FTM Top Surgery at Des Moines Plastic Surgery®

Masculinizing Top Surgery in Des Moines

FTM Top Surgery in Des Moines, IA

At Des Moines Plastic Surgery, Dr. Marcano specializes in FTM (Female-to-Male) top surgery, helping transgender and non-binary individuals achieve a masculine chest appearance. With years of experience in gender-affirming procedures, board certified plastic surgeon Dr. Marcano provides personalized surgical plans to ensure natural, life-changing results.

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We believe that every transgender patient deserves individualized care. We understand that there is no “one surgery” that fits all and we will design a surgical plan according to the patient’s preferences. As such we offer a range of procedures for our FTM and Non-Binary patients.

What Is FTM Top Surgery?

FTM top surgery is a gender-affirming mastectomy that removes breast tissue to create a flatter, more masculine chest. This procedure is a key step in the transition process for many transgender men and non-binary individuals.

Dr. Marcano customizes each procedure based on your body type, aesthetic goals, and skin elasticity to achieve the best possible outcome.

Chest Masculinization/Top Surgery:

This is the most requested type of FTM surgery in order to create a natural masculine look to the chest.

Based upon your body type, Dr. Marcano will choose the best procedure with you.

Types of FTM Masculinizing Top Surgery

Dr. Marcano offers several surgical techniques to best suit your needs:

1. Double Incision (DI) with Nipple Grafts

✅ Best for patients with moderate to large chest size
✅ Removes excess skin and breast tissue for a flat, contoured look
✅ Nipples are resized and repositioned as free nipple grafts
✅ Most common method for a defined masculine chest

2. Periareolar (Keyhole) Top Surgery

✅ Ideal for smaller chests with good skin elasticity
✅ Uses a small incision around the areola to remove breast tissue
✅ Minimal scarring and preserves nipple sensation
✅ Best for A or small B cup sizes

3. Nipple Free Top Surgery

✅ Majority of patients seeking top surgery will know how they feel about having nipples or not. Some patients may have gender dysphoria surrounding their nipples and performing a mastectomy without nipple graft will be the more affirming procedure for them.
✅ We will discuss with the patients if this is the option that they are looking for.
✅ Patients might prefer 3-D tattooing instead of free nipple grafts because this allows them to be in control at the moment of deciding position of the nipple and in some cases, even the color and design of the tattoo.

4. Non-flat Top Surgery

✅ For some patients with gender dysphoria, a flat masculinized chest may not be their goal. This is why an individualized approach for each patient is extremely important.
✅ Therefore, there are other choices like radical breast reduction with or without preservation of the nipples or even a regular breast reduction. Genderfluid patients may opt for some of these options.

During your consultation with Dr. Marcano, he will assess your skin elasticity, chest size, and goals to recommend the best surgical approach.

Top Surgery Revisions

At Des Moines Plastic Surgery we welcome patients who have had their original surgeries elsewhere and they are looking for improvement with their results. We offer:

✔️ Dog ear excisions
✔️Removal of excessive breast tissue left behind
✔️Scar revisions
✔️Nipple removal
✔️Nipple repositioning

Body Masculinization/Body Contouring

Some patients are also looking for a more a more defined body or they want to remove extra skin from their upper abdomen and arms after they have experienced weight loss. We are pleased to offer the following options that can be performed simultaneously with the chosen top surgery or at a later date:

✔️ Liposuction
✔️Tummy Tuck
✔️Combined FTM Top Surgery with Tummy Tuck
✔️Combined FTM Top Surgery with Reverse Tummy Tuck (removal of loose skin at the top of the abdomen)
✔️Combined FTM Top Surgery with Arm Lift

Who Is a Good Candidate?

You may be a good candidate for FTM top surgery if you:
✔️ Are transgender or non-binary and seeking a masculine chest
✔️ Are in good health with stable weight
✔️ Have realistic expectations about results and scarring
✔️ Are not required but may benefit from testosterone therapy

FTM Top Surgery: What to Expect

Pre-Surgery Consultation

✔️ Dr. Marcano will discuss your goals, assess your chest size, and recommend the best surgical technique
✔️ Before photos will be taken to track progress
✔️ You’ll receive detailed pre-op and post-op care instructions

Surgery Day

✔️ Performed under general anesthesia
✔️ Procedure length: 2-4 hours
✔️ Outpatient surgery – go home the same day

Recovery Timeline

🗓️ Week 1-2 → Swelling and tightness, drains may be removed
🗓️ Week 3-4 → Return to light work, compression vest still required
🗓️ Week 6+ → Resume normal activity, visible results taking shape
🗓️ 3-6 Months → Final chest contour and scars begin to fade

Dr. Marcano will provide customized aftercare instructions to ensure optimal healing and scarring.

Scarring & Nipple Sensation

✔️ Double Incision scars fade over time and can be treated with scar therapy
✔️ Periareolar method has minimal scarring
✔️ Nipple sensation varies—Keyhole technique offers higher chances of sensation retention

We offer laser treatments and scar-reducing therapies at our Coachlight Medical Spa to improve the appearance of scars over time.

Why Choose Des Moines Plastic Surgery?

🏆 Board-Certified Plastic Surgeon with expertise in gender-affirming procedures
✅ Personalized approach to chest contouring
💙 Compassionate, inclusive care in a welcoming environment
📍 Trusted provider in Des Moines, IA
At Des Moines Plastic Surgery, we believe every patient deserves a body that reflects their true self. Dr. Marcano is committed to providing safe, natural-looking results that align with your transition goals.