FTM Top Surgery


Procedure Time: 1-2 Hrs

Recovery Time: 3-5 Days


Gender dysphoria is a condition that some transgender and gender non-conforming may feel when their bodies do not match their gender identity. This can lead to various medical and mental health conditions which place the patient at risk. Many patients experiencing gender dysphoria choose to undergo FTM top surgery to treat and alleviate their condition. Dr. Craig Jonov at Seattle Plastic Surgery performs among the best FTM top surgery Seattle and Tacoma offers.


Female-to-male top surgery, also known as FTM top surgery, is a procedure that removes the traditionally feminine breasts and creates a masculine or flat chest. The procedure is similar to a mastectomy but typically leaves behind more tissue to appropriately shape the chest. The techniques for FTM top surgery also tend to differ from a traditional mastectomy.

The surgery most commonly is performed on FTM transgender, non-binary, and gender non-conforming patients. They usually want either a more masculine or flat chest. Thusly, it treats gender dysphoria and can lead to improvements in overall health. 


The first gender confirming surgery took place in 1912 in Germany on a transgender woman. Throughout the rest of the 20th century, an occasional top surgery or gender confirming surgery would take place. However, it did not start becoming more commonplace until the 1970s. Even then, doctors were often outcasted and it was still rare to find one to perform the surgery. 

In the 21st century, attitudes and societal norms around transgender people began to change. Top surgery became more commonplace and today it is widely available throughout the United States. Many medical insurance companies will also cover the surgery.


For transgender men, there are countless benefits to undergoing FTM top surgery in Seattle. Among some of the benefits and advantages of FTM top surgery include:

  • Alleviate gender dysphoria
  • Achieve a more masculine or non-gendered look
  • Improved mental and physical health
  • Increased quality of life
  • Chest binding no longer necessary
  • Eliminates risks of future chest binding
  • Ability to be more physically active
  • Generally short surgical time
  • Low complication rates
  • Safe surgery
  • Go home the same day
  • Usually an easy recovery
  • Often covered fully or partially by insurance

Of course, like any procedure, there are risks and possible drawbacks. Dr. Jonov accounts for the risks by thoroughly screening patients and advanced surgical techniques. Additionally, possible drawbacks of the procedure are the double incisions often required which can scar and stay visible following surgery. It is also possible to lose nipple sensation if nipple grafts are a part of your procedure. 

Dr. Jonov will discuss all of this with you at your consultation. Generally, most FTM top surgery patients understand the risks well and find it worth it to undergo the surgery.  Complications following top surgery are rare.



When you come to Seattle Plastic Surgery for a consultation with Dr. Craig Jonov, he will want to discuss your goals for the procedure, medical history, and any concerns you have. After this conversation where Dr. Jonov will conclude if you are a low risk candidate. He will then physically examine your chest to evaluate the best technique and results he can achieve.

Following this exam, Dr. Jonov will determine if you are a good candidate for surgery and the procedure. You will then receive a price quote. If you plan to use insurance, you will likely have already worked with the insurance coordinator. Although, if not, you will receive their information. If you choose to pay out of pocket or use outside financing, you will get a finalized price quote.


Candidates for FTM top surgery need to be in good health and manage all of their medical conditions well. They should have realistic expectations and preferably not smoke. Seattle Plastic Surgery does not necessarily require a letter of support from a mental health professional in all cases. However, many insurance companies do.

Top surgery is generally considered a medically necessary procedure for transgender patients experiencing gender dysphoria or harmful side effects of binding or otherwise concealing their breasts or enhancing their chest. However, not all transgender and gender non-conforming people experience dysphoria about their chests. Although, they can still undergo top surgery if they want. 

Dr. Jonov will typically determine that a patient is a good candidate for top surgery if they have a history of gender dysphoria, have otherwise transitioned, or have a good understanding of the procedure and results. Age does not play a role in candidacy. Transgender individuals under the age of 18 can undergo top surgery with parental consent.

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    Preparing For Surgery

    Often at your consultation, you will get an understanding of the steps you need to take to prepare. This may include obtaining letters of support from a mental health professional, medical clearances, and altering your lifestyle. 

    Other than the necessary documents and clearances, you will receive all other pre-operative preparation instructions at your pre-op appointment. The pre-op appointment takes place about three weeks before surgery. You will meet with a pre-op coordinator to finalize the paperwork, finances, and instructions at this appointment.

    Examples of pre-operative instructions may include:

    • Temporarily ceasing or reducing the usage of certain medications or supplements
    • Filling prescriptions
    • Eating well and exercising
    • Arranging for a ride, caregiver, time off from work, and other logistics
    • When to last eat, drink, and shower before surgery

    FTM Top Surgery In Seattle

    The most common type of top surgery that Dr. Jonov performs is bilateral double incision chest reconstruction. This consists of two incisions on either side of the chest. Through these incisions, he will remove breast tissue, glands, fat, and nipples and areolas.

    Once Dr. Jonov achieves the desired chest contours, he will replace the nipples. Patients do have the option to go without nipples if they want, which is sometimes popular with non-binary patients. Dr. Jonov will then close the incisions and you will slowly wake up from surgery.


    When you wake up from surgery, you will likely feel groggy. The Seattle Plastic Surgery team will monitor you for an hour or so, take your vitals, and wait for you to fully wake up. Once awake enough and stable, your caregiver is free to take you home.

    Your caregiver should stay with you for the first 24 hours. You may begin to feel pain and see some side effects like swelling and bruising in the coming days. Dr. Jonov will prescribe an antibiotic and pain medication to keep you comfortable. Most patients return to work within a week. In general, Dr. Jonov will ask you to avoid strenuous exercise and activities for around six weeks. This may require returning to work on light duty or making other accommodations. 

    Side effects should mostly resolve within two weeks. Though, residual swelling may take a few months to resolve. Luckily, this becomes nearly unnoticeable within a few weeks.


    Does Insurance Cover FTM Top Surgery?

    Medical insurance often does fully or partially cover FTM top surgery. The restrictions, requirements, and amount of coverage will vary widely by company. Seattle Plastic Surgery works with most major insurance companies. If you have insurance questions, our insurance coordinator can answer all of your questions. They can also help you find the best coverage for your Seattle FTM top surgery.

    How Long Does FTM Top Surgery Take?

    On average, FTM top surgery takes around an hour. It is typically a relatively short surgery. However, patients with larger chests or those that may require liposuction may see their top surgery take a bit longer. Generally, an FTM top surgery rarely takes more than two hours.

    Will Nipple Sensation Come Back?

    If nipple grafts were involved in your FTM top surgery, there is a chance that nipple sensation may not return. While this does not matter to every patient, it is an important risk to consider. Dr. Jonov will do his best to promote a return of sensation. On average, a majority of patients see a good amount of sensation return to their nipples after top surgery. 

    What About The Keyhole Approach?

    The keyhole, or buttonhole, approach to FTM top surgery primarily uses liposuction to remove breast tissue. This technique best suits patients with very little breast tissue and who have good skin laxity. Due to the specifications of this procedure, few patients are good candidates. Although, for those that are, this approach tends to create little to no scarring and does not require removing the nipples.

    How Much Is FTM Top Surgery?

    While many patients utilize insurance for their FTM top surgery, some patients may choose to pay out of pocket. At Seattle Plastic Surgery, FTM top surgery starts at $8,500. The price may then fluctuate based on the specifics of the surgery.


    Dr. Craig Jonov is an accomplished cosmetic surgeon with decades of experience performing all types of plastic and reconstructive surgeries. He was among the first to offer FTM top surgery in the Seattle area. Along with his surgical skill and expertise, Dr. Jonov is one of the top injectors on the West Coast. He is frequently called upon to educate his peers on correct injection techniques.

    Seattle Plastic Surgery is a premier plastic surgery clinic and outpatient surgery center. With a full surgical suite and clinic rooms, Seattle Plastic Surgery offers a comfortable environment to start your FTM top surgery journey. 

    To schedule a consultation with Dr. Craig Jonov, call us at 206-324-1120. You can also contact us online via Price Simulator™, chat, or contact form.

    Still Have Questions?

    Give us a call at 206-324-1120. Or, Chat by clicking the icon in the lower left hand corner of your screen additionally you can contact us by filling out the form above.