Before you can decide what non-binary top surgery is right for you, it's best to understand the different types of chest aesthetics for binary male or binary female chests. Although we know that bodies come in a variety of shapes and sizes, there are aspects of aesthetics that are consistent when looking at female and male chests.  

Female Chest Aesthetics

➝ Areolas

• Typically these are larger, approximately 40 mm
• Sit closer together but can vary depending on the size and shape of the breast  

➝ Nipples

• Typically these are larger and have more projection
• Centrally located to the breast mound, at the point of maximum projection of the breast

➝ Varying degrees of inner and outer breast tissue  

➝ Tear drop shape to the breasts

Male Chest Aesthetics  

➝ Areolas

• Typically these are smaller, approximately 22mm (the size of a nickel)
• Sit lower and wider-set on the chest, usually on the lateral aspect of the pec muscle  

➝ Nipples

• More commonly less projection and smaller compared to that of female nipples

➝ Uniform subcutaneous tissue on the chest  

➝ Boxy or trapezoidal shape to the chest  

As we now know what aesthetic qualities impact the appearance of a chest with breasts compared to a chest without breasts, there are multiple surgical approaches Dr. Stiller can achieve when considering non-binary chest aesthetics. Rather than sticking with a traditionally male or female aesthetic, Dr. Stiller can help you achieve your goals through different approaches in regards to the amount of tissue left behind, scars, nipple-areolar complex shape and size. In order to craft a more gender non-conforming chest, Dr. Stiller can incorporate both components of binary female and binary male chest aesthetics to help you achieve your goals.  

Below are some more common requests Dr. Stiller's patients have had when deciding what aspects of a non-binary chest is desired:

➝ Removal of nipple-areolar complex during double incision mastectomy

➝ Removal of nipple-areolar complex during keyhole mastectomy leaving you with horizontal scars on the chest in the place of nipples

➝ If areolas are desired, some patients desire them larger than the traditional male sized areolas or higher and more narrow on the chest

➝ Differing incision locations such as a straight line across the chest or a more curved incision following the border of the pectoralis muscle

➝ Some patients desire some breast tissue left behind instead of a completely flat chest depending on their levels of dysphoria or discomfort and their gender expression goals

• This may mean a non-flat top surgery where double incision top surgery incisions are made however, "mounds" of breast tissue are left behind and can vary in size depending on preference  
• This may mean patients still desire breasts however, would like a reduced size of breasts that still resemble a tear drop shape leaving them with anchor incisions  

➝ Liposuction only of the chest

• Patients may request this if there is a desire to breast feed in the future. Most commonly, the best candidates for this involve small chested individuals without ptosis of the breasts

➝ Breast Augmentation

• Transfeminine spectrum non-binary people may require breast implants to augment the size of their chest  

In order to discover what is right for you, schedule you consultation with Dr. Stiller today. He will discuss your goals in great detail and help create your own individualized surgical plan. Dr. Stiller encourages patients to look through before and after's or bring pictures themselves to make sure their goals are met.  

Click here to learn more about Double Incision Mastectomy, Keyhole Mastectomy, Breast Reduction or Breast Augmentation procedures.

The recovery for top surgery varies from patient to patient, however, most patients do very well. All procedures that Dr. Stiller performs takes about 2 hours and you will leave the hospital that same day. After surgery, you will be placed in a chest compression garment, have dressings on your incisions as well as a drain placed on each side of the chest. Drain care will be reviewed before you leave the hospital. It is best to leave your compression garment on until your 1 week appointment. If you undergo a breast reduction, most commonly you will not have drains.  

At the 1 week post-op appointment, your drains and nipple dressings (if you received nipples) will be removed. New bandages will be placed on the nipples which are to be kept on for 5 days. At the 5-day mark, you can remove them and continue with an antibiotic ointment and gauze. Gauze and antibiotic ointment will need to be placed on the nipples twice a day until they heal, most commonly around 6-8 weeks. You will wear your compression garment for 4 weeks total as long as there are no complications. Patients can usually begin light chest exercises around the 4-week mark but are encouraged not to lift arms above shoulders or any heavy lifting for 6 weeks. You will be provided with detailed post-operative instructions upon completion of your procedure. If at any time you should have any questions or concerns after surgery, please contact our practice immediately.

At Stiller Aesthetics, we welcome patients that may have had top surgery at another location. Dr. Stiller is extremely skilled in assisting and improving any complication or aesthetic adjustments you may desire. He will do his best to assure that your goals are met and you feel confident in your body.  

Common problems/aesthetic adjustments patients may seek help for:

• Scar revisions  
• Nipple resizing, repositioning or removal
• Chest unevenness  
• Dog ear excision