What Is Top Surgery?
Top surgery—also called chest masculinization or gender-affirming chest surgery—removes breast tissue and reshapes the chest to create a flatter, more traditionally masculine contour. For many patients, it’s a key step in alleviating gender dysphoria, improving comfort in clothing, and feeling at home in one’s body.
At Jandali Plastic Surgery (Trumbull, CT), we provide individualized surgical plans for patients across Bridgeport, Fairfield, Stratford, Milford, Shelton, Westport, Norwalk, Easton, Monroe, Derby, Ansonia, Seymour, Oxford, Newtown, Bethel, Weston, Wilton, and Southbury.
Who Is a Good Candidate?
You may be a strong candidate if you:
- Experience persistent gender dysphoria related to the chest
- Are in overall good health and a non-smoker (or willing to stop before/after surgery)
- Have realistic expectations about scars, sensation, and recovery
- Can follow post-operative instructions and attend follow-ups
- Have adequate support during the first 1–2 weeks after surgery
Local Tip: If you’re in Fairfield, Bridgeport, or Milford, you’re within a short drive to our Trumbull office for consults and post-op care.
Top Surgery Techniques (and How We Choose)
There is no “one best” technique—only the best fit for your body and goals. During consultation we discuss chest size, skin elasticity, nipple-areola position, and your preferences around scars and sensation.
1) Double Incision with Free Nipple Grafts
- Best for: Medium to large chests or reduced skin elasticity
- Approach: Two horizontal incisions along the lower chest; breast tissue removal and chest contouring; nipples resized/repositioned as grafts
- Pros: Most powerful reshaping & skin tightening
- Considerations: Visible linear scars; nipple sensation often reduced
2) Periareolar (a.k.a. Keyhole for very small chests)
- Best for: Small chests with tight skin and minimal ptosis
- Approach: Incisions around (and sometimes slightly beyond) the areola to remove tissue and reduce the areola
- Pros: Minimal visible scarring; preserves more native anatomy
- Considerations: Limited skin tightening; may require revision for contouring or excess skin
3) Buttonhole / Nipple-sparing Variants
- Best for: Select patients seeking to preserve more nipple sensation
- Approach: Maintains nipple-areola on a pedicle while allowing broader contouring
- Pros: Potential for better sensation preservation
- Considerations: Not ideal for larger chests or significant skin excess
Patient Perspective (Fairfield):
“I expected a cookie-cutter plan, but Dr. Jandali explained why periareolar fit my small chest and goals. The result looks natural in a tee.” — Eli, Fairfield
What Results Look Like
- Flatter chest profile visible as swelling subsides
- Improved clothing fit (tees, button-downs, swimwear)
- Scars are permanent but typically fade over 12–18 months with proper care (silicone therapy, sun protection)
- Sensation varies: double incision often reduces nipple sensation; some techniques may preserve more
Patient Perspective (Shelton):
“I used to layer hoodies even in July. Now I wear one T-shirt. The change in daily comfort is hard to overstate.” — Jordan, Shelton
The Consultation: What to Expect
- Medical review & goals: history, medications, prior surgeries, binding habits
- Exam & measurements: chest size, skin quality, nipple position
- Technique selection: pros/cons matched to your anatomy and preferences
- Insurance & logistics: our team helps gather documents and submit for authorization
- Recovery planning: time off, support person, garment and activity plan
Serving nearby: If you’re coming from Norwalk, Westport, or Wilton, we coordinate appointment times to minimize trips and streamline pre-op clearance.
Preparing for Surgery
- Medications: You’ll receive guidance on pausing certain meds/supplements (e.g., nicotine, some blood thinners)
- Nicotine cessation: Strictly avoid nicotine for optimal healing
- Binding break: We may ask you to pause binding pre-op to reduce skin irritation
- Home setup: Pillows for reclined sleeping, easy-to-reach essentials, zip-front tops
- Transportation: Arrange rides for surgery day and early follow-ups if you’re traveling from Milford, Stratford, or Ansonia
Recovery Timeline (Typical)
- Days 1–3: Rest, short walks, compression garment, manage drains (if placed), keep arms below shoulder height
- Week 1: First follow-up; many patients feel up to desk work by week 1–2 if non-strenuous
- Weeks 2–3: Bruising/swelling decrease; gradual return to light activities
- Weeks 4–6: Resume most exercise (avoid heavy chest work until cleared)
- 3–6 months: Contour continues to refine; scars start to settle
- 12–18 months: Scar maturation; final look
Patient Perspective (Milford):
“The first week was the hardest, but the team gave me a day-by-day plan. By week six, I was back at the gym and wearing fitted shirts.” — Casey, Milford
Scar Care & Sensation
- Silicone gel/sheets after incisions heal
- Sun protection (SPF/covering) for a year+ to reduce darkening
- Scar massage as directed
- Sensation: Some numbness is common at first; partial return may occur over months. Technique choice and individual healing both matter.
Risks & Safety
All surgeries carry risks such as bleeding, infection, seroma, delayed healing, contour irregularities, unfavorable scarring, and nipple pigment/sensation changes. We review your personalized risk profile, strategies to lower risk (nicotine cessation, diabetes control, weight stabilization), and how we manage complications should they arise.
Mental Health & Support
Many patients report reduced dysphoria and improved confidence post-surgery, while others benefit from ongoing therapy during the transition period. We’re happy to share local and online resources in Fairfield County and statewide.
Insurance & Costs
Most major insurers in Connecticut cover top surgery when it’s medically necessary. Typical documentation includes a Letter of Medical Necessity from a qualified mental health professional and sometimes hormone therapy history (requirements vary). Our team will:
- Verify benefits
- Submit prior authorization
- Coordinate any appeals
- Provide transparent cost estimates for self-pay or out-of-network scenarios
Patient Perspective (Bridgeport):
“I assumed I’d pay out-of-pocket. The office handled my paperwork and secured approval faster than I imagined.” — Riley, Bridgeport
(For a full step-by-step, see our upcoming post: Insurance & Coverage for Top Surgery in CT.)
How We Personalize Your Care
- Board-Certified Plastic Surgeon: Dr. Shareef Jandali
- Hospital affiliations & accredited surgical facilities
- High-volume experience with a range of techniques
- Data-driven protocols for safety and recovery
- Local continuity of care for patients from Trumbull, Fairfield, Bridgeport, Westport, Norwalk, Milford, Shelton, and neighboring towns
What to Bring to Your Consultation
- Government ID and insurance card
- Any prior surgery records or letters
- Current medication list
- Your top goals (scar placement priorities, nipple size/position preferences, sensation concerns)
- Questions! (Write them down – there’s a lot to cover.)
Frequently Asked Questions
How long is surgery?
Usually 2–4 hours, depending on technique.
Do I need drains?
Some techniques use drains temporarily; others may not. We’ll explain what to expect.
When can I raise my arms or drive?
Keep arms below shoulder height for ~1 week. You can drive once you’re off narcotics and comfortable with arm motion.
Will I lose nipple sensation?
It varies by technique and individual healing. We’ll discuss the trade-offs in detail.
When can I work out?
Light lower body by weeks 2–3, progressive strengthening after weeks 4–6, heavy chest work once cleared.
Is revision common?
Minor revisions happen; they’re more likely after periareolar in larger chests due to limited skin tightening.
Internal Links
- Recovery Guide: Top Surgery Recovery—Timeline, Scar Care, and Activity Plan
- Insurance & Coverage: How to Get Insurance to Cover Top Surgery in Connecticut
- Choosing a Technique: Periareolar vs Double Incision vs Buttonhole—Which Is Right for You?
- FAQs: Top Surgery FAQs Answered by a Connecticut Plastic Surgeon
Call to Action
Ready to talk? Book a confidential consultation with Jandali Plastic Surgery in Trumbull. We welcome patients from Bridgeport, Fairfield, Stratford, Milford, Shelton, Westport, Norwalk, Easton, Monroe, Derby, Ansonia, Seymour, Oxford, Newtown, Bethel, Weston, Wilton, and Southbury.
Jandali Plastic Surgery
5520 Park Ave, Suite WP-2-300, Trumbull, CT 06611
Phone: (203) 374-0310 | Website: jandaliplasticsurgery.co
