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A caring and supportive approach to gender confirmation surgery for transitioning adults.

Dr Sharp offers breast reduction or removal surgery for patients seeking to confirm their gender, or people undergoing female to male gender (FTM) transition, often called ‘top’ surgery. This procedure is sometimes called bilateral subcutaneous mastectomy or gynaecomastia surgery if the patient identifies as a male. The surgery involves the removal of breast tissue and repositioning of the nipple. This technique provides the possibility, but not certainty, or sensation returning to the nipple complex.

What is a bilateral subcutaneous mastectomy?

The procedure includes a semicircular areolar incision, with superior skin excision and total glandular resection. An inferior skin resection and areolar reduction and refashioning is performed in most cases. Its benefits include consistent results with minimal complications, allowing nipple areolar complex remodeling and repositioning, preservation of as much nipple sensation as possible, and adaptability to all breast sizes.

Dr Sharp performs this procedure for patients who are undergoing gender transition, where supported by their gender transition medical team, which can include psychologist, endocrine specialist and/or general practitioner with a special interest in gender confirmation medicine.

Preparing for female to male chest surgery

To organise a consultation with Dr Sharp, the patient needs to obtain a letter of referral from a medical practitioner. A supporting letter from the patient’s treating clinician/s must be presented prior to the initial consultation. At least two pre operative consultations in our rooms are required to weight up the benefits, risks and recovery involved with this procedure. At your initial consultation, Dr Sharp will assess suitability for the procedure and clearly outlines the likely operative details for each individual patient. At this consultation you will receive an itemised fee quotation.

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Post operative recovery from top surgery

Pre plan your post operative support as far in advance as possible. You will have a drain in place after the procedure. If performed as an inpatient in a hospital, you will have these drains removed before leaving hospital. If performed in a day hospital, you will need to attend post operative appointments for the drain to be checked and removed in the days following your surgery.

You will need someone to drive you to these appointments and help you with activities/dressing around home in the first initial days after surgery. Once drains have been removed, the patient may return home, however they will be required to only perform light duties in the home and preferably not return to work for three weeks postoperatively.

Dr Sharp recommends no heavy lifting for three months post surgery, however light cardiovascular exercise can be resumed three to six weeks after surgery upon his specific instructions. No isometric contraction of the pectoral muscles (i.e. weight training, heavy lifting) may be undertaken for 3 months postoperatively and even then, must be gradually introduced with caution over the subsequent 3 months. Patients intending to undergo this surgery should plan accordingly.

Where is ‘top’ surgery performed in Brisbane?

The surgery will take place at Greenslopes Private Hospital or South Bank Day Hospital.

How much does FTM surgery cost?

The fee quotation depends on many factors including health insurance cover, chosen hospital and the extent of surgery required – and is therefore available following consultation.

Thank you for your interest in this procedure.

Risks of surgery

As with all surgery, top surgery carries risks. These risks will be outlined in the consent documentation provided to you preoperatively. These include, but are not limited to infection, nipple loss, puckering or dog ears, unfavourable scarring and contour deformities.

Possible complications of surgery include:

  • Acute medical event such as stoke, heart attack, pneumonia
  • The need for revision or further surgery
  • Pain which does not respond to pain relief
  • Nerve damage, causing altered sensation or loss of sensation – temporary or permanent
  • Haematoma (collection of blood), oedema (collection of fluid) and abscess
  • Deep vein thrombosis (DVT) or pulmonary embolisms (PE)
  • Damage or or loss of loose teeth during placement of anaesthetic apparatus
  • Sore throat, swelling or discomfort following placement of breathing tubes during anaesthetic
  • Breathing difficulties following anaesthetic
  • Allergic reaction to medication
  • Allergic reaction to sutures, dressings, tapes or intraoperative solutions
  • Heavy bleeding from the wound, which may require further surgery
  • Poor or slow skin healing, wound infection, breakdown or necrosis (skin death)
  • Wound dehiscence (incision separation)
  • Adverse scarring
  • Nipple necrosis (death)
  • Psychological impact of surgery, recovery or altered appearance
  • Death
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We are often asked why we do not have more photos of top surgery results on our website. Due to the nature of the procedure, most patients having this procedure do not identify with their preoperative chest appearance and can, postoperatively, find images of their chest prior to surgery distressing. For this reason, most patients do not consent to their clinician images being shared.

We acknowledge that clinical photos are a helpful aspect of surgery research and thank the patients who have permitted us to feature their images below.

before and 3 months after surgery with Dr Sharp

before and 3 months after surgery with Dr Sharp

before and 3 months after surgery with Dr Sharp