There are different tenchniques and types of top surgery and it is best to consider the potential effects in bodily sensations prior to pursuing these procedures. This article provides information on what contributes to changes in nipple sensation including incision technique, nipple grafts, and medical histories. Chest reconstruction top surgery, formerly known as FTM top surgery, may also affect chest tenderness during menstrual cycle and sexual intimacy, both of which are also discussed in this content.
The goal of chest reconstruction top surgery is to create a flatter and often more conventionally “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, chest reconstruction top surgery also produces changes in bodily sensations.
Prior to undergoing chest reconstruction top surgery, you should fully understand the scope of the procedure and feel comfortable with the potential resulting outcomes of consequences of potential sensation retention and loss. Your consultation with your surgeon will cover these topics in-depth.
Ultimately, changes in nipple sensation will depend on the type of surgery you have and your body’s unique ability to heal. Patients with a significant amount of chest tissue often require a procedure that uses free nipple grafts to obtain their desired outcome. This technique gives the surgeon the flexibility to remove a significant amount of chest tissue while also contouring the chest to the desired shape.
Something to consider with nipple grafts is that the nipple and areola (pigmented area around the nipple) must be removed as skin grafts and relocated 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. Thus, sensation is still present, but is diminished from the sensation in 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 chest reconstruction top surgery. Patients who smoke or those who have diabetes or an autoimmune disease run an increased risk of partial or total nipple graft failure. During your consultation you can discuss your medical history with your surgeon so they can help you form realistic outcome expectations.
Chest tenderness is a common premenstrual symptom. Most of this discomfort is related to the chest tissue, which means that it will be significantly diminished or completely gone following chest reconstruction top surgery. If you choose to have a chest 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 other treatment that would discontinue your menstrual cycle.
Though nipple sensation is likely to be diminished following chest reconstruction top 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 trans men, transmasculine and non-binary people experience greatly enhanced body confidence following chest reconstruction top surgery.
Read our pages on chest reconstruction top surgery scarring to learn more about what procedure types are likely to yield different post-op scars.