Praxis für Plastische Chirurgie Dr. med. Britta von Stumberg
Identifying with a different gender than one was assigned at birth can cause a person a great deal of suffering—they have the sense of being “born in the wrong body.” Female-to-male (FTM) trans people often find their breasts especially bothersome. Clothing and binders can help conceal them, but this is obviously a less-than-satisfactory solution for many people, since they still feel uncomfortable in their own skin. Surgical breast removal (mastectomy) can provide welcome relief in this situation—individually tailored treatment can help trans men in Zurich achieve the masculine torso they desire.
Many trans men find that being able to show their torsos gives them the feeling of “not having to hide anymore,” which greatly increases their sense of self-worth and overall happiness. I would be glad to sit down with you here at my clinic in Zurich and discuss mastectomy options to fit your needs. Read on for a first look at what mastectomies are and how they can benefit trans men in Zurich.
The word “mastectomy” means surgical removal of the mammary glands. In this case, it means not only removing the breasts, but giving patients a flatter, more masculine torso shape overall. Several factors are important here: complete removal of the mammary glands and surrounding fatty tissue, leaving a completely flat layer of skin covering the pectoral muscles; correct positioning and size of the areolae and nipples; and eliminating the inframammary line (the crease beneath the breasts).
The female breast (lat. mamma) is made up of glands, fatty and connective tissues, and skin. It is a secondary sex organ, and generally extends from about the third rib to the sixth. It is positioned more or less exactly over the greater pectoral muscle, which is surrounded by connective tissue (the pectoralis fascia). This connective tissue is soft and loose, which makes it easy to shift the mammary gland. The mammary gland itself is mainly covered by skin and fatty tissue. It is made up of 15 to 20 branching lobes of different sizes, each of which is surrounded by connective and supporting tissue. Each of those lobes, in turn, is made up of several glandular lobules—the smallest unit of the mammary gland. Those lobules contain small mammary (milk) ducts, which later come together to create larger ducts and finally end at the nipple.
Generally speaking, the male breast has the same structure: like its female equivalent, it is made up of mammary, fatty, and connective tissue along with nerves, blood vessels, and lymphatic vessels. Female hormones released during puberty cause the glands, milk ducts, and fat bodies of the breasts to increase in size, as well as the nipples and areolae. Male hormones, on the other hand, trigger the formation of a panel of connective tissue, which is why the male chest is usually flatter—its shape is mostly determined by the greater pectoral muscle. However, men’s mammary glands are covered by a layer of fatty tissue as well, which affects the appearance of their chests; this layer of fat may be larger or smaller depending on the person‘s genetic predisposition and individual lifestyle.
People who come to my clinic seeking information about surgical options for trans men in Zurich are usually looking for a flat, masculine chest. The main goal of mastectomy surgery is to give patients a healthy, natural-looking masculine torso with minimal, discreet scarring, while retaining as much breast and nipple sensitivity as possible. Other treatment goals include minimizing post-surgery pain and choosing a low-risk surgical technique.
As an experienced plastic, reconstructive, and aesthetic surgeon, I know that contacting a specialist isn’t always an easy step to take. You have nothing to fear from discussing your situation with me openly. Your consultation will be held at my clinic in Zurich, in a confidential setting. I have been operating on trans men throughout Switzerland for many years, and I will address your concerns with understanding, empathy, and honesty as well as medical professionalism.
Personal consultations are mainly about getting to know each other and discussing your goals and expectations. We’ll work together to develop a treatment concept that’s right for you, to help you achieve the upper body appearance you desire. Of course, I’ll also give you a detailed explanation of the procedure itself, before- and aftercare, and any risks involved.
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The exact duration of the mastectomy procedure depends on the technique being used and the size of the breasts involved, but most operations take two and a half to three hours. Surgery is done under general anesthesia. For small breasts, an incision is usually made around the areola in order to remove the mammary gland; with larger breasts, a longer incision may be necessary. The procedure always involves liposuction to reduce peripheral fat deposits and provide natural-looking, aesthetically pleasing results. After surgery, patients usually remain in the hospital for two days for follow-up care.
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For ideal results, patients‘ nipples are often reduced in size and/or repositioned, but there’s no categorical answer on which patients will benefit from it – we’ll discuss whether it’s advisable for you personally as part of your consultation session.
Mastectomies are a major operation, so of course it’s very important for patients to rest and recover afterwards, in order to facilitate healing and minimize the risk of complications.
We’ve put together a brief outline of what to expect after surgery here.
As a Swiss patient, you can submit a medical evaluation to your health insurance provider. Swiss insurance will cover the mastectomy procedure, but considers the adaptive liposuction an aesthetic procedure, so you will be responsible for those costs. In our experience, if you are not covered by Swiss health insurance, you will need to pay for the mastectomy yourself.
As a trans man, you can bring your hopes and concerns to me without reservation. Mastectomies have been part of my treatment repertoire for many years, and I would be happy to help you achieve the torso shape and appearance that’s right for you. Come to my clinic for an individual consultation, and I will gladly spend time discussing your needs and addressing all of your questions in detail. I look forward to meeting and assisting you!