FTM Top Surgery: The Double Incision Procedure


For many trans men and transmasculine people, the double mastectomy procedure (better known as “top surgery”) is a vital part of medical transition. In addition to relieving dysphoria related to the chest, top surgery can also ease the difficulty of accessing spaces such as locker rooms, swimming pools, and beaches.

There are many different types of top surgery, but the most common is known as the double incision procedure. Today, Dr. Scott Mosser discusses the mechanics of this procedure as well as its pros and cons. “The downside of the double incision procedure is the visible scarring which is persistent after surgery,” explains Dr. Mosser. And although scarring is a concern for many people who access top surgery, double incision has some big upsides as well.

One significant advantage of DI is that virtually all patients are candidates for DI, whereas other procedures such as keyhole or periareolar are only available to patients with certain chest shapes and sizes. Second, according to Dr. Mosser, “[Double incision gives] the surgeon by far the best command control of the overall flatness of the chest. … It’s also the best control the surgeon has over placing the nipples,” meaning that double incision tends to produce the best results in terms of obtaining a flat chest and correctly sized and placed nipples.

Informing Consent and Dr. Mosser will bring you more information on top surgery in the near future, including videos on other techniques, such as the keyhole, the T-anchor, and the circumareolar procedures.

Note: this video is captioned in English. To access the captions, click the CC button on the bottom left of the video.