Mastectomies for trans men – frequently asked questions about mastectomy

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.