacobs for Top Surgery

• Dr. Alexander Facque (he/him)

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  Dr. Alexander Facque (he/him) is a board-certified plastic surgeon and proud member of the LGBTQ+ community. Dr. Facque got his start in gender-affirming care as a resident at the Icahn School of Medicine at the Mount Sinai Medical Center in New York, where he first recognized the importance of providing safe and accessible surgeries to trans and non-binary patients. He then spent a year training and expanding his knowledge under Dr. Loren Schechter, one of the world’s foremost gender-affirming surgeons, as a fellow at Weiss Memorial Hospital’s Gender Confirmation Surgery and Practice Leadership in Chicago. Dr. Facque officially joined our team in 2020 and brought with him over 5 years of previous experience in gender affirming care.
  

  

  

  

  

  

  Facque FTM Top Surgery Before and After 1

  Facque FTM Top Surgery Before and After 2

  Facque FTM Top Surgery Before and After 3

  Facque FTM Top Surgery Before and After 4

  

• Dr. Ellie Zara Ley (she/her/they)

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  Dr. Ellie Zara Ley (she/her/they) is a board-certified plastic surgeon and the only transgender woman of color to offer a full-spectrum specialization in gender affirming surgery: top surgery, bottom surgery, facial surgery and body contouring. She also specializes transgender adolescent care. She is highly trained, having completing her general surgery residency at University of Arizona, a fellowship in plastic and reconstructive surgery at the University of Utah, a fellowships in craniofacial and pediatric plastic surgery at Primary Children’s Hospital in Salt Lake City and another in hand surgery and microsurgery at the University of Southern California. Prior to joining our team in 2022, she worked as an assistant clinical instructor of plastic surgery at the University of Utah and had her own private practice in Arizona.
  

  

  

  

  

  

  Ley FTM Top Surgery Before and After 1

  Ley FTM Top Surgery Before and After 2

  Ley FTM Top Surgery Before and After 3

  Ley FTM Top Surgery Before and After 4

  

• Dr. Daniel Jacobs (he/him)

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  Dr. Daniel Jacobs (he/him) brings over 30 years of experience in reconstructive plastic surgery and research. He completed a General Surgery residency at LAC/USC School of Medicine and a Plastic Surgery residency at USC School of Medicine. His exceptional work has been recognized through prestigious medical awards such as the ‘Sidney R. Garfield, MD Exceptional Contribution Award’ in 2017, San Jose Kaiser Permanente’s ‘Outstanding Inpatient Physician of the Year’ in 2017, and the ‘Outstanding Achievement in Medicine’ award from Santa Clara Medical Association in 2016.
  

  

  

  

  

  

  Jacobs FTM Top Surgery Before and After 1

  Jacobs FTM Top Surgery Before and After 2

  Jacobs FTM Top Surgery Before and After 3

  Jacobs FTM Top Surgery Before and After 4

  

• Dr. Scott Mosser (he/him)

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  Dr. Scott Mosser (he/him) is a board-certified plastic surgeon who has over 15 years of experience serving gender diverse patients. He has devoted himself exclusively to gender affirming care since founding the GCC in 2013. Dr. Mosser is also a cofounder of the American Society of Gender Surgeons (ASGS), a member of the American Society of Plastic Surgeons (ASPS), the World Professional Association of Transgender Health, (WPATH), the United States Professional Association of Transgender Health (USPATH), and is a Fellow of the American College of Surgeons (FACS).

  

  

  

  

  

  

  Mossser FTM Top Surgery Before and After 1

  Mosser FTM Top Surgery Before and After 2

  Mosser FTM Top Surgery Before and After 3

  Mosser FTM Top Surgery Before and After 4

  Mosser FTM Top Surgery Before and After 5

  

Types of Top Surgery Procedures Offered

Top surgery encompasses a variety of chest reconstruction and breast reduction techniques in addition to the possibility for liposuction. Here we go over every incision type our surgical center offers and why patients tend to opt for them:

• Double incision – ideal for patients with a large amount of chest/breast tissue. It is also ideal for those who desire as flat of a chest as possible. The nipple-sparing double incision is a similar procedure that can allow for greater preservation of nipple sensation.
• Periareolar incision – ideal for patients with moderate chest/breast tissue and appropriate skin elasticity. Incisions are made around the periphery of the areola so that scarring can be more discreet. The lollipop incision is a similar procedure that allows for additional skin to be removed to increase chest tightness.
• Inverted T and buttonhole incisions can be used for breast reductions or mastectomies. It leaves upside-down T or anchor-shaped scars on the chest and is ideal for eliminating excess skin. 
• Keyhole incision involves the creation of a small incision at the base of the areola to remove chest tissue. This procedure is ideal for patients with minimal mammary tissue, no loose skin and high skin elasticity.
• Fishmouth or batwing incision is one of our least common procedures. The incision placement can allow for the scar to appear more consistent with the border of the chest muscle; however, it involves the areolas being placed slightly higher than in their typical position.

If you would like to learn more about how we help patients determine which incision type, you can read more about the Mosser Method here. This method considers a patient’s inframammary angle, skin elasticity, and goals around flatness and nipple sensation.

Cancellation fees

Our goal at the Gender Confirmation Center is to provide you with high-quality gender-affirming care in a timely manner. To help us do this, we have implemented the following rescheduling and cancellation policy for surgical procedures. By following these guidelines, you can help us better serve you and other patients by keeping appointment slots available for our community.

We understand that unforeseen circumstances may arise, and you may need to reschedule or cancel your surgery. However, to ensure efficient use of resources and minimize disruptions to our schedule a flat fee of $720 will be charged if you cancel or reschedule within 41 days of your scheduled surgery date. This fee may be waived in certain extenuating circumstances if evidence is provided.

We value the importance of early communication and understand that plans may need to change. Therefore, there are no fees or penalties for rescheduling or canceling your surgery if the requests are made 42 days or more before your scheduled surgery date. This allows us to make necessary adjustments to our schedule and offer the surgery date to another patient who needs it.

Recovery and Aftercare: Gender Confirmation Center’s Approach

It’s important to follow your surgeon’s post-op care instructions for optimal recovery after top surgery. Below is rough timeline for recovery but you can learn more about it in detail here:

• The first 7 days focus on maintaining a low-salt diet, resting, and engaging in gentle movements like short walks while avoiding strenuous activities.
• Between 8 to 21 days, showering is allowed with specific care for incisions and nipples, as well as long walks are permitted at a leisurely pace.
• From day 22 onward, cardio exercises can be reintroduced, with caution to avoid raising elbows above shoulders and excessive chest stretching to prevent scar widening.
• Beyond 43 days post-surgery, patients can resume normal activities and workouts.

Preparing for Your Surgery with Gender Confirmation Center

Physical Preparations

To prepare for top surgery, prioritize a balanced diet and regular exercise to support overall health and recovery. Arrange for assistance during the initial 24 hours post-op and consider ongoing support during the first week to facilitate recovery. Learn more about how to prepare for top surgery here.

Mental and Emotional Preparation

Emotional ups and downs during recovery, such as postoperative depression, are common after gender-affirming surgery. Temporary feelings of sadness or low mood after surgery can be physiological, psychological, or due to changes in routine. Having a strong support system, including a therapist, will be crucial for coping with postoperative depression and managing emotional experiences during recovery. Learn more about mentally preparing for surgery here.

Frequently Asked Questions (FAQs)

• Does the GCC offer free surgery?

• No, we do not offer pro-bono surgeries at the GCC. However, patients can apply for grants to fund their surgery from established non-profit organizations like the Jim Collins Foundation, Point of Pride, and Genderbands. The GCC’s philanthropic efforts have prioritized giving to these organizations, who are skilled in assessing need and selecting applicants.

• What is Care Credit and how does it work for financing surgery?

• Care Credit is a credit or financing company that helps finance medical costs, including surgical procedures. It functions like a regular credit card but is specifically for health needs. It offers convenient payment plans and no hidden costs. You can apply online instantly with no commitment.

• What are the included costs in the surgical procedure estimates?

• The estimates include consultations before and follow-up appointments after surgery, surgeon’s fee, operating room fees, anesthesia fee, and costs for implants and postoperative garments.

• Is there a fee for consultations?

• At the GCC, we do not charge patients for consultations, virtual or in-person, with our surgeons. We recognize that many trans, non-binary and gender non-conforming patients experience immense financial barriers to accessing medically necessary gender-affirming care. In addition to offering our consultations free of charge, we provide a free insurance concierge service that has successfully secured insurance coverage for over 90% of interested patients. To schedule a free surgical consultation, click here.

• How can I apply for financial assistance for top surgery?

• Financial assistance for top surgery is possible through surgery grants  through partnerships with organizations like the Jim Collins Foundation, Point of Pride, and Genderbands. Interested individuals should contact these organizations directly to learn about the application process.

• Are the prices mentioned fixed or can they vary?

• The prices mentioned are general estimates and can vary based on individual goals and body types. Exact price quotations are provided after the consultation with the surgeon.