What Is the Difference Between Top Surgery and a Mastectomy ?
Trans and nonbinary people can benefit from top surgery, which can be a life-changing — and often life-saving — procedure. However, because to internet disinformation, this gender-affirming procedure is frequently confused with a mastectomy. If you’re debating whether or not top surgery is best for you, learn about the distinctions, as well as the aftercare, expectations, and other details.
This story is part of our In Transit series
I never had a binder that was tight enough for me. Every morning, I fought to put it on, like a snake attempting to wiggle back into a shed skin. My breasts were squished into flesh patties against my ribs by surgical-grade, ultra-thick elasticized cotton, but it didn’t solve the problem. I yanked and fussed in the mirror, inspecting myself from the side. My breasts were still there no matter what I did. They’d be there for me when I pulled off the sweaty garment hours later — and I couldn’t bear them. Although I was aware of my gender dysphoria, the persistent, nagging irritation of my breasts was intolerable.
Living in a body that felt right
Late at night, I’d look through photos of ladies who’d had double mastectomies and had tattoos, flowers, and empowering messages adorning their scarred chests. I felt bad for wanting what they had — or, more accurately, what they lacked. It sounded like living without a binder was a dream come true. A mastectomy wasn’t in the cards for me because I wasn’t a cancer patient. Top surgery, on the other hand, was an option: a drastic reshaping of the chest that would allow me to get a look that was more in line with my chosen gender expression or identity.The overlap between the two surgeries is extensive in the Venn diagram of chest reshaping procedures. For me, top surgery meant finally living in a body that felt right. There’s no need for a binder.
What’s the Difference Between a Mastectomy and a Top Surgery?
You might be considering your next step if you’re a transgender or nonbinary patient whose gender dysphoria is exacerbated by the existence of breast or chest tissue. Mastectomies are more well-known than top surgery, making them an appealing option for removing your breasts. However, this isn’t always the method that will assist you achieve your desired look.
According to Tina Jenq, a board-certified plastic surgeon at the Oregon Cosmetic and Reconstructive Clinic, a total mastectomy removes all breast tissue from the latissimus to the armpit’s inframammary fold, all the way up to the clavicle. The procedure results in narrower skin flaps and a concavity on the lateral chest, as well as the complete removal of the areola, which some people replace with tattoos.
Where the Two overlap
Top surgery can include a mastectomy, but not every top surgery is a full mastectomy. Mastectomy is the surgical removal of breast tissue that is commonly used to treat or prevent cancer. Changing the shape and size of the chest’s skin envelope, repositioning the nipple or areola, and eliminating breast tissue are all things that this sort of surgery does.
Terminology Used in Surgery
While patients may relate to their bodies in unique ways, Jens U. Berli, an associate professor of surgery at the Division of Plastic and Reconstructive Surgery at OHSU School of Medicine in Portland, Oregon, points out that medical and surgical words aren’t always indicative of gender identification.
How to Find a Surgeon Who Is Gender-Affirming
Trans persons frequently have negative medical experiences, emphasizing the importance of finding a practitioner that is polite, receptive, and communicative. Bowers advises potential patients to seek for a surgeon who has made a point of being affirming. You want the knowledge without being embarrassed, so look for someone who isn’t a jerk, according to Bowers. It’s a narrow line to walk at times.
Surgery that Changes and Saves Lives
The mental health advantages of top surgery are undeniably favorable, especially when performed by a qualified, affirming practitioner. Regret after gender-affirming surgery is a rare outcome, according to a 2018 research coauthored by Berli. Top surgery and other gender-affirming medical interventions like HRT (hormone replacement therapy) can actually lessen the risk of suicide due to low reported rates of dissatisfaction.