Table of ContentsView AllTable of ContentsMastectomyTop SurgeryDifferencesFrequently Asked Questions
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Table of Contents
Mastectomy
Top Surgery
Differences
Frequently Asked Questions
The terms “top surgery” and “mastectomy” are often used interchangeably. However, the two are not one and the same. They are separate procedures designed for different goals.
This article discusses the differences between top surgery and mastectomy.
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What a Mastectomy Is Used For
A mastectomy is used to treatbreast cancer. There are several reasons why a person may opt for a mastectomy, including:
Mastectomy and People at High RiskA person may get a mastectomy as a preventive measure because they are at an extremely high risk of developing breast cancer.
Mastectomy and People at High Risk
A person may get a mastectomy as a preventive measure because they are at an extremely high risk of developing breast cancer.
How It Is Performed
There are several ways to perform a mastectomy because there are various types available. The types and methods include:
When Should a Person Choose Mastectomy?There are various reasons why a person chooses to have a mastectomy in their cancer treatment plan, such as:They can’t have radiation.They would rather have surgery over radiation treatment.They have already had breast cancer in the past and treated it using radiation.Breast-conserving surgery didn’t remove all of the cancer.There are several areas of the breast that contain cancer.There are tumors larger than 5 centimeters within the breast.They are pregnant and don’t want to put the fetus at risk during radiation.They have a genetic predisposition to a second case of cancer.
When Should a Person Choose Mastectomy?
There are various reasons why a person chooses to have a mastectomy in their cancer treatment plan, such as:They can’t have radiation.They would rather have surgery over radiation treatment.They have already had breast cancer in the past and treated it using radiation.Breast-conserving surgery didn’t remove all of the cancer.There are several areas of the breast that contain cancer.There are tumors larger than 5 centimeters within the breast.They are pregnant and don’t want to put the fetus at risk during radiation.They have a genetic predisposition to a second case of cancer.
There are various reasons why a person chooses to have a mastectomy in their cancer treatment plan, such as:
Side Effects
The side effects most associated with mastectomies include:
Postmastectomy pain syndrome, or PMPS, is a type of syndrome that causes nerve pain following the surgery. The pain develops in the chest wall and armpit and presents as a burning or shooting pain sensation. The pain can last for more than three months following the surgery, and roughly 28.2% of people who have a mastectomy develop this side effect.
Mastectomy: Overview
What a Top Surgery Is Used For
Top surgeryis a form of chest reconstructive surgery. When a person wants to change how their chest looks or its size, they will have top surgery.
This procedure is consideredgender-affirming surgeryfortransgenderindividuals who wish to alter their chest to match theirgender identity.
There are several top surgeries that can be done, including:
How Many Transgender People Choose to Have Top Surgery?Roughly 8% to 25% of transgender adults in the United States have opted to have top surgery as gender-confirming surgery.
How Many Transgender People Choose to Have Top Surgery?
Roughly 8% to 25% of transgender adults in the United States have opted to have top surgery as gender-confirming surgery.
Various types of top surgery are performed in different ways. For female-to-male or female-to-nonbinary, breast tissue is removed and the chest is reshaped and flattened using a surgical method known as contouring.
During all types of top surgery, the skin over the breast, the nipple, and the areola remains and is reconstructed to match the new appearance of the chest.
Top Surgery and Nonbinary IndividualsPeople who identify as nonbinary may to opt for top surgery that removes all breast tissue and reconstructs the chest to appear more masculine.
Top Surgery and Nonbinary Individuals
People who identify as nonbinary may to opt for top surgery that removes all breast tissue and reconstructs the chest to appear more masculine.
How Can We Improve Access to Gender-Affirming Health Care?
The most common side effects associated with top surgery are similar to those that occur in any surgery, such as:
While these side effects are uncomfortable, they are often worth it for transgender individuals. Studies show that these surgeries can immensely improve thequality of life for transgender individuals.
Top Surgery and ScarringWhile plastic surgeons aim to prevent as much scarring as possible, there is still a risk that scarring will occur.
Top Surgery and Scarring
While plastic surgeons aim to prevent as much scarring as possible, there is still a risk that scarring will occur.
What Makes Them Different?
While top surgery is sometimes called mastectomy, not all top surgeries are the same.
The main difference between the two is the goal they set out to accomplish. Mastectomies are reserved for people with breast cancer, whereas “top surgery” is the term assigned to people undergoing gender-confirming surgery.
For example, a total mastectomy is not the same as top surgery simply because of how much breast area is removed. Top surgery is most similar to a double mastectomy performed with skin and nipple-sparing surgical techniques.
The male-to-female top surgery process is entirely different from a mastectomy because no breast tissue is removed. Instead, an implant is added to the area. The only similarity is that some people who undergo mastectomies for breast cancer can have breast reconstruction and implant insertion done at the same time.
However, implant surgery is typically spread out over the course of two surgeries for those who are getting a mastectomy.
Can I Get Breast Cancer After Top Surgery?Top surgeries to make breasts smaller don’t always end with all breast tissue removed. Because of this, there is still a chance that a person may get breast cancer following top surgery. It’s crucial to keep up with screenings even after your transition.
Can I Get Breast Cancer After Top Surgery?
Top surgeries to make breasts smaller don’t always end with all breast tissue removed. Because of this, there is still a chance that a person may get breast cancer following top surgery. It’s crucial to keep up with screenings even after your transition.
Summary
Top surgery and mastectomy may seem similar, but the two are not the same. Top surgeries are used for gender-reaffirming purposes, and mastectomies treat breast cancer. There are various types of mastectomies, with only two being considered similar to top surgery.
Both procedures come with possible side effects, such as swelling in the area and pain. That said, a mastectomy and top surgery are often necessary, and the positive outcomes can be lifesaving and life-changing, respectively.
A Word From Verywell
Choosing to have surgery such as top surgery or a mastectomy can be a scary experience. Even if you know it’s necessary to either save your life or allow you to live happily in a body that feels right for you, it can be a hard decision.
That said, many people have undergone these procedures, and they are often safe and effective, leading to incredibly positive outcomes for those who opt into them.
Frequently Asked QuestionsWhile top surgery is often considered elective, many insurance providers cover the surgery. This is because they understand how necessary it can be for some people. If you are considering top surgery, contacting your insurance provider to see if it is covered on your current plan can help save you a lot of money.While a person who has top surgery can still get breast cancer, the removal of breast tissue to make breasts smaller lowers the risk greatly. With less tissue, there is less of a chance of getting cancer. That said, people who undergo top surgery should still get regular breast cancer screenings.Mastectomies are often recommended and highly effective. However, there are instances in which the procedure is not likely to help. If the cancer has spread to other parts of the body, for example, a mastectomy will not work.
While top surgery is often considered elective, many insurance providers cover the surgery. This is because they understand how necessary it can be for some people. If you are considering top surgery, contacting your insurance provider to see if it is covered on your current plan can help save you a lot of money.
While a person who has top surgery can still get breast cancer, the removal of breast tissue to make breasts smaller lowers the risk greatly. With less tissue, there is less of a chance of getting cancer. That said, people who undergo top surgery should still get regular breast cancer screenings.
Mastectomies are often recommended and highly effective. However, there are instances in which the procedure is not likely to help. If the cancer has spread to other parts of the body, for example, a mastectomy will not work.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.What is a Mastectomy?Johns Hopkins Medicine.Mastectomy.Gong Y, Tan Q, Qin Q, Wei C.Prevalence of postmastectomy pain syndrome and associated risk factors: A large single-institution cohort study.Medicine (Baltimore).2020 May;99(20):e19834. doi:10.1097/MD.0000000000019834American Society of Plastic Surgeons.Transmasculine Top Surgery.Nolan IT, Kuhner CJ, Dy GW.Demographic and temporal trends in transgender identities and gender confirming surgery.Transl Androl Urol.2019 Jun;8(3):184-190. doi:10.21037/tau.2019.04.09McEvenue G, Xu FZ, Cai R, McLean H.Female-to-male gender-affirming top surgery: a single surgeon’s 15-year retrospective review and treatment algorithm.Aesthet Surg J.2017 Dec 13;38(1):49-57. doi:10.1093/asj/sjx116Decuypere F, De Wolf E, Vyncke T, Claes K, Monstrey S, Buncamper M.Male-to-female gender affirmation surgery: breast reconstruction with Ergonomix round prostheses.Int J Impot Res.2020 Nov;33(7):720-725. doi:10.1038/s41443-021-00425-8Bustos VP, Bustos SS, Mascaro A, Del Corral G, Forte AJ, Ciudad P, Kim EA,Langstein HN, Manrique OJ. Transgender and gender-nonbinary patient satisfaction after transmasculine chest surgery.Plast Reconstr Surg Glob Open.2021 Mar 19;9(3):e3479. doi:10.1097/GOX.0000000000003479Poudrier G, Nolan IT, Cook TE, Saia W, Motosko CC, Stranix JT, Thomson JE, Gothard MD, Hazen A.Assessing quality of life and patient-reported satisfaction with masculinizing top surgery: a mixed-methods descriptive survey study.Plast Reconstr Surg.2019 Jan;143(1):272-279. doi:10.1097/PRS.0000000000005113KP SCAL Gender Affirming Surgery Program.Top Surgery (Mastectomy): Potential Risks and Complications.Gonzalez E, Frey JD, Bluebond-Langner R.Technical Refinements in Gender-Affirming Top Surgery.Plast Reconstr Surg.2020 Jul;146(1):38-40. doi:10.1097/PRS.0000000000006913American Cancer Society.Breast Reconstruction Using Implants.The Mauer Foundation.How Does Sex Reassignment Surgery Affect Breast Cancer Risk Factors?
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.What is a Mastectomy?Johns Hopkins Medicine.Mastectomy.Gong Y, Tan Q, Qin Q, Wei C.Prevalence of postmastectomy pain syndrome and associated risk factors: A large single-institution cohort study.Medicine (Baltimore).2020 May;99(20):e19834. doi:10.1097/MD.0000000000019834American Society of Plastic Surgeons.Transmasculine Top Surgery.Nolan IT, Kuhner CJ, Dy GW.Demographic and temporal trends in transgender identities and gender confirming surgery.Transl Androl Urol.2019 Jun;8(3):184-190. doi:10.21037/tau.2019.04.09McEvenue G, Xu FZ, Cai R, McLean H.Female-to-male gender-affirming top surgery: a single surgeon’s 15-year retrospective review and treatment algorithm.Aesthet Surg J.2017 Dec 13;38(1):49-57. doi:10.1093/asj/sjx116Decuypere F, De Wolf E, Vyncke T, Claes K, Monstrey S, Buncamper M.Male-to-female gender affirmation surgery: breast reconstruction with Ergonomix round prostheses.Int J Impot Res.2020 Nov;33(7):720-725. doi:10.1038/s41443-021-00425-8Bustos VP, Bustos SS, Mascaro A, Del Corral G, Forte AJ, Ciudad P, Kim EA,Langstein HN, Manrique OJ. Transgender and gender-nonbinary patient satisfaction after transmasculine chest surgery.Plast Reconstr Surg Glob Open.2021 Mar 19;9(3):e3479. doi:10.1097/GOX.0000000000003479Poudrier G, Nolan IT, Cook TE, Saia W, Motosko CC, Stranix JT, Thomson JE, Gothard MD, Hazen A.Assessing quality of life and patient-reported satisfaction with masculinizing top surgery: a mixed-methods descriptive survey study.Plast Reconstr Surg.2019 Jan;143(1):272-279. doi:10.1097/PRS.0000000000005113KP SCAL Gender Affirming Surgery Program.Top Surgery (Mastectomy): Potential Risks and Complications.Gonzalez E, Frey JD, Bluebond-Langner R.Technical Refinements in Gender-Affirming Top Surgery.Plast Reconstr Surg.2020 Jul;146(1):38-40. doi:10.1097/PRS.0000000000006913American Cancer Society.Breast Reconstruction Using Implants.The Mauer Foundation.How Does Sex Reassignment Surgery Affect Breast Cancer Risk Factors?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.What is a Mastectomy?Johns Hopkins Medicine.Mastectomy.Gong Y, Tan Q, Qin Q, Wei C.Prevalence of postmastectomy pain syndrome and associated risk factors: A large single-institution cohort study.Medicine (Baltimore).2020 May;99(20):e19834. doi:10.1097/MD.0000000000019834American Society of Plastic Surgeons.Transmasculine Top Surgery.Nolan IT, Kuhner CJ, Dy GW.Demographic and temporal trends in transgender identities and gender confirming surgery.Transl Androl Urol.2019 Jun;8(3):184-190. doi:10.21037/tau.2019.04.09McEvenue G, Xu FZ, Cai R, McLean H.Female-to-male gender-affirming top surgery: a single surgeon’s 15-year retrospective review and treatment algorithm.Aesthet Surg J.2017 Dec 13;38(1):49-57. doi:10.1093/asj/sjx116Decuypere F, De Wolf E, Vyncke T, Claes K, Monstrey S, Buncamper M.Male-to-female gender affirmation surgery: breast reconstruction with Ergonomix round prostheses.Int J Impot Res.2020 Nov;33(7):720-725. doi:10.1038/s41443-021-00425-8Bustos VP, Bustos SS, Mascaro A, Del Corral G, Forte AJ, Ciudad P, Kim EA,Langstein HN, Manrique OJ. Transgender and gender-nonbinary patient satisfaction after transmasculine chest surgery.Plast Reconstr Surg Glob Open.2021 Mar 19;9(3):e3479. doi:10.1097/GOX.0000000000003479Poudrier G, Nolan IT, Cook TE, Saia W, Motosko CC, Stranix JT, Thomson JE, Gothard MD, Hazen A.Assessing quality of life and patient-reported satisfaction with masculinizing top surgery: a mixed-methods descriptive survey study.Plast Reconstr Surg.2019 Jan;143(1):272-279. doi:10.1097/PRS.0000000000005113KP SCAL Gender Affirming Surgery Program.Top Surgery (Mastectomy): Potential Risks and Complications.Gonzalez E, Frey JD, Bluebond-Langner R.Technical Refinements in Gender-Affirming Top Surgery.Plast Reconstr Surg.2020 Jul;146(1):38-40. doi:10.1097/PRS.0000000000006913American Cancer Society.Breast Reconstruction Using Implants.The Mauer Foundation.How Does Sex Reassignment Surgery Affect Breast Cancer Risk Factors?
American Cancer Society.What is a Mastectomy?
Johns Hopkins Medicine.Mastectomy.
Gong Y, Tan Q, Qin Q, Wei C.Prevalence of postmastectomy pain syndrome and associated risk factors: A large single-institution cohort study.Medicine (Baltimore).2020 May;99(20):e19834. doi:10.1097/MD.0000000000019834
American Society of Plastic Surgeons.Transmasculine Top Surgery.
Nolan IT, Kuhner CJ, Dy GW.Demographic and temporal trends in transgender identities and gender confirming surgery.Transl Androl Urol.2019 Jun;8(3):184-190. doi:10.21037/tau.2019.04.09
McEvenue G, Xu FZ, Cai R, McLean H.Female-to-male gender-affirming top surgery: a single surgeon’s 15-year retrospective review and treatment algorithm.Aesthet Surg J.2017 Dec 13;38(1):49-57. doi:10.1093/asj/sjx116
Decuypere F, De Wolf E, Vyncke T, Claes K, Monstrey S, Buncamper M.Male-to-female gender affirmation surgery: breast reconstruction with Ergonomix round prostheses.Int J Impot Res.2020 Nov;33(7):720-725. doi:10.1038/s41443-021-00425-8
Bustos VP, Bustos SS, Mascaro A, Del Corral G, Forte AJ, Ciudad P, Kim EA,Langstein HN, Manrique OJ. Transgender and gender-nonbinary patient satisfaction after transmasculine chest surgery.Plast Reconstr Surg Glob Open.2021 Mar 19;9(3):e3479. doi:10.1097/GOX.0000000000003479
Poudrier G, Nolan IT, Cook TE, Saia W, Motosko CC, Stranix JT, Thomson JE, Gothard MD, Hazen A.Assessing quality of life and patient-reported satisfaction with masculinizing top surgery: a mixed-methods descriptive survey study.Plast Reconstr Surg.2019 Jan;143(1):272-279. doi:10.1097/PRS.0000000000005113
KP SCAL Gender Affirming Surgery Program.Top Surgery (Mastectomy): Potential Risks and Complications.
Gonzalez E, Frey JD, Bluebond-Langner R.Technical Refinements in Gender-Affirming Top Surgery.Plast Reconstr Surg.2020 Jul;146(1):38-40. doi:10.1097/PRS.0000000000006913
American Cancer Society.Breast Reconstruction Using Implants.
The Mauer Foundation.How Does Sex Reassignment Surgery Affect Breast Cancer Risk Factors?
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