The Fishmouth Incision method is a procedure for chest masculinization. The Fishmouth technique removes unwanted chest tissue and results in a flat chest. Because the horizontal scars that radiate out from the areola create a non-anatomic layout of scars, this procedure is more commonly chosen by non-binary transgender individuals.
The Fishmouth procedure combines elements of other surgical procedures. In some ways it is like a Double Incision surgery and in other ways it is like the Inverted T or Buttonhole technique. However, it is unique in that the resulting scars are not in anatomic locations. After the Fishmouth technique is used the scars are around the areola and extend out horizontally inward and outward from the areola itself.
For patients who wish to have a flatter appearing chest with an incision that is in the lower border of the muscle, this is not the procedure for them. Dr. Mosser performs this procedure most often for patients who are gender nonconforming and therefore do not wish to have either a male or a female appearing chest. Read our informational page on non-binary top surgery to learn more about ways we can tailor top surgery results for non-binary patients.
One of the advantages of the Fishmouth procedure technique is that, much like the Inverted T or Buttonhole, there is a better chance of maintaining increased sensation density of the nipple areola region. Another advantage is the enhanced ability to obtain a considerable degree of flatness and tightness to the chest that can be flatter than with the Inverted T approach.
If a non-anatomic scar is a desired or acceptable outcome for you, then this might be a good procedure to consider. However, if having an anatomic location for your incisions is important to you, then this procedure is not a good match for your priorities.