Gender affirming chest masculinisation, commonly called FTM top surgery, is a surgical procedure that removes breast tissue and reshapes the chest to create a flat, naturally masculine contour. For many trans men and non-binary people, it is one of the most significant and affirming steps in their transition.
While the surgical technique shares elements with chest reduction procedures, gender affirming surgery requires a deeper understanding of the trans body and a genuine sensitivity to what each patient is trying to achieve. Chest wall shape, skin laxity, breast volume, and the effects of hormone therapy all influence which technique is most appropriate and how your surgeon approaches the procedure. Choosing a surgeon with true specialist breast and chest expertise, rather than a generalist cosmetic surgeon, makes a meaningful difference to both your results and your experience.
The anatomy of the chest and breast is Mr Seni Mylvaganam's entire clinical world. As a Consultant Oncoplastic Breast Surgeon, his specialism goes far beyond cosmetic training. His career has been dedicated to the form, function, and surgery of breast tissue, from complex reconstruction after cancer to precision reshaping for aesthetic and gender affirming goals. As NHS Clinical Lead for Breast Services at Royal Wolverhampton Hospitals, he performs breast and chest surgery every single working day. That depth of expertise informs every gender affirming procedure he undertakes at Kat & Co.
Consultant Oncoplastic Breast Surgeon
The most common technique for FTM top surgery.
Two horizontal incisions are made across the chest to remove breast tissue, with excess fat extracted through liposuction where needed. The nipples and areolas are resized and repositioned as free grafts. The result is a flat, masculine chest contour with well-placed scars that sit naturally in the chest crease.
Best for: Those with a larger amount of breast tissue; those seeking a fully flat chest; the most predictable and complete result for most patients.
Consideration: As the nipples are temporarily removed and replaced as grafts, some patients experience reduced nipple sensation. Mr Seni will discuss the likelihood of this based on your anatomy.
Minimal scarring for suitable candidates.
A circular incision is made around the border of the areola to remove breast tissue and resize the nipple. Because the nipple remains attached throughout, this technique typically preserves more sensation than double incision.
Best for: Those with a smaller chest and good skin elasticity; those for whom minimal scarring is a priority.
Consideration: This technique is only suitable where the volume of breast tissue is limited. Mr Seni will advise honestly at your consultation whether this approach is appropriate for your anatomy.
A middle-ground option for some patients.
Where a fully flat result is not the goal, a chest reduction removes a significant portion of breast tissue while retaining some chest shape. This may be appropriate for some non-binary patients who wish to reduce chest dysphoria without complete removal of tissue.
Best for: Those who want meaningful reduction rather than a fully flat chest; non-binary patients whose gender affirmation goals involve a partial reduction.
Eligibility for gender affirming surgery is more straightforward than many people expect. The most important step is booking a consultation. Mr Seni will assess your individual circumstances and answer any questions you have. As a general guide, suitable candidates typically:
✓ Are aged 18 or over FTM top surgery is available to adults aged 18 and over.
✓ Have a diagnosis of gender incongruence A formal diagnosis, typically from a GP, gender specialist, psychiatrist, or clinical psychologist, is required. A diagnosis made within the last 12 months is preferred by most private providers. If you don't yet have a diagnosis, we can advise on next steps at your consultation.
✓ Have a referral or supporting letter A letter from your GP or a qualified gender specialist is required before proceeding to surgery. This confirms your diagnosis and confirms you have been assessed as suitable for surgical intervention. We can advise you on what this letter should include.
✓ Are in good general health You should be in good physical and mental health, with a BMI within a suitable range. Mr Seni will carry out a full pre-operative assessment to confirm you are fit for surgery under general anaesthetic.
✓ Are a non-smoker (or are prepared to stop) Smoking significantly affects healing and surgical outcomes. We ask patients to stop smoking for a minimum of six weeks before and after surgery, including vaping and nicotine replacement products.
✓ Have considered the role of hormone therapy Testosterone therapy is not an absolute requirement, but it can influence chest tissue composition and skin changes that affect surgical planning. If you are on, or considering, hormone therapy, Mr Seni will discuss what this means for your options and timing.
Not certain whether you qualify? Don't let uncertainty hold you back. Our free initial consultation is the right first step. There is no pressure and no commitment, just an honest, supportive conversation with Mr Seni about what is right for you.
Meet Mr Seni in person at our Edgbaston clinic. This is a relaxed, confidential conversation about your goals, medical history, and options. There is no pressure and no obligation. Mr Seni will explain your surgical options in plain language and answer every question you have.
Once you decide to proceed, you will attend a pre-operative assessment to confirm you are fit for surgery. This includes health checks and measurements. You will also have the opportunity to discuss your chosen surgical technique with Mr Seni and refine your plan before your operation date.
Your procedure is performed as a day case under general anaesthetic, typically taking 1.5 to 3 hours depending on the technique used. You will be cared for by our experienced clinical team throughout, and you can go home the same day once you have recovered from the anaesthetic. You will need a responsible adult to take you home and stay with you overnight.
Your recovery is fully supported by the Kat & Co team. You will receive a dedicated aftercare plan, follow-up appointments with Mr Seni, and direct access to your care coordinator if you have any concerns. We are with you every step of the way.
1.5 - 3 hours
Twilight Sedation
Daycase (no overnight stay)
3 - 7 days
Bruising, swelling, temporary numbness
Infection, scarring, asymmetry, changes in nipple sensation, seroma
1 week, 2 weeks, 3 months (after surgery)
2 to 3 weeks (desk-based); 4 to 6 weeks (physical work)
2 weeks post-op - walking, 4 weeks post-op - fast walking, 6 weeks post-op - everything
Immediate change in chest shape; scars continue to improve over 12 to 18 months
FTM Chest Masculinisation
From £9,995
Your package includes:
Finance options available
