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Female-to-Male (FTM) Top Surgery

  • Gender-affirming FTM Top Surgery
  • Removal of chest tissue for a flatter, more contoured chest
  • Alleviates physical and social dysphoria
  • Modern private hospital
  • Comprehensive aftercare programme

What is FTM Top Surgery?

FTM Top Surgery is a gender-affirming procedure that involves the surgical removal of chest tissue and contouring of the chest to help align a person's physical appearance with their gender identity. It involves the removal of excess fat and skin, followed by a repositioning of the nipples and areolas to create a naturally flat chest appearance. Multiple surgical methods are used in Top Surgery procedures, depending on factors such as the patient’s chest size and skin elasticity.

Proven to alleviate the effects of gender dysphoria and complications from regular chest binding, Top Surgery is a deeply personal and transformative procedure which requires serious consideration and the highest standards of patient care. Pall Mall  delivers safe and high-quality gender-affirming care, mirroring the established pathways that currently exist in the NHS. From your initial consultation to the procedure itself, our surgeons will engage in open, respectful communication that prioritises your personal goals and desired care outcomes.

Your Top Surgery procedure:

Compression Vest & Stockings: We’ll provide you with a snug compression vest that will help your body to recover for two weeks after your surgery. As well as compression stockings to reduce swelling and aid healing.
Results: 80% of our Top Surgery patients return home on the same day. Pain and scars generally fade within a few months.
Movement: You should avoid heavy lifting and limit your arm movements in the 6 weeks following Top Surgery.
Hospital Stay: You may need an overnight stay in our privately-owned Newton-le-Willows hospital. All of our overnight stays enjoy a room with en suite, Netflix and complimentary meals
Time Off Work: We recommend taking 2-3 weeks off desk jobs and 4-6 weeks from physically-demanding work after your procedure.
Sleep: Sleeping slightly upright on your back for 6 weeks will limit your arm movements during recovery. A v-shaped pillow can help to keep you comfy.

Am I eligible for Top Surgery?

At Pall Mall we’re proud to announce the commencement of our Gender-Affirming surgery and care services at our private hospital located between Manchester and Liverpool and look forward to supporting our patients through this life changing surgery. To register your interest in undergoing Top Surgery, and our dedicated specialist Patient Liaison, Mamuna, will be in touch as soon as possible.

Fill Out the Form

There are some initial requirements that you must meet to be considered for this procedure. In order to be eligible for FTM Top Surgery, you must:  

  • Be over 18

  • Have a referral letter from a UK-based Gender Specialist

  • Produce up-to-date GP medical history records.

  • Maintain a BMI of 18-40 and be in generally good health

  • Stop smoking for a minimum of four weeks before the procedure, as this may impact healing. This includes any nicotine replacement therapy such as vaping, nicotine patches, gum etc.

 

Unfortunately Pall Mall cannot proceed to surgery without a referral letter from a licensed UK Gender Specialist as per WPATH and NHS service specifications. There may be other medical conditions or risks, unrelated to your gender status, that prevent you from undergoing this surgery. Our Patient Liaison, Mamuna, can  discuss this with you during your consultation.

Results of FTM Top Surgery

FTM Top Surgery is a highly transformative procedure which results in profound changes to a patient’s appearance. Following surgery, patients can expect to see an immediate change in the shape and formation of their chest. The absence of breast tissue will immediately be apparent, along with resized and repositioned areolas that result in a flat and naturally-masculine appearance.

It is also important to highlight that people who have undergone FTM Top Surgery will have permanent, visible scarring as a result of their procedure. These will appear pink in the early months following the procedure, but will fade and become less prominent with time. In most cases, a patient’s positivity toward their new chest results in scarring becoming less of a significant concern.

Meet our surgeons

Every surgeon at Pall Mall Medical is fully accredited to practice as a plastic or general surgery specialist in the UK, comes from a relevant medical organisation and has accredited qualifications in aesthetic plastic surgery.

We are privileged to work with two leading surgeons and clinical experts in the field of gender-affirming care - Kate Williams and Chloe Wright. With over 20 years’ experience and more than 500 successfully-completed procedures between them, you can feel confident that you are receiving quality treatment and care from two of the UK’s foremost gender-related surgery specialists.

Kate Williams Gender-Affirming and Oncoplastic surgeon 

Kate Williams

Kate Williams is a highly accomplished consultant surgeon specialising in gender-affirming and oncoplastic surgery. Her qualifications include:

  • BSc (First Class Hons) in Clinical Science from the University of Leeds

  • MBChB Bachelor of Medicine (Surgery) from the University of Leeds

  • Research Fellow with the Royal College of Surgeons, England

  • MD Doctor of Medicine from the University of Manchester

  • Leading NHS consultant in Manchester, performing over 280 surgeries

  • Clinical Director for breast and chest wall surgical services at NMGH

Chloe Wright, Gender and Oncoplastic Surgeon

Chloe Wright

Chloe Wright is a Consultant Gender and Oncoplastic Breast Surgeon with extensive experience in both gender-affirming and breast cancer surgeries. Her qualifications include:

  • MBChB Bachelor of Medicine from the University of Manchester

  • USA Medical Certification

  • National TIG Oncoplastic Fellowship

  • Consultant Oncoplastic Breast Surgeon at Bolton NHS FT

  • Consultant at Manchester Foundation Trust

  • Specialist advisor to the Care Quality Commission (CQC)

  • Trained in gender-affirming Top Surgery since 2009, performing over 300 procedures

FTM Top Surgery procedures

Various surgical techniques can be used when performing Female to Male Top Surgery. The appropriate procedure is advised by the operating surgeon, based on the amount of chest/breast tissue to be removed, the elasticity of the surrounding skin and the desired outcomes. Surgeries are performed under general anaesthetic and take 3-4 hours to complete.

Periareolar

Periareolar Top Surgery involves making a circular incision around the border of the areola, followed by a second incision around the first one. Chest/breast tissue is extracted through these incisions and excess fat is removed through liposuction. The larger incision is then reclosed and the areola is resized accordingly.

The Periareolar procedure is generally performed on patients with smaller chests and low levels of excess skin. It is best-suited to patients who desire minimal skin incision during their Top Surgery.

Double incision

The Double Incision is the most common surgical technique used in FTM Top Surgery procedures. It involves complete removal and resizing of the nipples and areolas. Long horizontal incisions are used to remove the breast tissue, and excess fat is extracted through liposuction. Excess skin is removed if necessary, and the incisions are closed using specialised sutures to prevent skin puckering.

Double Incision Top Surgery is typically performed on patients with larger amounts of chest tissue which can not be sufficiently removed with a periareolar procedure. As nerves are severed during the removal of the nipple and areola, patients may not regain full sensation in this area. For patients with larger chests who are hoping to retain nipple sensation, our dermal flap surgery technique repositions the areolae while leaving them attached to their nerve supply.

Chest (breast) reduction

This is a surgical procedure aimed at reducing chest/breast size to align an individual's physical appearance with their gender identity. This procedure is particularly significant for individuals who may experience gender dysphoria related to chest/breast tissue. This procedure also offers a choice to the individual who may want to have some chest/breast tissue.

Revision surgery

We also offer revision surgery for people who have previously undergone a Top Surgery procedure elsewhere that did not meet their expectations or resulted in complications.

Revision surgery aims to correct aesthetic or functional issues from the initial procedure. This can include reshaping the chest/breasts, correcting asymmetry, or addressing complications such as scarring or changes in nipple sensation.

Dr Tang, GP at Pall Mall

What’s involved with the procedure?

FTM Top Surgery is an intensive procedure which requires careful planning and comprehensive patient care. From pre-surgery consultation to the day of your procedure and the weeks and months that follow, it’s important to gain a full understanding of what to expect at every stage of the process. 

Pre-op

Before your Top Surgery, you’ll need to complete a series of consultations to ensure that you are adequately informed and meet the relevant medical requirements. Following your initial call, you’ll attend a preliminary virtual consultation with our dedicated gender surgery Patient Advisor, Mamuna, to ensure that you are comfortable, well-prepared and happy to move forward. Kate and Chloe will then review information from your Gender Identity Clinic and make a decision on whether to proceed. 

The next step is a relaxed first meeting with your surgeon via video consultation. It is helpful if you can show your chest to the surgeon during this consultation, but this can be avoided by simply answering some descriptive questions. There is a two-week cooling off period following this consultation, giving you sufficient time to make your final decision. You will receive a Patient Information Guide following your first consultation, which you can read and compile questions on before meeting your surgeon in person. A face-to-face surgeon consultation will be scheduled four weeks after your virtual meeting, after which a convenient date for your surgery can be selected.

The day of your surgery

Once the pre-surgery process is complete, your procedure can be scheduled for an available and convenient date up to six weeks after your initial consultation. The duration of your Top Surgery will depend on the number of surgeons overseeing the procedure, and can take anywhere from 90 minutes to three hours to complete. Upon your arrival at the hospital, the surgeon will visit your room to obtain your final consent and answer any last-minute questions about your procedure.

You will then meet with the Consultant Anaesthetist to agree on a plan for your pain control and ask any relevant questions. 

Once the procedure is complete, dressings will be applied and your compression vest will be fitted. There may also be drainage tubes in place to collect blood leakage, but this does not prevent a same-day discharge. It’s important to arrange transport to and from the hospital on the day, as you should not operate a car for at least two weeks following Top Surgery. While 70% of patients return home on the day of their procedure, we recommend packing a basic overnight bag, in case you are required to stay.

Post-op

We are committed to ensuring that you remain as comfortable as possible during the post-operative recovery period. Due to the nature of FTM Top Surgery, it’s important that you thoroughly understand all aftercare requirements and ask questions about anything you’re unsure of. A comprehensive post-operative care package will be discussed with your surgeon during consultation, and your local clinic will serve as your primary point of contact throughout the healing process. You will be provided with out-of-hours contact information during your consultation, which should be used in the event of any urgent post-op concerns.

Following your surgery, you may be provided with medicines to take home. Please take these medicines as prescribed, and continue taking any pain relief, HRT or birth control medication as normal. As antibiotics can impact the efficacy of the birth control pill, however, we do not recommend the concurrent use of both. You should also avoid using vitamins, herbal supplements, Omegas and aspirin for two weeks following your procedure, unless they have been prescribed to you by a doctor.

Maxine, Pall Mall Nurse

Comprehensive aftercare 

Our commitment to patients doesn’t end following surgery, and we provide a comprehensive aftercare programme that has been specially developed with your comfort and best interests in mind. As one of the few clinically-led providers of gender affirming surgery in the UK, Pall Mall puts you in the best possible hands at every stage of the surgery process — ensuring that your safety and comfort are always the top priority.

Before leaving the hospital after your Top Surgery, you will be provided with a post-op leaflet, 24/7 emergency contact information and a booking for your first post-op check-up. Our specific aftercare package for FTM Top Surgery includes a post-op dressing appointment 9-10 days after your procedure, as well as multiple surgeon reviews carried out over the ensuing 12-month period. All aftercare services are provided as part of our surgery packages — leaving no hidden costs or extra charges to worry about during your recovery.

Lorna, Cara and Shannon our amazing Pall Mall nurses

Why choose Pall Mall for your top surgery?

Pall Mall  is one of the UK’s only private providers that is owned and led by doctors. This means that you receive quality care without compromise, and patient safety is prioritised to the highest clinical standards. We pride ourselves on delivering gender-affirming care that makes you feel confident about yourself at every stage of your journey — from that very first call to our comprehensive aftercare service.

When you choose Pall Mall for your FTM Top Surgery, you benefit from: 

  • Care Quality Commission (CQC) regulated service
  • General Medical Council (GMC) registered surgeons
  • State-of-the-art theatre facilities
  • The comfort of our privately-owned hospital
  • Comprehensive aftercare from our dedicated patient experience team
  • A dedicated team of gender affirming medical professionals who will be there to support you every step of the way

Always here to help, whenever you need us

You can also expect the utmost care from the moment you walk through the entrance of any Pall Mall clinic - not to mention qualified advice from the second you make your initial enquiry.