Your Guide To Top surgery
Top surgery for transmasculine and non-binary people is a gender-affirming procedure that removes breast tissue to create a flatter, more traditionally masculine or androgynous chest shape.
This surgery can address the body changes—or lack thereof—that come from exposure to estrogen during puberty, especially in the chest area.
Since the chest is one of the most visible gendered features, it often plays a significant role in how others perceive and gender us. For many, this can lead to frequent misgendering and discomfort. By reshaping the chest, top surgery can help you feel more aligned with your gender and reduce the social stress that comes from being misgendered.
While some trans and non-binary people see top surgery as a key step in their journey, others choose not to pursue it. Like all gender-affirming care, it’s a deeply personal choice. At Catalyst Surgical, we offer multiple top surgery techniques to suit a wide range of goals and body types.
Key Procedures
Masculinizing Top Surgery
Masculinizing top surgery, also known as a mastectomy, is a gender-affirming procedure that removes breast tissue to create a flatter, more masculine or non-feminine chest. People often choose this surgery to help align their chest with their gender identity.
A flatter chest is one of the most visible characteristics of a masculine appearance. During surgery, breast tissue and excess skin are removed to create a chest contour that feels right for you. Depending on your body and preferences, surgery can include keeping or removing the nipples and areolae.
The surgical technique and scar placement depend on your chest size and skin elasticity. We’ll talk you through your options during your consultation, including scar patterns and nipple placement.
Thanks to our specialized closure technique, 95% of our patients do not require surgical drains during recovery, which makes healing more comfortable and straightforward.
Not-Flat Top Surgery (Breast Reduction for Gender-Affirming Care)
Not-flat top surgery, also known as gender-affirming breast reduction, involves reducing breast size while preserving some chest volume. This procedure is ideal for people who experience chest dysphoria but don’t identify with having a fully flat or traditionally masculine chest.
Not everyone identifies within the gender binary—and not every gender expression needs to conform to binary expectations. For many trans and non-binary individuals, a flat chest may not reflect how they see themselves. Not-flat top surgery creates space for a more personalized outcome that can feel more affirming and aligned with your body and identity.
If your current chest size causes discomfort or dysphoria, but a full mastectomy doesn’t feel right, this option may be worth exploring.
Complimentary Procedures
Top surgery is a significant step—but it’s not the only one. Additional body contouring procedures can help align your body with your gender identity and reduce feelings of dysphoria in other areas.
At Catalyst Surgical, we offer a range of gender-affirming body procedures that can support your transition goals, including:
- Chest contouring to enhance a flat, defined chest shape
- De-feminizing body contouring and liposuction to reduce curves and create a more angular silhouette
- Abdominoplasty (tummy tuck) to tighten the abdomen and remove excess skin
- Monsplasty or mons contouring to flatten and masculinize the lower abdomen
- Fat grafting or removal procedures for shaping the hips, waist, or buttocks in a way that feels right for you
Our approach is personalized and grounded in years of surgical experience. We understand how deeply individual this journey is, and we’re here to help you feel more comfortable and confident in your body.
Book a consultation to discuss your goals and learn more about which procedures may be right for you.
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