Chest Reconstruction & Scarring for FTM/N Top Surgeries

If you’re considering chest reconstruction surgery, you may be concerned about the possibility of scarring. Though permanent scarring is an inevitable consequence of FTM and FTN chest surgery (or any surgery), most patients feel that their final results are well worth it.

FTM/N chest surgery involves the removal of excess skin and underlying chest tissue, and in some cases, nipple relocation. The chest muscles are not altered or affected during this process. Once the appropriate amount of skin and tissue has been removed, your incisions will be secured with sutures. The detached skin and tissue is then sent off for pathologic analysis to be sure that it is free of cancer. Read here for more information on our pathology process.

The size, location and length of your scars will ultimately depend on the surgical techniques used during your surgery as well as your body’s healing response. Following a personal consultation with Dr. Mosser or Dr. Facque, you will have a better idea of how much skin will need to have removed during your procedure and the necessary incision patterns.

What will my scars look like?

Scars are areas of fibrous tissue that replace healthy skin following trauma to the skin. Common causes for scars include wounds, acne, burns, and surgery. Scar formation is a normal part of the healing process, but how your body responds to injury depends on several factors such as age, genetics, location on the body, and skin color.

With FTM/N chest surgery, the techniques used during your procedure will have a direct influence on the resulting scars. Keyhole and periareolar incision patterns are less invasive and result in less scarring than double incision chest surgery.

  • Keyhole incisions – This technique is usually only successful on very small breasts. Incisions run around the lower circumference of the areola (pigmented area around the nipple).
  • Periareolar incisions – Patients with small-to-medium sized breasts may benefit from this technique. Incisions extend completely around the border of the areola.
  • Double incisions – Large breasts require a larger incision to address excess skin and tissue. This technique involves horizontal or U-shaped incisions placed just beneath the chest muscle. Another incision is also made to relocate the nipple.

Your scars will look most prominent in the six weeks immediately following your procedure, appearing raised and dark against the rest of your skin. They will gradually fade and flatten over time. The final appearance of your scars may not be apparent for 12-18 months.

How can I minimize my scars?

There are several options to help minimize scarring. Dr. Mosser or Dr. Facque will provide you with personalized recommendations following your surgery. To learn more about scar minimization, here’s a downloadable PDF about scar management.

If you currently smoke, avoiding tobacco use for at least 3-6 weeks before and after surgery is one of the easiest ways to improve your body’s healing response.

Eating a nutritious diet that contains adequate protein, zinc and vitamin C, all of which have been clinically proven to accelerate healing, is a simple step you can take in advance of your procedure.

Following surgery, it is important to keep your scars out of the sun (or wear strong sunscreen) for at least one year. Over-the-counter topical treatments like Scarguard and Bio-Oil have been shown to speed up wound healing and improve the appearance of scars.

Using silicon sheeting or compression tape is also effective way to treat scars because they create an atmosphere of moisture, which prevents the build-up of collagen that can cause scarring. Dr. Mosser or Dr. Facque will be able to recommend specific treatment based on your skin type.

If topical treatments don’t result in your desired outcome, there are several more invasive treatments that can improve the appearance of scars such as:

  • Steroid injections
  • Surgical revision
  • Laser scar removal
  • Microdermabrasion
  • Medical needling