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Trans men don't need top surgery to prove they're men, but many want it anyway. Learn more about top surgery and decide whether it's for you!

Plastic Surgeon Answers Questions About Top Surgery for Trans Patients

Cosmetic procedures on transgender patients are often referred to as “gender affirmation surgeries.” They help trans patients to identify with their true gender and feel more comfortable in their bodies.

These procedures can range from body contouring, facial cosmetic procedures, to breast implants. We spoke with Toronto Plastic Surgeon Dr. Jacqueline Makerewich to get her answers to some of the most commonly asked questions on Top Surgery. 

Dr. Jacqueline Makerewich is known by patients at the SixSurgery Clinic for being a very caring and empathetic cosmetic surgeon. And while she brings this energy into every appointment with every patient, it is especially important in appointments with transgender patients for whom plastic surgery is a more sensitive decision.

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She discusses Top Surgery, a procedure where the breast tissue is removed in order to create a more “masculine” looking chest.

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What is recovery like? 

Recovery from top surgery is similar to other procedures performed in the same area. For the first week, you will need to refrain from getting your incisions wet, and you may have a drain in place that will remove any excess fluid collecting in the area.

After 1 week, most patients feel comfortable performing a majority of their regular activities with the exception of vigorous activities like exercise, which are to be avoided for six weeks.

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What can patients expect from scarring? How can you heal scars faster?

Top surgery for a trans man involves the removal of breast tissue to create a “masculinized” chest. The incisions are discreetly placed around the areola and in the breast fold which is an area of natural shadow.

Scars go through an evolution process as they heal. They strengthen and then soften, which takes about a year. To achieve the best scar outcome possible, we recommend protecting your scars from any sun exposure with clothing coverage and SPF.

Silicone scar products can also assist in the healing and fading of scars. You can begin using silicone products to optimize your scars after three weeks, and scars will continue to improve for 1 year.

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Are there any other procedures for trans men to masculinize their bodies?

Contouring procedures can be used in general to masculinize other areas of the body. Facial masculinization surgery may include chin or jawline implants or reshaping, masculinizing rhinoplasty, and Adam’s apple enhancement.

Liposuction can be used for torso contouring to remove focused feminizing fat deposits, or to define the abdominal muscles. Gender confirming bottom surgery is a highly specialized procedure, generally performed in a specialized center.

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Do you have any advice for trans patients who are nervous about surgery/choosing a surgeon that will understand them? 

My biggest advice would be not to rush into any decision when it comes to plastic surgery procedures, especially when it comes to choosing your surgeon. When choosing a surgeon, have an in-person consultation to ensure that your surgeon understands and respects your goals, and has experience with gender-affirming surgery.

Try to seek out as much support and as many educational resources as you can. Speaking to others who have undergone gender-affirming surgery may be helpful. Surgeons like Dr. Makerewich are an excellent resource for patients who have questions about Top Surgery.

Cosmetic surgery is not something to be taken lightly – Seek more information on Understanding Trans and Gender-Diverse Bodies. Always do your research and ensure you are getting the information from a trusted party.

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