Periareolar Top Surgery; For many trans men and non-binary people, removing the breasts is integral to their gender expression. In this article, we’ll take a look at how periareolar top surgery is done and what you can expect during recovery.
Periareolar top surgery reduces the size of the breasts by removing excess skin and tissue. It’s an outpatient procedure that takes about two hours to complete, but patients will be under general anesthesia.
Unlike double incision top surgery, which creates a horizontal scar underneath the nipples, a periareolar incision is made on the edge of the areola (the pigmented part of skin surrounding the nipple). This allows for an alternative to double incision surgery which may be more appropriate for patients with small to medium-sized breasts and who want to maintain nipple sensation after surgery.
Periareolar top surgery is the most common type of female-to-male (FTM) chest surgery procedure. Its popularity has grown in recent years because it:
Provides good chest contouring with a low risk of complications
Results in a scar that is easily concealed by clothing and may be covered by insurance
Allows for nipple grafting when needed to achieve symmetry or provide projection
Periareolar top surgery is a type of FTM chest surgery that uses the areola to create the new contour of the male chest. This procedure results in the most natural appearing male chest, and is often the best option for patients with smaller breasts.
Periareolar incisions: This is the most common type of incision for Top Surgery. The surgeon uses a circular incision around the areola (the pigmented skin surrounding the nipple) to remove breast tissue and reposition the nipple-areola complex. With this surgery, there is usually less scarring than with inframammary incisions and a quicker recovery period.
Inframammary incisions: With this type of surgery, the surgeon places the incision in the fold below your breasts. The surgeon can then remove excess breast tissue and skin through this incision. This procedure results in a visible scar on your breasts, although it will be well hidden under your shirt or bikini top.
Double incision/Inverted T/Bilaterally anchored scars: This is one of the more invasive forms of Top Surgery which involves two separate horizontal incisions along each breast to remove excess breast tissue, fat, and skin. There are typically two scars after this procedure; one horizontal scar across each breast and one around each nipple-areola complex. Double Incision Top Surgery is usually reserved for people with larger breasts who have a significant amount of excess tissue.
The periareolar incision is made around the pigmented portion of the skin that surrounds the nipple. This incision gives surgeons access to remove breast and glandular tissue, reposition the nipple and areola, and reshape the new chest contour.
The periareolar technique is frequently chosen for individuals who have a large amount of breast tissue that needs to be removed, but do not need any fat removed from their chest. This technique can also be performed on individuals who only need a small amount of tissue removed from their chest, or only need liposuction in the area surrounding the nipple.
The common areas where fat can be removed to create a more masculine chest appearance include:
the upper chest (pectoralis major muscle)
the lower chest (subcutaneous layer of adipose)
the outer chest (latissimus dorsi muscle)
Each individual is unique and fat removal may be recommended for some, but not all individuals undergoing male chest contouring surgery.
Step 1: The surgeon will draw two incisions around the areola in order to remove a circular piece of skin. The surgeon will take care of the areola, nipple and skin grafting.
Step 2: The surgeon will move the nipple to its proper location, but it will not be attached to any breast tissue.
Step 3: If necessary, the surgeon will reduce the size of your areolae by removing excess skin from around them.
Step 4: The surgeon removes excess breast tissue from underneath your nipple (which is now detached) until he or she reaches your desired chest size.
Step 5: Finally, the surgeon reattaches the nipple to your chest muscles.
Dr. Mosser is a board-certified plastic surgeon and member of the American Society of Plastic Surgeons, whose practice is devoted to cosmetic surgery of the face, breast, and body. A San Francisco native, Dr. Mosser completed his undergraduate studies at Northwestern University, earning a Bachelors of Science in Learning and Organizational Change. He then attended the University of California, San Francisco (UCSF) School of Medicine for his medical degree before completing his plastic surgery residency training at the world-renowned UCSF Department of Surgery.
During residency training, Dr. Mosser was selected as Chief Resident in Plastic Surgery and dedicated his time to advancing innovative techniques in patient care and surgical education. During this time, he also completed an additional year of fellowship training in cosmetic surgery, focusing on aesthetic procedures such as breast augmentation and body contouring.
Who Qualifies for Periareolar Top Surgery?
Periareolar top surgery is an often-requested procedure for female-bodied people seeking breast reduction.
If you qualify for periareolar top surgery, your surgeon may recommend this type of procedure because it’s considered less invasive.
Who qualifies for Periareolar top surgery?
Periareolar top surgery is a breast reduction procedure that involves making an incision around the areola and removing excess breast tissue through the incision. In most cases, patients will also receive liposuction to remove fat deposits from their chest. The nipple and areola are not moved during the procedure.
Not everyone qualifies for periareolar top surgery. Your surgeon will use a variety of measurements to determine if you’re a good candidate, including:
Nipple position. Your nipples should be positioned as low as possible on your chest without drooping below the inframammary fold (the crease where your breast meets your chest). If your nipples are positioned too low, you may not be able to undergo periareolar top surgery.
Breast size. You must have enough breast tissue to cover the implant after it has been placed and to achieve a natural-looking appearance after the procedure has been completed. If you don’t have enough natural
There are few specific criteria for periareolar top surgery. Candidates must:
Be at least 18 years of age.
Be in good health and physically fit.
Have realistic expectations.
Dr. Mosser will discuss your goals and expectations during your consultation. If you have recently lost a significant amount of weight, he may ask that you wait until your weight has stabilized before proceeding with surgery.
You should stop smoking a minimum of four weeks before surgery to improve healing, and refrain from drinking alcohol for a minimum of two weeks before surgery.
Periareolar Top Surgery is a great option for candidates who have small breasts with medium to large areolas. The incision is placed in the natural contour of the areola, so it is not visible after healing. This procedure can also be used to reduce the diameter of areolas that have become enlarged over time.
Pre-operative marking of the nipple position on a female to male patient prior to periareolar top surgery.
The Periareolar Top Surgery requires that there be enough skin to cover the new male contoured chest, and enough breast tissue to allow for removal without creating unnatural depressions in the chest. The size and shape of the areola will also determine if this technique can be used. If there is too much breast tissue, we would recommend performing a Double Incision Top Surgery instead, as this will give more tissue removal ability and help avoid an unsightly chest later on.
If you have very small breasts with small areolas, we may recommend performing Liposuction instead of Periareolar Top Surgery. The amount of tissue removed is usually less than 1 pound during this procedure, so it is important that we use a technique that gets you optimal results in terms of scarring and aesthetic outcome.
Periareolar surgery is a procedure which reduces the size of the chest by removing excess breast tissue. A circular incision is made around the nipple and areola, so that the resulting scar will be concealed when the healing process is complete.
There are numerous reasons why someone may consider top surgery, including gender dysphoria and discomfort with their chest. Our surgeons consider a variety of factors when determining if a patient is a candidate for surgery.
You should consult with one of our doctors to determine if you are a good candidate for surgery. We find that patients who are generally healthy and have realistic expectations are more likely to be satisfied with the results.
For Dr. Mosser, the patient must be 18 years old and have lived as a male for at least one year prior to surgery (as per WPATH guidelines).
The patient should be in good health. Smokers, patients with uncontrolled diabetes or hypertension, or patients with active infections are not good candidates for surgery.
The patient should not be significantly overweight (BMI greater than 30).
There should be enough breast tissue that can be removed. The nipple-areolar complex (NAC) should not be so small that it makes the procedure technically challenging.
Breast tissue does not grow back after this procedure
The nipple remains intact, and sensation is maintained
This procedure can be done later, or in conjunction with other procedures like hysterectomy or vaginoplasty
There are fewer complications than with other top surgeries such as mastectomy**
How Long Does it Take to Recover From Periareolar?
Periareolar is a type of surgical procedure that removes excess skin. The procedure is usually done on the abdomen, flanks, thighs or arms and can be performed using one incision.
The recovery period can vary widely depending on the patient and the location where the periareolar procedure was performed.
Depending on which region of the body is being treated, recovery can take between 3 to 12 weeks. For example, an abdominal or flank tummy tuck tends to take about 4 weeks to heal. On average, the recovery time for a periareolar liposuction procedure is about 10 days to 2 weeks.
Periareolar breast lift surgery is a new, minimally invasive procedure performed under local anesthesia. The procedure takes about 45 minutes per side, and we can typically perform the surgery here at our hospital in less than one hour. The recovery period after this surgery is around two weeks, and we do not require patients to stay overnight in the hospital, so they can go home the same day.
When a patient is ready to undergo this surgery, a plastic surgeon can count on a number of aesthetic benefits.
Indications for Periareolar Breast Lift Surgery
Periareolar breast lift is indicated when there are:
- Signs of sagging skin on the lower pole of the breast (below the nipple) that become more obvious as you age or when you gain or lose weight; or
- Signs of sagging skin on the upper pole of the breast that become more obvious after menopause; or
- Significant loss of breast volume due to aging; or
- A “double bubble” where both breasts droop downward at the same time.*
Peri areolar is a common facial surgery performed in the inner rim of the ear, which involves freeing up an obstructing fold of skin in the outer ear. It’s a relatively simple procedure with excellent results, but it can take as long as six months to fully recover.
The recovery time depends on the type of surgery you had, but this is a good rule of thumb: It takes about four weeks for the swelling and bruising to go down. Then you’ll want to be careful about keeping your ears dry so infection doesn’t set in. Soaking your ears in water for too long can lead to permanent damage. The first two weeks after surgery are also when you’ll want to avoid getting any new injuries — especially to your earlobe — because that can cause more swelling and put still more pressure on the incision.
Periareolar surgery is a breast augmentation procedure performed to increase the size of the breasts by removing excess skin from under the areola and repositioning it around the areola. Periareolar surgery is often performed with a technique known as “pocket reduction,” in which excess skin is removed from under the areolae, but not simultaneously from beneath them.
There are several ways to perform periareolar surgery to ensure that you get the best result possible. Your board certified plastic surgeon will assess your candidacy for this procedure, and may suggest several techniques that would give you better results. Unfortunately, no one technique is guaranteed to produce excellent results, because everyone’s body is unique and different techniques can make a significant difference. It’s important to have your plastic surgeon assess your candidacy for this procedure, and we encourage you to ask questions about your options and how they’ll work with your body.
If you have any small or medium-sized scars, a periareolar incision is the best option. The fact that the incision is made at the base of your areola and not on your areola itself reduces the chances of scarring and makes it easier to heal.
The procedure usually takes about two hours, depending on your skin type and how much work you want done. Dr. Schwartz will numb your areola before starting surgery, then she’ll remove a section of skin and fat just below your areola (the periareolar area). The scar will end up in a vertical line across the base of your areola.
Periareolar is a pattern of facial hair that can result from pregnancy, weight loss or breastfeeding. It’s caused by hair follicles that are too sensitive to the hormone progesterone, which causes the hair to grow in areas where they shouldn’t.
“Although it’s called ‘periareolar,’ it can be anywhere on the body where there are thin patches of skin,” says Dr. Sigmundson. “In women, it’s often found around the lips and chin, but it can also occur on other areas such as the forehead or cheeks.”
The good news is that although this type of facial hair is permanent and won’t disappear on its own, it can be treated. There are two main approaches: laser hair removal or electrolysis (electrical tweezing).
According to Sigmundson, periareolar treatment takes about an hour for each area you want removed. In addition to stopping hair growth in these areas for good, electrolysis also removes any existing hairs before you start treatment. This makes it ideal for treating large areas like the upper lip and chin because you’ll get better results in fewer treatments overall.