Surgical Options for Transgender and Nonbinary Individuals

There are several different surgeries that can be performed for transgender and nonbinary individuals. Feminizing surgical procedures include top surgery for breast enlargement, feminization of the face, body contouring procedures, orchiectomy, throat shave, and vaginoplasty with penile inversion. Masculinizing surgical procedures include top surgery, body contouring procedures, and hysterectomy/oophorectomy. The most common procedure is the top surgery. 

The Reason for Opting for a Top Surgery Procedure

The main reason for opting for surgical procedures is gender dysphoria. Gender dysphoria is the discomfort you experience when the sex you were assigned at birth does not correspond to what you consider to be your real gender. Top surgery for transgender women and nonbinary people is a technique that increases the size of the breasts and alters the form of the chest. Feminizing breast surgery is sometimes known as breast augmentation. Transgender women and nonbinary people may benefit from top surgery that includes the placement of breast implants or tissue expanders beneath the chest tissue. In some circumstances, fat from other regions of the body can be extracted and transferred into the chest, and if necessary, both methods might be used.

Mandatory Mental Health Statement Criteria

A mental health statement should be elaborate, explanatory, and should cover all of the following topics;

• Dysphoria and gender identity.
• The influence of gender identity at work, school, home, and in social settings, including discrimination, relationship abuse, and minority stress.
• Concerns about one's mood or other aspects of one's mental health.
• Concerns about sexual health.
• Risky behaviors, such as substance use and the use of non-medical-grade silicone implants, hormone therapy, or supplements.
• Emotional support from family, friends, and peers are protective factors.
• Your treatment objectives, risks, and goals, as well as your future plan of care.

The Risks of Top Surgery Procedure

Top surgery procedures do not always go to plan and there are some potential risks involved including;

• Bleeding
• Infection
• Severe response to anesthesia
• Poor or delayed wound healing
• Fluid accumulation underneath the skin
• A firm lump of clotted blood within your tissues
• Body tissue that has been damaged or is dead, such as the nipple
• Scarring
• Dissatisfaction with one's looks following surgery
• A problem with the chest tissue

Preparing for Top Surgery Procedure

• There are certain measures that should be taken in the preparation for top surgery procedures. These include:
• Lab tests and/or a medical examination
• A statement of approval from your therapist is required.
• Take specific prescriptions or make changes to your present medications
• Quit smoking
• Aspirin, anti-inflammatory medicines, and herbal supplements should be avoided since they might cause excessive bleeding
• Adopt healthy hygiene practices
• Avoid alcohol
• Arrange transportation

The Importance of Informed Consent before the Procedure

Informed consent builds confidence between the doctor and the patient by ensuring good understanding. It also lowers the danger for both the patient and the doctor. Patients can make the best decisions for themselves when there is clear information about risks and choices, and physicians have a lower chance of legal action.

What to Expect from Top Surgery Procedure

Top surgery is usually performed as an outpatient treatment and under the use of a general anesthetic.

During the procedure

Top surgery procedures can be done for two different outcomes that are to reduce breast size or to enlarge it. The breast size may be reduced by surgery (subcutaneous nipple-sparing mastectomy) sparing your skin nipple and areola. To give the look of a more manly chest, that is to reduce breast size and shape, you may need to have your nipples and areolas removed, reshaped, and repositioned. This can result in increased scarring and loss of feeling in the nipple. The feeling can return after a few months to a few years.

After the procedure

When you awaken after top surgery, you will be wearing a compression vest and may have drains coming from the sides. It is necessary that you wear this compression vest at all times until your surgeon gives you the green signal to remove it. It prevents excessive bleeding and infection. You might have nausea, shortness of breath, or fever but you will usually feel normal in a few days.

It is very important to follow any guidance or restrictions. This generally includes limiting arm motion and refraining from lifting during the first few weeks of surgery.

Results

In all treatments, the patient survey displayed a high degree of satisfaction with the overall cosmetic outcome in all the techniques. In 86.5 percent of cases, the aesthetic outcome was judged as "very nice" or "good."

Conclusions

Top surgery can help transgender and nonbinary persons overcome gender dysphoria and enhance their quality of life.