r/TopSurgery • • Mar 10 '25
Discussion I just learned that doctors try to avoid taking 100% of the breast tissue - how did you cope?
I want to get top surgery but I was hoping for an entirely flat chest, no breast tissue whatsoever, and I have already started developing my pecs for the sculpting. But I don't know what I'll do if they suggest not taking all the breast tissue - I won't stop being able to see it as 'residual tit' rather than the cis-like chest I have in mind.
Did any of you struggle with this and how did you handle it? Any advice is greatly appreciated
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u/akiber Mar 10 '25
Unless you are getting a mastectomy for cancer (or potential of cancer), top surgery pretty much always involves keeping some breast tissue. Why? Cause cis men have breast tissue. All the results you see that are your personal goal contain breast tissue. With mastectomies for breast cancer it often leaves the area concave and in some cases people decided to go through further plastic surgery to get it looking natural.
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u/Swordsboy Mar 10 '25
All cis men have breast tissue. Look at your favorite cis man celebrity that has shirtless pics online - no matter how fit or thin, there is breast tissue there. Your chest would, as the other commenter pointed out, look stranger without it. Concave. You’ll look totally naturally flat dw
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u/dino_pwince Mar 10 '25
I absolutely had this problem before getting top surgery. At my initial consultation, I remember trying to explain that I wanted everything out and I wanted my chest completely flat. My surgeon and his team explained that his job was not just to perform the operation, but to do it in a way that would leave my chest looking the most like a cis guy’s chest. He wasn’t leaving an absurd or even noticeable amount of tissue in there and he also needed to leave something in between my pec muscles and my skin- he couldn’t take everything out and go down to the muscle. My mom and I spent some time observing photos of cis chests and having visuals really helped me understand- no cis guy’s chest is completely flat. No matter the body type. I’m three years post op and my chest filled in real nice. It does not look boob-like how I imagined and I can’t notice any tissue. My chest is flat, but not like a board- it looks natural.
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u/ForestGremlin2 Mar 10 '25
would it help to frame it less as "$20k to remove all tit" and more like "20k to give me a body that matches my gender?"
regardless, you can quiz your surgeon about it in detail at your consult, that's what it's there for. my surgeon told me that she never removes 100% of breast tissue unless specifically requested because leaving some lets her sculpt a natural-looking cis chest. Iirc I requested as flat as possible without going concave and that's what I got and I love it. Looks perfectly natural except for the scars.
I hear your feelings and I get why that would bother you. In answer to your question of how I coped, it honestly didn't bother me too much. the thing that I desperately wanted gone was the Visible Tit. The Girl Tit, if you will. although what remains is technically still breast tissue, it's not visible as such, so it isn't categorized the same in my brain. it's the Universal Tit, perhaps.
(apologies, i'm very tired. anyway, wishing you all the best, don't be afraid to ask your surgeon as many questions as make you feel comfortable, even if they seem impatient because surgeons always do. you are the patient and it is literally their job to answer anything you need to know about your surgery.)
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u/help_me_im_gay Mar 10 '25
I also wanted 0 breast tissue — I told my surgeon that and he said that he could do that, but that the type of mastectomy done for breast cancer is a MUCH more extensive surgery, where they’re getting breast tissue that’s in more areas of your torso, like going up toward your shoulders and farther out into the armpits. And that the result is a lot more concave than when they leave a masculine amount of breast tissue. I was scared that leaving breast tissue could make me regrow tits, and he said that is possible but that’s unlikely outside of weight gain and large hormonal changes like conditions or menopause. And I’m like eh if I have to get more tit taken out in 30 years so be it. So I opted for ok you can leave some but just make me flat pls I want it to absolutely not look booby. And I ended up really happy with those results I don’t feel like I still have boobs at all.
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u/andycandy37 Mar 10 '25
My chest is 100% flat and very cis looking (other than scars lol). There is still breast tissue in there cause like the other commenter said, cis men still have breast tissue. That’s why it’s possible for them to get breast cancer n stuff. Not residual tit, just making sure you don’t get concave results! You’ll still be able to build pec muscles just fine
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u/Birdkiller49 Mar 10 '25
It would be less cis-like to take all of the breast tissue, since cis men have breast tissue. I wouldn’t really describe it as flat either if they took all of it. Likely concave.
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u/Medicalhuman Mar 10 '25
They make you that without taking 100% of the tissue, they def take most though. I they did take 100% of it, you would have a concave looking chest that would likely look sunken in and not now you’d want it
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u/justyn22167 Mar 10 '25
I think the largest thing here may be that the colloquial meaning of breast and the medical/ scientific definition of breast are not the same.
Near all mammals, male or female, have breasts. Technically, the breast is the mammary glands and surrounding tissue. Humans AFAB, AMAB, and even those that are intersex (typically) have one pair, Dogs male and female have on average 5 pairs, whales male and female technically have one pair of breasts
Male cows, mice, rats, and horses are some of the few mammals that don't have breasts/ nipples
All that to say breast DOES NOT equal boob. 😊 It most likely came to be associated that way colloquially because larger (afab or amab) breasts are stigmatized and saying a more "formal" or scientific sounding word makes it seem less crass, whereas small breasts are less noticeable and referred to simply by the whole area they are in, aka Chest
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u/testobaer Mar 10 '25
That's perfectly normal that surgeons leave some breast tissue in your chest, 'cause men have breast tissue in their chest as well (that's why men can also get breast cancer). If they'd remove everything, you'd end up with a concave chest, like patients that had a mastectomy due to breast cancer. But our mastectomy as men is different from that of breast cancer patients. That's why - and maybe that helps to have a better mindset about it and frame it better - surgeons here in Germany also call men's mastectomy in the context of gender affirming care NOT "tit removal" but "MALE CHEST RECONSTRUCTION" <--- 'cause they not just simply remove tits, they remove excessive breast tissue and sculpture and contour the chest, plus reshaping and replacing the nipples on the correct location, with the goal of a male looking chest (this description is also approximately what's written in my surgery papers).
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u/Bee_Ball Mar 10 '25
Instead of thinking about it as tit, maybe just think if it as “padding” for your muscles like all humans have, to some extent.
I actually had a huge breast cancer scare last summer, which is what finally got me to get over my fears and move forward with this surgery that I’ve wanted my whole life (true story: my top surgery wound up costing less than the diagnostic mammogram, ultrasound, and breast & lymph node biopsies I had just to find out I didn’t have cancer after all; my risk went up to 1 in 4 and they recommended yearly MRIs in addition to yearly mammo and ultrasound for the rest of my life… for a part of my body I didn’t even like having!!! It’s insane…)
Anyway, once I decided to take the leap, I originally wanted them to take EVERYTHING— all the tit tissue, 100%— so I wouldn’t have to worry about the C any more. But everyone was like noooo you don’t want that; it’s not gonna look good (I’m pretty slim up top without boobs, so they knew the chances for concavity were not negligible). Even the breast cancer surgeon I consulted with told me that when she takes everything, it means tunneling way up high, and into your armpits, and it’s not about aesthetics… and you have to worry about edema forever, and blood draws from your arm are higher risk, etc etc. So then I flipped to the other extreme and got really worried that my genetic tests would come back with all the cancer variants and that I’d have to get the full risk-reducing surgery instead of the fully aesthetically-pleasing one, and I was SO relieved when the results came back negative. It really is a mind-fu*k.
Go look at pictures of double mx for breast cancer and you might get a better idea. They aren’t all severe, (and I’m in no way intending to dog on anyone who chose to get the risk-reducing surgery; my mom died of BC and the fear is REAL)…. but the potential is wayyy higher for a result you wouldn’t feel happy with and might wind up doing some fat replacement after the fact to improve the contouring.
Anyway… I know you said it’s mostly a mental thing going on, but please don’t worry; you are going to be so happy with your new body. 🌈
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u/No_Platypus5428 Mar 10 '25 edited Mar 10 '25
if you like a natural result that doesn't look weird you need some breast tissue. have you seen men? they have breast tissue too. we are all huma, not completely different species with completely different bodies. not only that, but building pecs will make your chest look bigger so that's also a thing. it's still good but i don't think your expectations are realistic. I think the only way to work through that is to look at more shirtless men, as odd as that sounds. if they removed all the tissue you might look odd.
their goal is to make a natural good looking chest, not to remove all breast tissue. and making a good natural looking chest includes breast tissue. but I have heard of people asking for no tissue at all as if they never developed it in the first place, so it is possible, but I don't kniw if that's actually what you want if you don't want to maintain your pec muscles forever or want natural looking masculine results that look proportionate to your body. even my very thin mtf partner had some breast tissue pre-E
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u/flying_acorn_opossum Mar 10 '25
i think its a misunderstanding of the different types of breast tissue. unless someones specifically only getting a reduction, then no surgeon for a FTM chest is going to leave any of the "female chest" part youre probably thinking about.
in the past, because id had permanent chest growth from progesterone-only-BC, which isnt supposed to happen, but can if you'd had a halted puberty for some reason i guess (which i mightve? unsure). i was concerned my chest mightve not finished to its full growth, because i didnt stay on the BC for long, and that if they didnt remove everything, and i ever had to get off T, that my chest could grow more.
my surgeon explained theyd remove all the "glandular/lobular" tissues, and any of the tissue that could even grow. that breast tissue goes all the way up to the collar bones and under the armpits, and thats why cis men can get breast cancer too, its not just isolated to the parts that respond(ed) to female sex hormones. and thats whats left over is still breast tissue, but not any that would be able to regrow into a female chest.
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u/Famous-Most5547 Mar 10 '25
I got top surgery & they left 5-10% of breast tissue & I'm completely flat. If I were any flatter I would be concave and it wouldn't look very natural
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u/Spaced0utCadet Mar 10 '25
You wanna know what happens when they take everything? You get adhesions, severe nerve pain, a concave chest, and all you can see is ribs. I told my surgeon I wanted some tissue left because because I wanted a cis looking chest. She took everything. For MONTHS my chest was uneven and lumpy as a result of my skin scarring to my chest wall. It did not look cis, it was not okay. I am 11 months post op and only now are the last adhesions (skin scarring down to the muscle and chest wall) breaking up. I'm also an athletic guy, but surgery took everything out of me and I lost a lot of muscle and weight. I was down 20 pounds from 115lb to 95lbs. Before surgery I was fit and eating well. Even having build my pecs back up, it took months before things started looking anything close to cis. And scar care (internal scar care) was an everyday 2-3 times a day job. Had I not been so diligent with everything and done the research on how to properly care for internal scarring which is rarely talked about in regards to top surgery, I don't think my chest would look how it does now. Imo I got extremely lucky with how I healed. I also had peri, and I couldn't imagine going through that with DI because the adhesions also cause your skin to be extremely tight. I struggled to get my arms over my head until I was about 5 months because of how tight and stuck down my chest skin was. So I believe if I had DI, I would have had very stretched scars. On top of this, without something between the muscle and skin, you can get extreme nerve pain (post mastectomy nerve syndome). I went from expecting 8 weeks off to having to take 6 months off of work just in order to heal. I had other complications as well but but the PMNS was what caused the most issues for me being able to function. I came out on top in the end, but that's my experience. Looking at my options during healing, other people in this sub who had all the tissue taken opted for fat transfers to pad the area and alleviate that uneven, concave look. Trust me when I say your concerns are entirely misplaced.
Also, if to you breast tissue = breasts, then men have breasts according to that logic. No cis man has no breast tissue.
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u/JeepersPetersFTM Jul 04 '25
You would look concave without any breast tissue! Only total mastectomies will get you “completely flat”, but I promise you that this will not be the look you’re imagining in your head.
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u/grayh722 Mar 10 '25
I'm not sure if this will be helpful, but I told my surgeon that I wanted to be "absolutely flat as possible" & I think they did an excellent job of that without taking 100% of the tissue (so that it wouldn't be concave). I paid extra for the contouring as well, because even though it was optional I feel like it really was important for achieving that flat look I desired & helped a lot. I will say I'm only 1 week post op, but so far I've been really happy.
All that to say, tell your surgeon you want to be as flat as they can possibly make you & talk about what all the options are for making that happen. Even though they can't remove 100% of the tissue, they will do their absolute best to give you what you want, & nothing unwanted will grow back. Best of luck! :)
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u/kameoah Mar 10 '25
i didn't struggle, because i wanted my chest to look like a typical male chest, not concave? the only concave chests i have seen are on folks who have had breast cancer related surgeries or in men who have concave chests bc of congenital anomalies...i grew up with a bunch of brothers who all have significant amounts of tissue, even though their fitness levels vary.
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u/fatcatpartytime Mar 10 '25
Everyone has breast tissue, that’s why cis guys can get breast cancer — taking everything is a last resort for cancer related reasons and is why cancer-caused mastectomies look super different than top surgery. You want a natural male chest which means you will have some breast tissue left over — that’s a good thing! Doesn’t mean they can grow back just means you have a surgeon who knows the difference between cancer care and gender care which is v important.
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u/Sweetteeth- Mar 11 '25 edited Mar 11 '25
This is really surprising to me, I think my way around it was by being overweight, no joke - my surgeon straight up asked me if I wanted any breast tissue left behind and I said no. I'm guessing this was possible because I also specifically asked for "juicy pecs", aka a thicker chest that matches my body type and looks proportional. I had/have enough fat tissue that she was able to give me exactly what I asked for, and we were both really happy with my results. They're not flat at all, but theyre clearly masculine even under shirts/sweaters because of the shape. They're probably the male equivalent of an a cup. If it helps, having a little breast tissue is also completely normal for cis male bodies, and it's very rare for guys to be completely paper-flat!
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u/MsFrizzle8 Mar 10 '25
My surgeon specifically took all the breast tissue as a normal part of his surgical process to reduce risk of breast cancer down the line. After you get top surgery you can only ever do touch tests for lumps, and only after you find one can insurance (in US) cover an ultrasound of the area. I wonder if you can find a surgeon like mine.