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Subcutaneous Mastectomy, also known as TOP Surgery, refers to a procedure to remove the female breasts in a female to male transgender individual. There are various techniques including:
  • Double excision with free nipple graft
  • Peri-Areolar Incision
  • Liposuction
The technique used is based on the size of the breasts, skin laxity and the desired result.

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Surgery Time 2.5 hrs
Anaesthetic General
Hospital Stay Day case
Reasonably Mobile Same Day
Time Off Work 2 weeks
Sleep Position 45 degrees for 2 weeks
Washing 6 days
Dressings & Garments 6 weeks
Exercise inc. Gym 6 weeks
Full Recovery 6 weeks


  • To create a natural-looking male chest
  • To positively address dysphoria associated with the chest


At The London Transgender Clinic our 20 years of breast surgery expertise aims to ensure that you achieve the shape you desire in a safe and supportive environment.


  • How much does it cost?

    The cost varies depending on the technique required to achieve the desired results. Costs can vary from approximately £3,500 to £6,900. For an exact quotation please book a consultation with a member of our team.
  • What happens at the consultation?

    You will be seen by your surgeon and LTC nurse who will ask about your goals and concerns. A full medical history and examination will be carried out before discussing your planned surgery. The risks and benefits of TOP Surgery will be discussed as well as the recovery and results expected. You may be requested to undergo medical investigations such as blood tests, ECG or other, as medically advised by your surgeon.
  • How do I prepare for my surgery?

    Prior to surgery you must have had a psychological assessment by a gender specialist to discuss the surgery and whether it is the right time for you to proceed. They must provide you with a letter of support prior to proceeding with surgery. Once you have your consultation and your surgery is booked, you will have a pre-operative assessment with your nurse 2 weeks before surgery, during which any outstanding questions will be answered. Your preparation for surgery will be reviewed and information will be provided regarding medications, diet and post-operative care. You will not need to stop your hormone therapy before your surgery. You must stop smoking a minimum of 2 weeks before your surgery and up to 6 weeks postoperatively.
  • What happens on the day of my surgery?

    On the day of your surgery you will travel to the hospital where they will admit you to your room. You will be assessed by your surgeon and your anaesthetist before going to the theatre. The hospital team will complete the necessary pre-operative health checks. Following your surgery, you will remain in bed for 4 hours, closely monitored by the hospital medical team. They will assist you with anything you need. You will be tired and spend most of this time resting. You will be provided with something to eat when you are alert and slowly mobilised with assistance. Once you are fully awake and mobile, you will be discharged from the hospital to your home. You must have a chaperone to bring you home and stay with you for a minimum of 24 hours.
  • What aftercare will be provided for me?

    You will be assessed 2 weeks, 6 weeks, 12 weeks, 6 months and 1 year post operatively to monitor your progress. You will be provided with post-operative manual lymphatic drainage therapy to reduce swelling and promote better healing. LTC has a nurse on call 24/7 in the event you have any emergencies following discharge from hospital. You will be seen immediately if medically required or appropriate advice will be provided.
  • What happens if there is a complication?

    In the event of a complication you will be medically assessed as soon as possible by your surgeon or a qualified member of our nursing team. In the unlikely event you need to return to theatre this will be arranged for you by our team. Hospital and anaesthetist fees may be charged, however there will be no surgical fee. Further information is outlined in our terms and conditions.


5 5 Star Rating Written onOctober 10, 2018 I would definitely recommend LTS, the staff are kind and welcoming and the service is very professional. I had a recent consultation with Mary O’Brien and she is always exceptionally lovely and understanding, made me feel at ease throughout the process.  

by Dean

We support and endorse the Guidelines for the Standards of Care for transgender, trans-individuals set out by the World Professional Association for Transgender Health (WPATH).

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