Sensation and FTM/N Top Surgery

The goal of FTM/N chest reconstruction surgery is to create a more masculine-looking chest. The reconstructive process often involves removing chest tissue and excess skin, and resizing or repositioning the nipples. In addition to obvious physical transformations, FTM/N chest reconstruction also produces changes in bodily sensations.

Prior to electing FTM/N chest surgery, you should fully understand the scope of the procedure and feel comfortable with the potential resulting consequences. Your personal consultation with Dr. Mosser or Dr. Facque will cover these topics in-depth.

Nipple Sensation after FTM/N Chest Surgery

Ultimately, changes in nipple sensation will depend on the extent of your surgery. Patients with a significant amount of chest tissue often require free nipple graft chest reconstruction to obtain desired results. This technique gives your surgeon the flexibility to remove a significant amount of chest tissue while also contouring the chest to your desired shape.

A trade-off to this approach is that the nipple and areola (pigmented area around the nipple) must be removed as skin grafts and relocated to a more natural position on your chest. Their blood supply and nerve endings are disturbed during this process, which often results in some loss of sensation. The degree of sensation after surgery is usually similar to the sensation of the upper chest before surgery. So, sensation is still present, but is diminished from the “hypersensation” of the nipples that is usually present before surgery.

Though very uncommon at The Gender Confirmation Center, it is possible to lose all nipple sensation following FTM chest surgery. Patients who smoke or those diagnosed with diabetes or an autoimmune disease run an increased risk of partial or total nipple graft failure. During your consultation with Dr. Mosser or Dr. Facque, you should be honest and up front about the entirety of your medical history, so that they can help you form realistic outcome expectations.

Chest Tenderness and the Menstrual Cycle

Chest tenderness is a common pre-menstrual symptom. Most of this discomfort is related to the chest tissue, which means that it will be significantly diminished or completely gone following FTM chest reconstruction. If you choose to have FTM/N breast reduction rather than reconstruction, you may still experience some tenderness or discomfort during your cycle unless you begin hormone therapy, have your ovaries removed, or initiate a treatment that would discontinue your menstrual cycle.

Sexual Intimacy Following FTM/N Chest Surgery

Though nipple sensation is likely to be diminished following FTM/N chest surgery, most patients report increased sexual satisfaction. Studies have shown that sexual satisfaction is often intimately connected to feeling comfortable in one’s own skin and most transmen and transmasculine gender non-conforming people experience greatly enhanced body confidence following FTM chest surgery.


Read our pages on FTM/N top surgery scarring to learn more about what procedure types are likely to yield different post-op scars.