Female to Male Surgery for Trans Men
As a transgender male, your goal for female to male surgery (FTM) for gender-confirmation can involve top surgery, bottom surgery, or both. You may or may not want facial procedures. It’s up to you.
Female to Male Surgery at UVA
We’re here to offer consultations, second opinions, and information to help you choose and plan. Come to us with your questions and concerns. We’ll explain:
- Procedure options and details
- Recovery and healing
- What to expect of your results
We want you to feel confident about the direction and quality of your care.
Charley's Gender-Confirmation Surgery
From a young age, Charley Burton knew that his body did not match his gender identity – a struggle he kept inside for 50 years. With the help of family nurse practitioner Reagan Thompson, FNP, MSN, RN, and a whole team of caring providers, Charley found a safe place to become his true self.
CHARLEY BURTON: I'm Charley Burton. I'm a native of Charlottesville, Virginia. There's a picture of me as a little kid, and you can't tell that I wasn't a little boy.
I always knew. My body just didn't match my mind. And I pushed that in for the next 30, 40 years until I became 50 years of age and started my journey.
REAGAN THOMPSON: When I first met Charley, he was pretty frustrated. He had hit a lot of barriers getting appropriate transgender care and had given up on our system.
CHARLEY BURTON: And so when I go to the hospital, there's this level of anxiety that builds up in me every time. But I've been lucky because I've had a Reagan Thompson in my corner. She truly wants to know, what can she do as a medical professional to make my life better?
REAGAN THOMPSON: I think it's super important to listen to your patients and try to figure out what they're angry at.
CHARLEY BURTON: She has seen me at my lowest. And she now sees me where I'm at today.
[MUSIC PLAYING]
CHARLEY BURTON: Today's the day that I have my top surgery. Top surgery is the removal of the breasts. It's another stage in my transition. So I'm a little nervous today. Nervous and excited.
[MUSIC PLAYING]
JT STRANIX, MD: It's impossible not to like Charley when you meet him. We talk about what the goals are for surgery. His, in particular, were to have a chest that was congruent with his male identity.
SPEAKER 1: And can you tell me what Dr. Stranix is going to do? And Dr. Sopata?
CHARLEY BURTON: Yeah, we're doing a double mastectomy.
SPEAKER 1: OK.
CHARLEY BURTON: The top surgery.
SPEAKER 1: Yup.
CHARLEY BURTON: And total hysterectomy.
CARRIE SOPATA, MD: Trans patients should feel comfortable coming to any location in UVA and knowing that they're going to get the right care and the best care.
[MUSIC PLAYING]
CHARLEY BURTON: There was this one nurse. One night, she came in and she just wanted to know so the next person that comes on her floor that has had top surgery or is trans, what could she do better? And she asked some of the most beautiful, poignant questions. It was just total respect.
[MUSIC PLAYING]
JT STRANIX, MD: In my mind, a successful gender-affirming surgery is one that makes a patient feel more comfortable with their gender identity and really improves their overall well-being.
CHARLEY BURTON: The first day that I was able to take the ACE bandages off, I saw the chest that I've always wanted and it was-- I'm getting emotional now. It was just 10 times more than what I thought it would be.
REAGAN THOMPSON: And now Charley is a very happy person with very few complaints, and has a desire to fix a system that is driving him to be more involved in the transgender community.
[MUSIC PLAYING]
CHARLEY BURTON: I'm becoming the man that I want to be. I am confident in who I am, and I never thought I'd ever be there.
[MUSIC PLAYING]
FTM Top Surgery
To give you a flatter chest, we’ll have to remove breast tissue. We might also need to move and shrink your areolas.
If you have smaller breasts, we can sometimes use liposuction, which doesn’t involve many incisions.
Larger breasts may require the “double incision” technique. This method saves the pectoralis major muscle, the most defining characteristic of a male chest.
Whatever your breast size, we will use the techniques that optimize the results.
FTM Bottom Surgery
We can give you male genitalia in two different ways:
- Phalloplasty creates a penis and urethra (to stand while urinating). We use tissue from your forearm or thigh. We do this in 2 stages.
- Metoidioplasty takes your existing genital tissue and makes it longer, turning it into a defined phallus. This needs only one surgery.
You may or may not want to also have an operation to remove your internal reproductive organs. A hysterectomy takes out your uterus, fallopian tubes, and ovaries.
Facial Masculinization
Through a combination of procedures, we can sculpt your chin, jaw, and cheeks to appear more masculine. We can also reshape your nose and make your Adam’s apple look bigger. We can use synthetic implants for this work.
Questions? See our transgender surgery FAQs.