FTM Surgery
At the Center for Cosmetic and Reconstructive Surgery (CCRS), we recognize that your journey is uniquely yours, and we’re here to support you in every way we can. Gender-affirming procedures are far more than surgeries—they are powerful, life-affirming steps toward living as the truest version of yourself. We understand that this transformation is deeply personal and transformative, and we are honored to be part of this journey with you.
Our FTM (female-to-male) procedures are carefully crafted to help you align your body with your true identity, achieving results that are both natural and authentic to who you are. Every aspect of our approach is designed with respect, sensitivity, and precision, acknowledging the courage it takes to pursue this path. From sculpting a masculine chest to refining facial features or creating a natural, functional neophallus, our procedures are tailored to reflect your vision and support your goals.
Our team of expert surgeons brings extensive skill and experience, while our compassionate care team offers ongoing support to ensure you feel valued, understood, and comfortable throughout your journey. At CCRS, we combine technical expertise with a deep commitment to your comfort, privacy, and well-being. We’re here to provide not only exceptional results but also an environment where you feel seen, respected, and supported at every step.
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FTM SURGERIES @ CCRS
We are dedicated to providing comprehensive care and support for individuals seeking gender transition or gender-affirming treatment. Our team of healthcare professionals is committed to providing high-quality, compassionate care to help you achieve your gender-affirming goals. FTM surgery, or female-to-male surgery, is a series of surgical procedures that help individuals who were assigned female at birth to physically transition to a male gender identity. These surgeries are part of a larger process known as gender-affirming therapy or gender reassignment therapy.
Lets talk about Gender Reassignment Surgery
Dr.Sameer Karkhanis | Welcome to CCRS
FTM surgeries at CCRS
The Road to FTM Transformation
Age Requirement
The individual must be at least 18 years old to consent to SRS legally. For those under 18, parental consent is generally required for any gender-affirming procedures.
Psychiatric Evaluation and Mental Health Certification
A thorough psychiatric assessment is required to confirm the diagnosis of Gender Dysphoria, as per the guidelines of the World Professional Association for Transgender Health (WPATH).
The individual must obtain a mental health certificate from a qualified mental health professional, usually a psychiatrist, affirming that they have been diagnosed with Gender Dysphoria and are mentally prepared for SRS.
This assessment typically involves counseling sessions to evaluate the individual’s understanding of the surgery and its implications.
Hormone Therapy
Although not a strict legal requirement in all cases, most surgeons and medical guidelines recommend that individuals undergo hormone therapy for at least 1–2 years before SRS.
Hormone therapy helps the individual experience some physical changes, allowing them to further affirm their gender identity. It also provides time to assess the person’s readiness and commitment to transition.
"Real-Life Test"
Individuals are often encouraged, though not legally required, to live in their identified gender role for a minimum of 1 year before undergoing SRS. This practice, commonly known as the “real-life test,” allows the person to experience life in their affirmed gender role and helps assess their comfort level.
Legal Documentation and Consent
The individual must provide informed written consent before undergoing SRS. This includes understanding the risks, benefits, and irreversible nature of the surgery.
While a Gender Dysphoria diagnosis from a mental health professional often serves as a basis for moving forward, some surgeons or institutions may also require a second opinion.
Depending on the state, individuals may need to submit legal documents affirming their chosen gender identity. In cases where legal recognition of gender has been obtained (such as a gender identity certificate or updated identification), these documents can be useful in the process but are not strictly mandatory.
Affirmative Consent for Surgery
A legal declaration may be required, especially for irreversible surgeries, to ensure the individual is fully aware of the implications. This is part of informed consent to ensure clarity around the permanence of SRS.
Financial Preparation
Since SRS is typically not covered by health insurance in India, individuals should be prepared to handle the financial costs.
Different hospitals and clinics have varying requirements regarding documentation and medical assessments, so it’s essential to consult with the facility performing the surgery for any additional requirements.
Post operative plan
A follow-up and care plan should be in place, which may include regular consultations with mental health professionals, hormone therapy adjustments, and physical rehabilitation if necessary. This plan, though not legally mandated, is often required by medical institutions to ensure post-surgery recovery and support.
FTM TOP SURGERY
Top surgery is a transformative procedure that helps align physical appearance with gender identity, creating a masculine chest contour in FTM (female-to-male) transitions. At CCRS, our skilled surgeons provide personalized techniques to achieve natural, comfortable results that reflect your authentic self.
TOP SURGERY (Periareolar or Keyhole)
Best suited for individuals with smaller chests, this method involves making incisions around the edge of the areola to remove breast tissue. The scars are minimal, and the nipples remain attached, preserving sensation. However, it’s less effective for those requiring extensive tissue removal.
TOP SURGERY (Double Incision Mastectomy)
This technique is commonly used for individuals with larger chests. It involves removing breast tissue through two horizontal incisions across the chest, and the nipples are resized and repositioned as grafts to create a masculine appearance. This approach leaves visible scars but allows for effective contouring.
TOP SURGERY (VASER Assisted )
Primarily suitable for individuals with small chests and good skin elasticity, this method uses liposuction to remove fat from the chest area, creating a flatter appearance. While it’s less invasive and leaves minimal scarring, it’s typically less effective for those needing significant tissue removal.
Adjunctive FTM Procedures
FTM (female-to-male) surgery at CCRS is designed to help you align your body with your true identity. From chest masculinization to bottom surgery, our expert team provides individualized care, creating authentic, natural results that empower you to feel fully yourself.
HYSTERECTOMY & OOPHORECTOMY
These procedures involve the removal of the uterus and ovaries and are often part of a comprehensive FTM transition plan. CCRS provides compassionate care, guiding patients through each step of this deeply personal choice to ensure safety, comfort, and peace of mind.
BODY MASCULINIZATION SURGERY
Body masculinization surgery sculpts the torso and other areas to accentuate a masculine physique. This may include liposuction and contouring techniques to create broader shoulders, a more defined chest, and a tapered waist, all designed to enhance a masculine silhouette.
METOIDOPLASTY
This genital reconstruction procedure leverages the growth of the clitoral tissue, often enhanced by hormone therapy, to create a neophallus. Metoidioplasty offers a natural-appearing outcome and can be customized with or without urethral lengthening, depending on the patient’s preferences and goals.
FACIAL MASCULINIZATION SURGERY
Facial masculinization surgery reshapes the face to achieve a more traditionally masculine look. Procedures such as brow bone contouring, jaw reshaping, and chin augmentation can be customized for each patient, allowing for a balanced and natural masculine appearance.
PHALLOPLASTY
This technique is commonly used for individuals with larger chests. It involves removing breast tissue through two horizontal incisions across the chest, and the nipples are resized and repositioned as grafts to create a masculine appearance. This approach leaves visible scars but allows for effective contouring.
Consultation
Meet the skilled professionals behind our transformative treatments. Each of our specialist doctors brings extensive experience and a commitment to excellence, ensuring personalized care and exceptional results.
Sameer Karkhanis, MD
Board-Certified Mumbai Plastic Surgeon
Chief Plastic Surgeon & the Director at CCRS is a qualified Aesthetic Plastic and Reconstructive Surgeon. He is Board Certified, with the qualification of DNB Plastic Surgery (Diplomate of National Board). He is an active member of the International Society of Aesthetic Plastic Surgery.
FAQs
Our dedicated team of professionals provides top-notch surgical services in a modern, comfortable environment. Explore our gallery to see the advanced facilities and compassionate care that set us apart in the field of surgery.
Like all types of surgery, gender-confirmation procedures carry risk. That’s why we thoroughly evaluate your health before planning surgery. Our experienced team follows best practices when it comes to your safety.
The length of your journey depends on your individual needs and choices. Along with surgical procedures, you might also have hormone therapy, voice therapy, and counseling. It’s up to you where to start and when you feel you’ve met your goals.
FTM top surgery is a major procedure with several preparatory steps. You must first meet the guidelines of the World Professional Association for Transgender Health (WPATH), including undergoing a mental health evaluation by a licensed therapist or psychiatrist to confirm your understanding of the procedure. Most patients are already on testosterone hormone therapy and regularly see a therapist. It’s also essential to choose a board-certified surgeon to ensure safety and effectiveness. The process may take up to a year and involves significant physical changes, so careful planning is key. Dr.Sameer will guide you through all available gender-affirming surgeries, helping you choose the best option for your goals.
Fortunately, recovery from FTM top surgery is generally easier than the procedure itself. After surgery, you’ll need to wear compression bandages on your chest for three to six weeks to prevent fluid buildup, reduce scarring, and minimize the risk of infection. During recovery, you’ll need to sleep on your back and take it easy. Rest and pain medications will support a smooth recovery. Plan for at least two weeks of rest and avoid raising your arms or engaging in strenuous activities for six to eight weeks.
Changes in nipple sensation vary by technique, which depends on your chest size and other individual factors. If you are very attached to keeping nipple sensation, it makes sense to consider the Inverted T Anchor or Buttonhole procedure as alternatives.
Though chest reconstruction surgery significantly reduces your risk of developing breast cancer, there will still be some breast tissue that remains in the chest wall after surgery.
For this reason, you should still routinely check for breast cancer with your primary care physician.
Complications from FTM top surgery can include poor scarring, where scars may remain red, thick, or rarely form keloids. Infection is a risk, but antibiotics are given during surgery to minimize it. Bleeding may occur due to the vascular nature of the breast, and a drain is used to reduce the risk of hematoma.
Asymmetry is common, but differences should be minimal and fade with time. Free nipple graft failure may occur, requiring healing by secondary intention and possible nipple tattooing. Dog ears (puckering) at the scar ends can happen, especially with larger breasts, and may need revision if they don’t improve. Seromas, or fluid collections, may develop post-surgery but can often be managed with a binder or drained if necessary.
Gender reassignment (confirmation) surgery is more common in transgender men (42 to 54%) than transgender women (28%). Top (chest gender confirmation) surgery is performed approximately twice as often as bottom (genital) surgery. In studies that assessed transgender men and women as an aggregate, top surgery accounts for 8 to 25% and bottom surgery accounts for 4 to 13%.
Female-to-male (FTM) top surgery sculpts a more masculine chest for transgender men by removing breast tissue to create a muscular appearance. This gender-affirming surgery is a crucial step in reducing gender dysphoria and helps relieve the physical strain of chest binding. By aligning physical appearance with gender identity, top surgery supports both emotional well-being and mental health. FTM top surgery can significantly relieve emotional and psychological challenges tied to gender incongruence, helping patients feel more comfortable and confident in their bodies.
here are several types of FTM top surgeries. At CCRS, Dr. Sameer performs periareolar surgery and double-incision surgery, both of which leave minimal scarring and can be performed on almost all breast sizes. Periareolar surgery is best suited for those with small to moderate sized breasts with good elasticity. Double-incision surgery is best suited for those with larger breasts. During your consultation, Dr. Sameer will discuss your medical history and evaluate your breasts to determine which surgery is optimal for you. Whichever surgery you’re prescribed, you can expect that:
- Both of your breasts will be removed with a double mastectomy.
- The excess skin around your breasts will be removed along with the underlying tissue.
- Your areola and nipple will be repositioned to sit in a more natural space on your chest.
- Other changes may be made to create a more flat-looking, natural chest.
Dr. Sameer will go through these steps with you in greater detail leading up to your surgery.
Losing weight may result in a decreased chest size; however, you cannot eliminate all chest tissue in this manner. Some people feel more comfortable once they reduce their chest size, while others opt for surgery regardless. Large amounts of weight loss are generally unsustainable and thus should not be counted on for a way to reduce chest-related discomfort or gender incongruence; surgery is often necessary for a drastic change in chest size.
Many patients opt for decorative tattoos to cover or embellish their scars. As always, this is a very personal choice.
Although extremely rare in our practice (less than 2%), in the case of a nipple graft failure a nipple tattoo reconstruction is an option. An innovative approach is to have a nipple tattoo made that uses optical illusion to create a very realistic 3-D type appearance, even though the skin is still quite flat.
Removed breast tissue doesn’t grow back. We do leave some fat behind to create natural-looking chest contours. While this fat can enlarge like fat anywhere on the body, it likely will not take on a feminine appearance.
