What is the difference between an aggressive breast reduction and top surgery?
When it comes to top surgery, patients sometimes decide between having an aggressive breast reduction and top surgery with a non-flat result. The majority of the particularities here involve the
aesthetic difference between the two, and how those differences impact someone’s particular experience with gender dysphoria or discomfort associated with their chest. This article will address the difference between a breast reduction and a top surgery with a non-flat end goal.
The photos and descriptions on this page are used to highlight breast aesthetics that are shared among many people who underwent an estrogenic puberty. Because there is natural variation to body types and sizes, your particular body shape might not be represented in the images below. To learn more, please contact Dr. Mosser and our team for a better understanding of what these end results might look like on your own body.
What is an aggressive breast reduction?
- Aggressive breast reductions are defined as procedures that yield a smaller breast with the classic teardrop shape (defined below) and some overhang of skin and tissue below the incision. Aggressive breast reductions reduce the amount of overhang and minimize the teardrop shape, usually leaving some overhang, and results in skin that is not as tight, i.e. there is most often some ‘bounce’ of the chest tissue during body movement after a breast reduction.
- Image A on the right shows the classic teardrop shape to a breast aesthetic that is usually maintained with a breast reduction. The teardrop/cone shaped aesthetic can be described as a gentle convexity towards the nipple and sloping into a more full and round shape towards the bottom of the breast.
- Image B on the left shows the degree of overhang that can be achieved with a breast reduction. Breast overhang is a component that can really impact someone’s experience of gender dysphoria or discomfort, and the procedure that is chosen should take this into consideration.
- Image C and D below show what results someone can expect from an aggressive breast reduction.
Non-Flat Top Surgery
There are two different types of top surgery incisions that are likely to yield a result that is nonflat in appearance, the Buttonhole and the Inverted T. For individuals who want to maintain some gender fluidity in the appearance of their chest, these procedures might be the best option. Because there will still be some tissue left over, folks can present more feminine on some days and more masculine on others, without needing to wear a chest binder.
Image E and F below depict a likely end result for someone who received the Buttonhole incision type, and Image G and H show the end result of someone who received the Inverted T incision type.
- Aggressive breast reductions are performed on patients who wish to maintain some elements of the teardrop shape and minimal breast overhang, and are okay with a bit of movement of the chest (i.e. “bounce”) after surgery.
- Top surgeries with a non-flat result (Buttonhole and Inverted T) are performed on patients who want a more non-binary or gender-neutral appearance to their chest after surgery.
- Consult with Dr. Mosser or another board certified plastic surgeon to discuss the particularities of your needs and goals.