Keyhole vs. Double Incision FTM Top Surgery

Posted: February 4, 2018


Keyhole vs. Double Incision

How to Decide

This is for guys who are trying to decide between keyhole surgery and the double incision with the free nipple graft.

Is Keyhole even an option for you?

First of all not many guys are candidates for keyhole surgery at all. Patients have to be pretty small in order to undergo it, this means an A cup or less. This can be very confusing because obviously not many transgender men wear bras! So what is an A cup? Basically my rule is you want to have no droopiness in the breast whatsoever. That means the nipple sits above where the fold is. If you have that situation you may be a candidate for keyhole surgery. About 1 – 2 out of every 10 guys I see will do very well with either keyhole surgery or a double incision. This often comes down to a matter of personal choice. How important is it to you to avoid that scar?

What if you have both options?

One trick I find that is super useful in order to help guys predict what their result will look like, is to stand in front of a mirror, and just imagine that someone has sucked all the air out of your breasts and they are completely deflated, now in your mind’s eye, where those nipples are, is exactly where they are going to end up. There is nothing we can do in keyhole surgery that will move them. A problem is that often in a female chest nipples are more closely spaced and if you just deflate everything, the eye can catch that, and it may look a bit unnatural. Also, often if you need a nipple reduction, that may have to happen at a second surgery.

That’s just a quick pointer that may help guys to choose between the two. Take a look at our website or Instagram, FB or Twitter, we have more and more pictures of keyhole surgeries going up all the time.

Dr. Sidhbh Gallagher
University Gender Affirmation Surgery

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