Top Surgery: The Keyhole Technique

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Over the past couple months, we’ve heard from Dr. Scott Mosser about the double incision approach to top surgery, as well as the circumareolar approach. Today, Dr. Mosser tells us about another popular approach: the keyhole technique.

As with other top surgery techniques, the keyhole approach has some upsides and some downsides. The biggest reason that many trans men and transmasculine folks are interested in keyhole is the limited scarring that results from this surgery. The biggest downside of keyhole is that only folks with a very small amount of breast tissue and excess skin in the chest area are good candidates for this procedure. Very few patients fall into this category, and thus most folks will not be able to pursue keyhole.

One clarification we want to make about the video explanation of the keyhole technique is that the skin flaps that Dr. Mosser describes are simply the patient’s original chest skin — the surgeon does not create these flaps with donor skin or any other technique. The procedure simply involves making a small incision around the areolae and excavating the breast tissue that lies between the skin and the chest wall.