Mastectomy ( Breast Removal for FtM)

Mastectomy (FtM) “Top surgery”

In FtM mastectomy, the goal is to create a “male” looking chest.  This can include removing breast tissue, excess skin, resizing and repositioning the nipple and the dark area around areola.

FtM mastectomy also includes preserving as much sensation as possible and trying to minimize scaring.

Many Trans men seek bilateral mastectomy, also called “top surgery“, the removal of female breasts and the shaping of a male contoured chest.

Trans men with moderate to large breasts usually require a formal bilateral mastectomy with grafting and reconstruction of the nipple-areola. This will result in two horizontal scars on the lower edge of the pectoralis muscle, but allows for easier resizing of the nipple and placement in a typically male position.

For Trans men with smaller breasts, a peri-areolar or “keyhole” procedure may be done where the mastectomy is performed through an incision made around the areola. This avoids the larger scars of a traditional mastectomy.

 

FtM Sex Reassignment Surgery

For FtMs, the goals are to reduce “Female” characteristics and make the body look more “masculine” or androgynous.  FtM can include some or all of surgeries listed on the following. 

Top Surgery  = Chest Reconstruction / Mastectomy.

Chest reconstruction (Mastectomy) is to removing breast tissue and excess skin and altering the nipple and dark area around it (areola)

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Lower surgery :

Hysterectomy/ salpingo-oophorectomy = Removing the uterus/ removing the fallopian tubes and ovaries.

Colpectomy, or vaginectomy = Removing the vagina/ closing vagina.

Metaidoioplasty (“Metoidioplasty”) = Making the clitoris appear larger to form a small penis.

Phalloplasty = Making a penis using tissue from another part of the body (Big penis).

Scrotoplasty = Creating a scrotum (Testicle balls).

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Other possible surgeries (FtM:

Liposuction = to removing fat from the hips, thighs, and buttocks.

Implants = Inserting material into the calf, jaw, chin, or chest to make these areas look more muscular.

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Mastectomy Thailand’s package inclusive :

- Accommodation for 1 night in hospital private room after surgery

- Operating Room Charges: OR Room Use, Recovery Room, Scrub & Circulate Nurse

- Regular menu food charges

- Laboratory Testing: necessary for the procedure as CBC, EKG, UA, Anti HIV, Chest X-Ray

(If age over 50 need to check Cardiology.  An extra charge 100 USD)

- Medical Equipments and Medical Supplies

- General Anesthesia – Pre Anesthetic Drugs, Anesthesia and Medical Gas (Oxygen, Nitrous Oxide)

- Medical Treatments

- Doctor fees

- Anesthesia fees

- Nursing services

- Take home medication and supplies

- Post op cares

- Transportation pick up

 

Service Accommodation

- Transportation pick up from airport –hotel-clinic-airport  as well as follow up period

- Mobile service during recovery with local number.  People can get in touch with you

- Hotel reservation upon request with special rate discount by PAI

- Touring services

- Interpreter services  with any language

- Free internet Wifi

 

Mastectomy, Breast Removal preparation

You will most likely be admitted to hospital the same day as surgery.  You may be asked to come to the hospital the day before surgery to go over lab tests or psysical checkup.

- Inform us about any allergies, any serious medical condition(s), and all medications you are taking (both prescription and non-prescription).

- No Aspirin 2 days before surgery.

- Stop vitamin E Oil 1 day before surgery.

- Stop smoking 2 days and a month after surgery.

- Tell doctor if you have any serious medical condition(s).

- Stop meal and water starting from midnight before surgery.

- Plan to be in Thailand at least 5-7 days after surgery.

 

There are three possible techniques that can be used in Mastectomy (Breast Removal). It’s depend upon the size of breast, elasticity of skin and your preferences:

1. Keyhole – Best for small breasts (A or small B cup) with good skin elasticity.

Incision/scar – Along bottom border of areola.

How’s done – Breast tissue is removed via a small incision across or under the areola.

Nipples – Not resized or repositioned.  But can be perform as nipple reduction surgery.

2. Drawstring/ Pursestring – Moderate size breast (B or C cup), with good skin elasticity.

Incision/scar – Circle around the edge of the areola.

How it’s done – Breast tissue is removed via an incision around the edge of the areola.  A ring of skin is then removed in a wider circle around the areolar incision and the skin is pulled toward the centre of the opening and stitched to the edge of the areola.

Nipples – Areola may be trimmed to reduce its size.  It may be possible to slightly reposition the nipple.  But preserve sensation.

3. With free nipple graft (Double incision) – Large saggy breasts or inelastic skin.

Incision/ scar – Horizontal or U-shaped cuts across each breast, usually just below the nipple.  The aim is to place the incision just under the line of the pectoral muscles so it is not highly visible.

How it’s work – The skin is peeled back and the breast tissue and excess fatty tissue are removed.  The excess chest skin is then trimmed and the incisions closed.

Nipples – Removed, trimmed to smaller size, and grafted onto the chest to approximate positioning of “male” nipple.

 

Mastectomy preoperative 

Mastectomy is usually done as a single surgery, but in FtM procedures where there is a PAI’s team of surgeons working together, it can be done at the same time as hysterectomy/oophorectomy to reduce the number of times you have to go through general anesthesia.

New FtMs program that is under development in Preecha Aesthetic Institute (PAI) is aiming to bring plastic surgeons and gynecologists together.  So FtMs can choose to have both surgeries done at the same time.

Mastectomy postoperative recovery

After surgery, there is some soreness and discomfort which is easily controlled by medication.

Swelling and skin discoloration around the incisions generally will subside in a few days after surgery. There may be a temporary loss of sensation in the nipples and breast skin.  This condition will improve with time.  Sutures will be removed within five day of surgery.

Scars remain highly visible for 8 month or up to a year following surgery, then fade.

 

Mastectomy, breast removal surgery Thailand.

- The day after surgery. PAI doctor team will visit you.

- Removing Incisions will appoint within 5 days after surgery.

- No heavy exercise 4 weeks after surgery.

During in hospital after surgery, nurse, surgeon will visit you to check your dressings and monitor and empty your drains.  It is normal for the incisions to be red, but redness should not go beyond the incision for more than 2 cm.  It is normal to see or feel the knot in the stitches at the end of the incision.

Your chest will probably feel sore and swollen for at least a month after surgery.  Feeling of sharp shooting pain, burning pain, or general discomfort are common as part of the healing process and will eventually go away.  Usually serious discomfort passes 1-2 days after the surgery.

To permit proper healing, you should avoid excessive exercise and refrain from overhead lifting for there to four weeks.

The decision on when to return to work and normal activities depends on how fast you heal and how you feel.

 

Surgery

Time required: 1-2 hour(s)

Anesthesia: General Anesthesia

Mastectomy Recovery

Back to work: 7 days

More strenuous activity: 3-4 weeks

Fading of scars: several months to a year

 

Surgery Schedule (required 10 days Mastectomy after surgery in Thailand)

Day 1 – Consultation and Prepare for Laboratory Testing

Day 2-3 – Surgery and one night in hospital private room after surgery

Day 3 – Discharge from Hospital
Day 3 to Day 6 – Stay in hotel for recovery period and follow up on doctor appointment

Day 6 – Stitches removal and final checkup (5 days, after surgery)
Day 6– Safe to fly

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Set up an appointment and or question in Mastectomy.

1. Write your question, interest at consult us in program form

2. Via email at.

Consult@pai.co.th

2.1   list your expectations or procedure that you are interest and give us your detail as possible

2.2   email to us

2.3   We will get back to you shortly after receive your question with recommendation from specialize surgeon

Once you know your planning date for surgery.

Here is the next step.

3.1   Consultation with us via email for details and procedure

3.2   Plan your available date to be surgery and departure from Bangkok

3.3    We will confirm you for surgery date

3.4    You may start to book your airline ticket

3.5    We will confirm you all detail and hotel booking, if require

3.6    For transportation to be pick up from the airport, we can do for you as optional

 

Address:

PAI (Preecha Aesthetic Institute)

898/1 Sukumvit 55

Wattana, Bangkok 10110 Thailand

Tel: (662) 715-0111

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Airport Meeting point.

The driver will stand by for you at the door number 4 (Meeting point) after exit from customs.  The driver will stand by with your name and PAI’s logo.

Hotel

At Preecha Aesthetic Institute, we have many ranges of hotels for you to select with special rates.

 

Language

- Thai, Japanese, Italian and English

- Other Language upon request

 

Payment:

1. The payment can be prepared in Cash by US dollars, Euro Dollar, Japanese Yen, HKD, SGD, AUD or pay by Traveler‘s Cheques.

2. Bank’s transfer.

3. If using credit cards, the hospital will charged 3% for international transaction fee.  This is only for surgery fees.  Hotels are not charged for international transaction fee.

An extra charged for HIV is 30% from total cost.

 

Cost of meal

Cost of living meal per day is 15-20 USD.

 

Passport and VISA

Preecha Aesthetic Institute can issue the letter to clarify with your local Embassy or Passport.

 

Tourist Visa Exemption (30 days without VISA)

Australia, Austria, Belgium ,Brazil ,Bahrain , Brunei Darussalam   ,Canada, Denmark ,Finland ,France, Germany  ,Greece ,Hong Kong ,Iceland  ,Indonesia  ,Ireland  ,Israel  ,Italy  ,Japan  ,South Korea ,Kuwait ,Luxembourg , Malaysia  ,Monaco  ,Netherlands  ,New Zealand  ,Norway  ,Oman ,Peru  ,Philippines  ,Portugal , Qatar , Singapore  ,Spain  ,South Africa  ,Sweden  ,Switzerland  ,Turkey  ,United Arab Emirates, United Kingdom  ,United States of America ,Vietnam.

 

Airport Immigration and Customs

Please present the supporting documents confirming the scheduled operation upon request. Please do not carry any unnecessary drugs or dangerous objects in your luggage.

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FAQs

Q: Can testosterone make my breast go away ?

PAI: Testosterone tends to bulk up muscles and reduce fat and can slightly change the shape of chest.  But does not make breast tissue go away.  Only surgery can remove breast tissue.

 Q: Is it possible to binding without Breast Removal (FtM)?

PAI: Binding refers to the process of flattening breast tissue to create smaller and less noticeable chest as short term until surgery.  Tight binding is dangerous for young FtMs who bodies are still growing as it can affect rib and lung development.  To reduce the potential risks of binding.  You should loosen binder, if hurt, give skin a chance to breathe, wear a thin undershirt under your binder to help absorb sweat or irritation.

 

 

Dr.Sirachai Jindarak MD, Dr.Prayuth Chokrungvaranont MD, Dr.Sattha Siritantikorn, MD, Dr.Apichai Angspatt, MD, Dr. Preecha Tiewtranon MD, Dr.Sutin Khobunsongserm, , Dr.Burin Wangjiraniran MD. FRCS    

 

Risk

All surgery carries risks – But can minimize by closely following your surgeon’s advice on follow up care during the healing process.