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Awaking to a body in which you don’t feel at home can be an unhappy situation. You should know you’re not alone. According to the Williams Institute of UCLA Law School, nearly 1.4 million people in the United States identify as transgender. That’s not a small number.

Top surgery is one of the procedures that can begin to align your external body with your true identity. Top surgery will not make you a man or a woman, you are already the person of the gender you know in your heart. Top surgery simply allows your body to match your true gender. Our Board-certified Portland plastic surgeon, Dr. Matthew Lewis, counts it as a privilege to be your partner and counselor as you embark on your journey to gender confirmation.

What is Top Surgery?

Top surgery is a procedure on the path to gender confirmation that will align your body with your internal identity. For male-to-female transgender patients, this includes sculpting the beautiful, womanly breasts that are so intertwined with femininity. For female-to-male transgender patients, this will involve removal of the breasts in order to create firm, masculine appearance to your chest.

FTM Top Surgery

Remove your natural breasts to sculpt a more masculine chest.

MTF Top Surgery

Feminize the chest with silicone or saline breast implants.

What it takes to be a candidate for Top Surgery

  • At least 18 years of age
  • In good overall health (physical and emotional)
  • Having lived as your preferred gender for at least 1 year
  • A letter of support from a doctor or therapist who knows you well
  • 100% committed to the gender transition journey

Top Surgery - Frequently Asked Questions

What Should I Do to Prepare for my Top Surgery?

It is your job to make sure your body is as healthy as possible prior to any surgical procedure in order to aid the healing process and reduce downtime. Therefore, if you are a smoker it is necessary that you stop smoking at least three weeks prior to your top surgery. Smoking slows the flow of blood through your body and will impede your body’s ability to heal following surgery. You should also avoid consuming alcohol for at least two weeks prior to your procedure as it can increase your risk for bruising and bleeding.

What Kind of Anesthesia is Used in Top Surgery?

Top surgery is performed on an outpatient basis under general anesthesia in order to allow you to rest comfortably while Dr. Lewis sculpts your body.

How do I Know if Top Surgery is a Good Option for Me?

Surgery of any kind is an intensely personal decision, and you are the only one who can decide if it is right for you. Many transgender patients feel that top surgery is one of the most important procedures they have had on their road to gender confirmation. As one of the most visible parts of your body, and a symbol of both male and female sexuality, the presence of breasts or a flat, masculine chest can help you see your truest self when you look in the mirror. Dr. Lewis will happily discuss with you your goals, concerns, and dreams in seeking top surgery and help you find the best path to achieving your aesthetic goals.

Is the Recovery from Top Surgery Painful?

Since each body is different, each patient has a different experience during his or her recovery from top surgery. Most patients report mild to moderate discomfort following top surgery which can be well managed with pain medication. While pain generally doesn’t last long into the recovery period, you may find there is a bit of discomfort for a few weeks as your incisions heal, and your skin adapts to its new form.

Are you ready for a change?

Top surgery is a life-changing procedure that involves altering your physique. If you are unsure about the operation, our Board-certified Portland plastic surgeon, Dr. Matthew Lewis, is available to discuss the benefits and risks with you and help you arrive at an informed decision.

The Procedures

Female-to-male (FTM) surgery


Perfect for large and heavy breasts, this technique involves an incision along the lower border of the breast and across the top of the breast and meeting at the corners creating an elliptical incision. Through the resulting opening, Dr. Lewis will remove breast tissue and relocate the nipple to a masculine position as a graft.


If you have good skin elasticity and a minimal amount of breast tissue, this approach may be ideal. Dr. Lewis will make a semi-circular incision around the areola and remove the breast tissue through this opening.

Male-to-female (MTF) top surgery

MTF top surgery is done under general anesthesia and takes about an hour and a half. It requires a small incision along the bottom border of the chest. Through that opening, Dr. Lewis will create a pocket and place a saline or silicone breast implant. For MTF operations, Dr. Lewis typically uses silicone implants placed behind the muscle. To complete the procedure, he will carefully close the incisions to minimize scarring and wrap the area with dressings.

The Recovery

With both MTF and FTM top surgery, there is a substantial recovery period. You can expect:

  • Time off from work. Plan to take approximately 7 to 9 days off from work to rest. At that point, most of our patients are able to return to sedentary jobs.
  • Swelling + discomfort. Swelling, bruising, pain and discomfort are virtually guaranteed after surgery. The effects will gradually improve as you heal and Dr. Lewis will prescribe pain medication to help you manage the discomfort in the meantime.
  • Rest + self-care. During the recovery period, you should rest frequently. Walk lightly around the house as soon as you’re able, but avoid heavy lifting, exercise and other strenuous activities for at least six weeks.

What are the Benefits of Top Surgery?

While the benefits of top surgery may seem evident, there are so many to consider including:

  • Increased confidence
  • Decreased feelings of depression
  • Clothes fit better
  • More proportional figure
  • Your body matches your gender identity

What Should I Look for in a Surgeon
when Seeking Top Surgery?

When considering your options for gender confirmation, one of the most important decisions you will make will be the selection of your plastic surgeon. Our Board-certified Portland plastic surgeon, Dr. Matthew Lewis, sees each of his patients as so much more than just a patient. It is his honor to get to know you as an individual and assist you to reveal the physical vessel which aligns with your vision for your body. Dr. Lewis is a skilled board-certified plastic surgeon with a mind inspired by science and technical skill, and an enduring compassion for and care for the patients with whom he works.

Why Should I Choose
Dr. Matthew Lewis
for my Top Surgery?

Choosing to begin your journey toward gender confirmation is one of the most courageous acts an individual can take. Dr. Matthew Lewis honors this journey and believes it is a privilege to assist you in finding the peace that comes from a body which matches your internal identity. As a Board-certified plastic surgeon, Dr. Lewis possesses the technical skill, experience, and artistic eye necessary to help bring your aesthetic vision to life. He will treat you with dignity, compassion, and care, advising you on the transformation that will make you feel more at home in your own body.

Schedule an appointment today >>

Top surgery is a life-changing procedure that makes many patients feel much more comfortable in their own bodies. Contact our Portland office today to schedule an appointment and begin planning for your transformation.

A Portland Plastic Surgeon

407 NW 17TH AVE, STE 2Portland, OR 97209

Matthew Lewis,MD

Discover your true beauty. At the office of Dr. Matthew Lewis, we take everything into consideration, including your comfort, discretion, and of course your outcome. Please call us to schedule an appointment.

Schedule your Complimentary Consultation Today