Any surgical procedure obviously requires a great deal of planning, and mastectomies for trans men in Zurich are no different. Plastic surgeons adapt the procedure to each individual set of circumstances in order to achieve patients‘ desired results as closely as possible. Personal consultation sessions before the operation are an opportunity for patients to ask any questions they have, and to obtain expert information on what surgical options are available, what the procedure will be like, and whether any risks are involved. On this page, we’ve answered a few of the most common questions patients have about mastectomy operations.

When is mastectomy an option?

Mastectomies, or breast removal, may be performed for a variety of reasons. As a gender confirmation procedure, mastectomy becomes an option if and when patients decide to have their breasts removed. In other words, it’s a completely individual decision rather than one of strict medical necessity: female-to-male trans people often find having breasts extremely bothersome, because it goes against the body image they identify with, and female breasts can often be difficult or impossible to conceal. Having a mastectomy can give people a new sense of positivity about their own bodies.

How do I arrange for an operation?

Thorough consultation is important before treatment begins. For one, it helps doctors and patients get to know one another and establish a basis of trust. For another, it gives the plastic surgeon a chance to explain the procedure in detail, examine the patient thoroughly to make sure that surgery is not contraindicated, and create a plan with the patient on how to proceed. The specialist will also go over the necessary prerequisites with the patient (psychiatric/psychological letter of referral, application for insurance coverage, etc.) Once preparations have been made and any questions have been cleared up, the doctor gives the patient time to decide whether or not to have the operation. If the patient chooses to proceed, the patient and the plastic surgeon work together to set a date for surgery.

What are the different mastectomy procedures?

With mastectomies for trans men, the type of incision used typically depends on the size of the patient’s natural breasts. With smaller breasts, the plastic surgeon will make a circular incision around the areola, and then use it as an access port to remove the mammary glands before smoothing out the periphery of the torso using liposuction for a natural, aesthetic result. If the patient has larger breasts, an additional horizontal incision will be necessary in order to tighten the skin. Here, too, additional liposuction helps refine the results of the procedure.

What kind of anesthesia is used during the operation?

Mastectomies are always performed under general anesthesia. Some hospitals use an additional pectoralis block, a long-acting local anesthetic which numbs the entire chest area for 18 hours. This makes less pain medication necessary after the operation, which reduces the associated side effects.

Do I have to stay in the hospital afterwards?

Mastectomy procedures do involve a short hospital stay, so that the patient has a chance to recover and receives good medical care immediately after the operation. If any complications do develop, hospital staff can react quickly in order to prevent any additional complications or discomfort. Most patients can go home after two days, though this varies depending on the specific procedure and the patient’s individual condition following surgery.

How long will I have to wear the bandage?

A protective bandage is applied after the mastectomy. The sterile surgical bandage is removed the day after the operation; the day after that, the protective bandage is replaced with special compression clothing that helps minimize post-operative pain. The compression effect also holds the wound cavities closed, which makes the end results look more natural.

What can I do to minimize scarring?

Mastectomy incisions are chosen to ensure that any future scars are hardly visible. Patients should avoid exposing the treated area to direct sunlight in the first few months following surgery, because excess UV radiation can impair healing and result in scar hyperpigmentation. Special scar creams are also available. Within a year (sometimes as long as two years), the scars generally fade to the point that they can barely detectable.

How long after my mastectomy will I need to rest?

It is especially important for patients to get plenty of rest in the first few days after surgery. After that, they can resume some physical activity (taking walks, for example), though strenuous movement and sports are best avoided at first. After four to six weeks, upon medical consultation, patients can start doing sports again. However, make sure to start slowly and avoid overexertion.

Do breasts grow back?

No, once removed, mammary gland tissue will not grow back. An unhealthy diet and a lack of exercise can cause the remaining fat cells in the chest to increase in size, however—in other words, patients can still gain weight and volume in their torsos as usual. Leading a healthy lifestyle can help patients maintain the aesthetic results of their treatment.

Female-to-male (FTM) gender confirmation surgery involves a number of individual steps; which of those individual steps may come into question for a particular person depends, among other things, on what changes that person is hoping to achieve. Of course, the patient’s physical condition and any potential contraindications also factor into the final decision as to whether a particular surgery can be performed or not. For many trans men in Zurich, mastectomies are a significant step on their journeys, because breasts are often associated with femininity and can be difficult to conceal. Clothing and binders can help „hide“ them, but don’t solve the problem of making people feel comfortable in their own skin. Surgical breast removal can be an excellent treatment option to help people really identify with the person they see in the mirror. Read on for more information on mastectomies and other gender confirmation options.

What does transgender mean?

Topics related to gender dysphoria and trans identity have started receiving more public and media attention in the past few years; fortunately, as more information becomes available, overall trans acceptance is on the rise as well. Even so, there is still a great deal of misinformation and prejudice out there.

For trans individuals, the gender they were assigned at birth (their external sex characteristics) does not match the gender they feel they are (their gender identity)—they often feel like they were „born with the wrong body“. Of course, the reality is often much more complex than this simple definition is capable of expressing. Being trans is about more than simple anatomy; it affects many areas of a person’s life.

Plastic surgery can offer trans people a way of getting one step closer to a physique that they can feel good about and identify with.

Breast removal – the mastectomy

Gender confirmation mastectomy means that the plastic surgeon removes the patient’s mammary gland tissue to create a flatter torso with more masculine contours. Several different incision pathways can be used for the procedure, which is why the plastic surgeon uses patient consultation sessions to create a treatment plan specific to the patient’s desired results and individual circumstances. One possible method is to make a circular incision around the areola. This technique is preferable with smaller breasts, because it leaves small scars that are largely invisible. If larger amounts of tissue will need to be removed, however, a longer incision is usually necessary. As part of the operation, the plastic surgeon also removes any excess skin and uses additional liposuction to smooth out peripheral fatty tissue, yielding more harmonious results.

Other gender confirmation procedures

Mastectomies are just one of several treatment options available to FTM people. Whether they are performed depends primarily on the individual’s goals and desires.

Are there any risks involved in mastectomies?

Operations are always associated with certain risks. Choosing an experienced plastic surgeon – particularly one experienced with breast surgery – helps minimize the risk of mastectomy-related complications.

Swelling, redness and bruising are normal following an operation; patients should also expect a temporary feeling of numbness or tension in the chest. Some people find that their chests are more sensitive than usual. Most of the time, these issues subside after a few days to a few weeks. Proper after-care and sufficient rest can help actively support the healing process.

More serious complications can occur in rare cases, such as impaired wound healing, chronic changes in sensation, tissue swelling, excessive scar formation, infections, bleeding, or embolisms. A reputable plastic surgeon will take time to go over potential risks in detail as part of the patient’s individual consultation session.

Goals and results of mastectomy procedures

The goal of mastectomy operations is to remove female breasts and give the patient’s chest and torso a masculine shape. Plastic surgeons take great care to make sure that the results will be as natural-looking and aesthetically pleasing as possible, while minimizing the risk of complications and scarring. Liposuction optimizes the results even further. As long as the patient’s weight does not fluctuate excessively, the patient’s chest will retain its new shape permanently. Corrective procedures are an option for patients who desire scar correction or are dissatisfied with their results in general.

A mastectomy means that the plastic surgeon removes the patient’s mammary glands. Many trans people consider breast removal one of the most important steps on their gender confirmation journey: even though binders can help conceal breasts underneath clothing, that obviously doesn’t change the wearer’s individual perception of their body, or increase their personal well-being.

Having a mastectomy in Zurich is a way for patients to bring their chests more in line with their ideal and give them the most natural-looking, masculine torso shape possible. Human mammary glands are always embedded in fatty tissue, though the thickness of that layer varies from person to person; as a result, the mastectomy process also involves liposuction to create a smooth, flat chest. Without liposuction, the fat deposit left behind may be reminiscent of a breast. The plastic surgeon performs this step as part of the mastectomy operation, eliminating the need for an additional procedure.

When can a mastectomy be performed?

As a gender confirmation procedure, mastectomy surgery offers people suffering from gender dysphoria (formerly known as „gender identity disorder“) a way of getting one step closer to the body they want. For people who identify as female-to-male or female-to-nonbinary transgender, having breasts can be a source of great discomfort. A mastectomy can help those people stop feeling like strangers in their own bodies. Prerequisites for the procedure include a thorough consultation and medical examination to rule out any potential contraindications. Patients will also need a letter of referral from their treating psychiatrist or psychologist.

Where will the incisions be made?

During their consultation, the doctor and the patient will plan the mastectomy procedure individually, tailoring it precisely to the patient’s needs. Depending on the results the patient is looking for and the patient’s particular anatomy, several different surgical techniques or incision paths may come into question. With small breasts, the plastic surgeon usually creates a circular incision around the areola (a periareolar incision), and then removes the patient’s mammary tissue and excess skin. The periareolar method generally leaves very little scarring, but the technique can only be used to remove smaller amounts of tissue. If the patient has larger breasts, a longer incision will generally be necessary in order to remove enough tissue.

Will there be scarring?

Any procedure that involves incisions carries a risk of scarring, though some techniques help minimize scars. In the case of mastectomy operations, it mainly depends on the incision used and the patient’s individual healing process, which can never be predicted with total certainty. Experience has shown that periareolar mastectomies leave little to no visible scarring, as the incision is made at the junction between the areola and the surrounding skin. Removing larger breasts usually requires longer incisions, which can result in scarring of the chest. Scars are often darkest and most visible immediately after the procedure, and generally fade with time.

After one to two years, they are barely visible at all in many cases. Proper aftercare is important for scar prevention. For example, patients should allow themselves plenty of rest and recovery time, and should avoid direct sunlight or tanning beds, because UV radiation can cause scars to darken. Medical personnel will give patients more information on how to care for their scars and which products are most helpful.

If the results aren’t satisfactory, can they be corrected?

Personal consultation sessions before mastectomy operations are about more than just planning the operation precisely and providing detailed information—they’re also about helping patients develop realistic expectations about their results. Even so, on occasion, the final results of the breast removal process don’t line up with what the patient was hoping for. Slight asymmetries can occur, although this usually looks natural, since the two sides of the human body are never exactly identical. If the procedure yields disharmonious results, patients can arrange for a corrective procedure—to pull the overlying skin more taut, for example, or perhaps to correct scars that have not healed and faded as desired. However, any corrective operations should only be considered after the healing process is complete and the final results are visible, which generally takes a minimum of six months.

Careful planning is crucial when it comes to a mastectomy in Zurich. The plastic surgeon adjusts the breast removal operation to fit each individual patient’s exact circumstances. That of course includes accounting for the patient’s goals and desires, so that the results will be harmonious and aesthetic in a way the patient is completely satisfied with. However, mastectomy cannot always deliver the exact results people have in mind, which is why it is so essential that the plastic surgeon talk to them beforehand about what the treatment can offer and what, if any, restrictions may apply.

Finding the right surgeon

With any plastic surgery procedure, the most important first step is to find the right surgeon for the job. Patients often see this as a hurdle, because they aren’t sure how to identify a good, reliable doctor. One of the biggest factors is choosing a surgeon who has the right qualifications in the field of aesthetic, plastic, and reconstructive surgery—that’s the only way to minimize the risk of complications and undesired side effects. The surgeon’s level of experience also plays a role in aesthetically pleasing, healthy-looking results.

The more frequently a plastic surgeon has performed the particular procedure in question, the more likely it is that the patient can look forward to desirable results and a low risk of complications.

Patients should never have a mastectomy performed by any doctor who does not provide thorough consultation, fails to answer questions, or puts any kind of pressure on them to have the operation. A doctor-patient relationship based on trust is essential to the success of the entire treatment, so if   anything about the conversation feels „off“, it’s better to get a second opinion from a different plastic surgeon.

The individual consultation session – the be-all and end-all of treatment

Any respectable plastic surgeon who values patient safety, satisfaction and well-being will take plenty of time to discuss the procedure with the patient in detail. As part of an individual consultation session, the surgeon will ask about the patient’s personal motivations for seeking a mastectomy, and together the two of them will work out a treatment plan most suited to the patient’s needs.

It goes without saying that a good plastic surgeon will use the consultation as an opportunity to answer the patient’s questions and explain any risks associated with the procedure. Knowing all the key details about the mastectomy process is the only way for patients to set realistic expectations for their own results and make an informed decision on whether to proceed.

What kinds of preliminary medical tests are necessary?

Most of the time, no preliminary medical testing is needed before a mastectomy. The personal consultation session will include a discussion of the patient’s complete medical history and a physical examination, so that the doctor can rule out any potential contraindications that would make mastectomy an inadvisable option. For planning purposes, the doctor will often use radiographic imaging (X-ray or ultrasound, for example) to evaluate tissue and structures; the plastic surgeon and the patient will discuss whether such an examination is necessary in the patient’s particular case.

How do I prepare for my mastectomy?

Generally speaking, mastectomy surgery does not require any special preparation. Patients can prepare for their personal consultation sessions by noting down concrete questions to ask the specialists. Patients should also talk to their psychiatrists or psychologists beforehand to get a letter of referral, which will be required for cost reimbursement purposes – the plastic surgeon will send it to the insurance company along with photos taken during the consultation session. Patients who take medications or other substances that can affect blood coagulation should discontinue them about a week before surgery if possible. Naturally, the plastic surgeon will discuss these types of questions more thoroughly during consultation.

The day of the operation – procedure and information

Patients are admitted to the hospital the day before their mastectomy or two hours prior, depending on their individual treatment plans. They consult with the plastic surgeon and the anesthesiologist to review the plan and make sure that they are in good health. Once the specialists have determined that no contraindications to surgery have developed, the patient is brought into the operating area with an empty stomach. The patient’s mammary glands are removed while the patient is under general anesthesia. For optimum results, additional liposuction is usually required to remove any fat deposits around the breasts. Generally speaking, patients pay liposuction costs out of pocket.

Individual consultation and care before, during, and after your mastectomy

Are you looking for more information on mastectomy procedures, or would you like to schedule a personal consultation at my clinic in Zurich? I would be glad to provide you with the information you need and explain the procedure to you in detail. Having spent many years working in aesthetic and reconstructive plastic surgery, I know what a major step breast removal represents for you and how hard it can be to discuss it openly, which is why creating a friendly, confidential discussion environment is a major priority for me. I want you to feel comfortable at my clinic, and I want you to know that you’re in experienced, competent hands. I look forward to meeting and assisting you!