What to Expect with Incisions During FTM Chest Contouring Mastectomy

Choosing FTM chest contouring surgery is a major and affirming step for transgender men and nonbinary individuals. For many, this procedure marks the start—or the continuation—of living more fully and comfortably in their gender identity. At AMG Plastic Surgery in Reston, Dr. Ghaznavi offers advanced, insurance-based chest masculinization procedures tailored to each patient’s body, goals, and lifestyle. One of the most important decisions in this journey is understanding the type of incisions you may receive—and what those incisions mean for your outcome, recovery, and results.

Why the Incision Matters

Top surgery isn’t a one-size-fits-all procedure. While all approaches aim to remove breast tissue and create a flatter, more masculine chest, the type of incision used determines how the chest will look, how visible the scars will be, and how the nipples are positioned or preserved.

Dr. Ghaznavi takes an individualized approach for every patient, considering chest size, skin elasticity, body proportions, and surgical goals. Her microsurgical background and attention to detail allow her to create a natural chest contour while minimizing scarring as much as possible.

Common Incision Techniques Used in Chest Masculinization Surgery

There are three primary incision methods used during FTM top surgery. Each has its own indications and benefits.

Double Incision Mastectomy (With Free Nipple Grafts)

This is the most common approach and is typically used for patients with medium to large chest sizes or less elastic skin.

• Incisions are made horizontally beneath the pectoral muscle line on both sides of the chest
• Nipples and areolas are removed, resized, and repositioned as free grafts
• Scars extend from one side of the chest to the other, usually placed where they can be concealed by shirt seams or body contour

This technique allows the surgeon maximum control over chest contouring and nipple placement. At AMG Plastic Surgery, this method is often chosen for its reliable outcomes and excellent aesthetic results.

Around 80–85% of patients nationwide undergo the double incision technique, making it the most utilized and preferred option for its precision and lasting results.

Periareolar (Circumareolar) Incision

This technique is best suited for patients with small to moderate breast volume and tight, elastic skin.

• Incision is made around the edge of the areola
• Tissue is removed through this small access point, and the areola is often reduced
• Scars are limited to the border of the areola, making them very discreet

Periareolar incisions may result in less skin removal, which makes this technique most effective for individuals with minimal excess skin and good skin retraction.

Dr. Ghaznavi carefully evaluates skin tone, elasticity, and body structure to determine whether this option will yield symmetrical, flat results without compromising the overall masculine contour.

Keyhole Incision

Keyhole surgery is reserved for the smallest chest sizes, with very little extra skin or sagging.

• Incision is made at the lower edge of the areola
• Tissue is removed through this small cut, and the nipple remains attached
• Scarring is minimal, and nipple sensation may be preserved

Because this method does not allow for major skin removal or contour shaping, only about 5–10% of patients qualify. However, when used appropriately, it offers subtle, natural results with minimal downtime and excellent scar concealment.

What to Expect After Surgery

The healing process and scar appearance will vary depending on the incision type and your individual healing response. Dr. Ghaznavi provides a thorough post-op care plan and close monitoring during your recovery period at AMG Plastic Surgery.

Post-Op Milestones

• Week 1 Rest, restricted arm movement, and wearing a compression binder
• Week 2–3 Drain removal, return to light activities, reduction in swelling
• Weeks 4–6 Incisions begin to settle, scarring softens, light exercise resumes
• 3 Months+ Full chest contour is more visible; scars continue to fade and flatten over time

It’s important to follow all instructions carefully to avoid complications such as wound separation, fluid buildup (seroma), or infection. Dr. Ghaznavi provides each patient with scar management tools including silicone treatments and customized care routines.

Let’s Talk About Scars

All top surgery incisions will leave scars—this is a fact. However, how the scars look, where they are placed, and how well they heal are all influenced by the surgeon’s skill and your post-op care.

• Double incision scars are often the most visible but placed deliberately along natural contours
• Periareolar and keyhole scars are more subtle and usually blend into the areola or lower chest
• Nipple graft scars may fade considerably, but pigment and sensation can vary

At AMG Plastic Surgery, Dr. Ghaznavi uses advanced closure techniques and post-op scar management strategies to help patients achieve the cleanest, smoothest possible result.

Revision Rates and Realistic Expectations

While many patients are satisfied after their initial surgery, revision procedures are sometimes needed to refine contours, adjust nipple position, or improve scar appearance. Nationally, revision rates after top surgery can range from 15–25%, depending on the technique and patient healing.

Dr. Ghaznavi’s patients benefit from her meticulous surgical planning and follow-up, which helps minimize the need for future revisions. However, if a touch-up is needed, she provides compassionate, judgment-free support and corrective options.

Why Choose AMG Plastic Surgery for Your Top Surgery

Dr. Amir Ghaznavi is a board-certified plastic surgeon who brings advanced training and a patient-centered approach to every case. With her background in microsurgery and breast reconstruction, she offers exceptional results for FTM chest contouring, with a deep understanding of symmetry, aesthetics, and function.

Patients throughout Northern Virginia and the greater Reston area choose AMG Plastic Surgery not only for Dr. Ghaznavi’s surgical expertise but also for her dedication to each patient’s personal goals and identity. Her experience with insurance-based gender-affirming care ensures that top surgery is accessible and affirming from consultation to recovery.

Frequently Asked Questions About Top Surgery Incisions

• Which incision leaves the least noticeable scars? Keyhole and periareolar incisions leave the most minimal scarring, but only certain body types qualify.
• Will I lose nipple sensation? Sensation changes are possible with all incision types. The double incision technique, especially with free nipple grafts, often leads to reduced sensation.
• Can I request a specific incision type? Yes, but it depends on your anatomy. Dr. Ghaznavi will review your options and recommend the most effective and safe choice.
• How long do scars take to fade? Most scars begin to fade within 6–12 months. With proper care, they can become soft, flat, and significantly lighter in color over time.
• Can incisions be revised later if I’m unhappy with them? Yes. Scar revision and contouring adjustments can be performed if needed. Dr. Ghaznavi provides long-term support for every patient.

Begin Your Top Surgery Journey with AMG Plastic Surgery

Understanding your incision options is a vital part of preparing for chest contouring surgery. At AMG Plastic Surgery in Reston, Dr. Ghaznavi offers a supportive and experienced environment where your identity is affirmed and your results are prioritized.

Ready to take the next step? Schedule your consultation with Dr. Ghaznavi today and begin your journey toward a flat, masculine chest that reflects the real you.