FTM Top Surgery

Chest Wall Reconstruction | Create a More Masculine Chest Appearance

FTM Top Surgery in Fargo, ND

Chest wall reconstruction surgery, also referred to as bilateral mastectomies for gender reassignment or FTM top surgery, is a procedure to remove excess fat, glandular tissue, and/or skin from the chest, with the goal being to masculinize the chest.

There are a variety of surgical techniques for chest masculinization. The technique, along with the surgical approach, will depend on your preferences, your anatomy, and your surgeon´s recommendation. The two main procedures Dr. Adams performs are the Double Incision and the Periareolar procedure.

Double Incision Procedure

This procedure is ideal for patients with medium to large chests or who have an excess amount of loose chest skin. The chest tissue is removed with an incision along the chest fold and the nipple/areolar complex is replaced as a graft. This technique does leave a scar across the chest wall. A surgical drain is placed on each side and removed about a week later.

Periareolar Procedure

Good candidates for this procedure have a small amount of chest fullness without a significant amount of loose skin. The tissue is removed through a small incision hidden at the edge of the areola. Liposuction is often used to contour the chest. A drain is placed on each side and removed about a week later.

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(701) 412-2400

3171 44th St S Suite 102, Fargo, ND 58104

New Consultation Checklist

In order to schedule a consultation, you will need the following:

  • Must be 18 or older.
  • If you plan to pay for the surgery, you can call us at (701) 412-2400 and schedule the consultation.
  • If you want to use your insurance for coverage you will need to do the following:
    • Please call your insurance company and verify coverage for gender-affirming surgery as well as the insurance companies requirements for prior authorization (ie: hormone therapy, referral from a therapist, etc)
    • If required by your insurance company, please provide us with a letter of support from your mental health provider. The letter must state how long you have been in therapy, the diagnosis of gender dysphoria, the duration of time you have been living full-time as the desired gender and the therapist’s opinion regarding your readiness for surgery. The letter must be signed by the care provider.
    • Fax or email the letter(s) to our office (fax # 701-941-7606) or email to [email protected]. Include your phone number so we can contact you with your appointment.

*Note: In addition, some insurance companies require referrals. If your insurance does, please contact your primary care doctor for the referral and ask them to fax it to us. The appointment cannot be scheduled without the referral.

FAQ: FTM Top Surgery

How should I prepare for my FTM top surgery consultation?

Researching Transmasculine Top Surgery on reputable internet sites such as the American Society of Plastic Surgeons can provide an informative overview. The best information for your personal case, however, will be obtained by making an appointment and speaking with your surgeon. It may also be helpful to view before and after photos of patients that have had the procedure. It’s best to view photos of patients with a similar body type as yours. Remember to write down any questions or concerns you have so they can be addressed at your consultation. Know what your surgical expectations are so your surgeon can discuss them with you. If you are a smoker we recommend you quit to help reduce the risk of wound healing. We also recommend a healthy lifestyle to help your recovery process.

Are there different types of FTM chest wall surgery procedures?

Yes. The two techniques Dr. Adams uses for chest masculinization are the double incision and periareolar techniques. The type of procedure performed is chosen on a patient-by-patient basis. Your chest size and amount of loose skin determine which procedure is recommended.

Where will my FTM top surgery scars be?

The final scar for the double incision approach is at the lower chest fold, just under the pectoralis muscles. The nipple/areolar complex is grafted back on. The scar for the periareolar approach is along the edge of the nipple/areolar complex. We place a drain on each side and place you in a binder for compression.

What is the FTM top surgery surgical process?

The surgery is performed at a hospital or surgery center and is outpatient, meaning you go home the same day following your surgery. During surgery, you will receive general anesthesia. The surgery will take between 2-3 hours. Once you are awake you are taken to the recovery room for another 1-2 hours.

What is the FTM top surgery recovery process?

The first few days you may feel soreness or pain. You will notice that the pain decreases with each passing day. You are sent home on pain medications which will decrease your discomfort. We will recommend that you wear the binder to provide compression and help minimize swelling. We will see you one week after surgery to evaluate your healing process and remove the drains. We request that you do no heavy lifting for at least one month following surgery.

How much does FTM surgery cost?

The cost is approximately $9,000 – $12,000, which includes the surgeon’s fee, hospital/facility fee, and anesthesia. The pathology fee, approximately $200-400, is not included and you will be billed by the hospital after surgery. Visit our Financing & Fees page to learn more. 

Can I finance my FTM top surgery?

Yes. We offer patient financing through PatientFi and CareCredit . See our financing page for more information.

Do you accept insurance for FTM surgery?

Yes, we accept many different insurances. You can contact your insurance and ask if Nicholas Adams, MD is listed as a contracted provider.

Which codes can I provide to my insurance carrier for FTM top surgery?

To find out if your insurance covers the surgery, provide them with the following codes: CPT Code (procedure code): 19318-50, and diagnosis code: F64.0 (gender dysphoria).

Can I have FTM top surgery without ever seeing a therapist?

Yes, but it is recommended and may be required by your insurance company. Dr. Adams follows the “Informed Consent”  method and doesn’t require a letter from your therapist. 

For insurance patients, the therapy requirements vary. Please check the medical policy for your insurance.

Is hormone therapy a requirement for FTM top surgery?

Dr. Adams does not require you to have hormone therapy. However, some insurances do require a minimum of 12 months. You will need to review the medical criteria for your insurance policy.

What are the age requirements for FTM top surgery?

Dr. Adams offers gender-affirming procedures for patients aged 18 years and older. 

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