Top Surgery Center Düsseldorf, Germany
Your Specialists for Mastectomy and Non Flat-Top Surgery for Transidentity, Non-Binary and Gender Incongruence
Information on mastectomy & non flat-top surgery:
- Treatment duration: 1.5 - 2.5 hours
- Anaesthesia: General anaesthesia
- Hospital stay: 1 - 2 days
- Downtime: 1 - 2 weeks
- Restriction from sports: 6 weeks
- Price: 5.000 € - 7.000 € (plus anaesthetic costs)
What does “Transgender”, “Transidentity” or “Trans*” mean?
The internationally used term “transgender” refers to individuals for whom the external, sexual characteristics and thus the gender assigned at birth do not match their experienced gender, the so-called "identity gender". Simply put: trans individuals live, in terms of their gender identity, with a body that feels “inappropriate” for them. However, the real-life circumstances of transgender patients cannot be reduced to this simple formula. This is because the topic extends to many more areas of life than just the physical aspect.
Binary and non-binary gender incongruence
Transidentity is multifaceted, with a basic distinction being made between non-binary and binary transident individuals. The terms “binary” and “non-binary” refer to the gender system. If the traditional categories of “male” and “female” are present, this is referred to as binary division, however, many people do not fit into these two categories in terms of their gender identity. This is then referred to as “non-binary transidentity”. People with this characteristic often describe themselves as “non-binary”, and their experienced gender can be subject to fluctuations and changes (otherwise known as "genderfluidity").
Binary transidentity occurs, for example, when individuals assigned female at birth have a male gender identity, or vice versa. In the case of individuals assigned female at birth but with a male gender identity, they are referred to as trans men; conversely, when individuals assigned male at birth have a female gender identity, they are referred to as trans women.
Not all patients can be assigned to these categories!
In order to adequately address the diverse forms of gender-related non-identification with one's own body, and to avoid potentially inaccurate categorization of the affected individuals, it has proven helpful to generally speak of "gender incongruence." The term "gender dysphoria" is also frequently used, and points to the associated ongoing distress of the affected individuals.
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Are you interested in a mastectomy (top surgery) or have questions about the procedure?
Do you have questions about mastectomy or top surgery? No problem. Call us on +49 211 87630240 or schedule an online appointment with us directly.
Important questions and answers
1. What are the benefits of breast surgery for gender incongruence?
Aligning the breast shape to a flat or neutral chest in individuals with gender incongruence is crucial, due to the high psychological stress and the associated distress that arises in daily life from concealing the female breast, making it often the most significant surgical alignment for many. The aim is to modify the existing female breast to the desired chest shape, achieving a flatness, neutralization, or significant masculinization of the body silhouette in everyday life, during sports, and at work.
2. Why come to us?
Over the past several years, during our work in one of the largest care clinics for plastic breast surgery in the country, we have performed breast surgery on between 250 and 300 trans men and non-binary individuals per year. Over the last 14 years, we have consistently enhanced our techniques to achieve positive and fulfilling results for our patients.
The goal of a mastectomy should therefore be:
- inconspicuous scars, whether for small, medium or large breasts
- a flat, neutralized, or masculine chest that is presentable in everyday life, such as at the swimming pool
- minimal risks with short operation time and brief clinic stay
- rapid reintegration into everyday life without long downtime
Together for your wellbeing – rely on our expertise!
If you need more information on mastectomy or would like a consultation, we are here for you. Contact us on +49 211 87630240 or conveniently book an online appointment.
Online Appointment Scheduling3. What conditions do I have to meet to undergo surgery?
- Clear desire for mastectomy: This is the most fundamental prerequisite.
- Specialist medical report: In certain cases, we require a report from a psychologist or specialist, but not always. This should confirm gender incongruence and contain a recommendation for surgery. Whether this report is necessary will be clarified by your specialist during a detailed initial consultation.
- Consent for minors: For individuals under 18 years of age, written consent from the legal guardians is required.
- Preliminary examinations: Our experts will discuss with you whether further examinations are necessary.
- Hormone therapy: If you are considering hormone treatment with testosterone, it would be ideal if this had already commenced 6 - 12 months prior to the surgery. However, this is not a mandatory criterion!
4. Which top surgery techniques do we offer?
The choice of the appropriate surgical method for the breast alignment operation is crucial and depends on the shape and size of the existing breast. In this procedure, the breast gland is always completely removed ("mastectomy"). Additionally, excess fatty tissue and skin can be reduced. In certain cases, the nipple along with the areola is reduced in size or its position is altered, that is, elevated.
For a smaller breast volume, the "keyhole" method is often suitable, where a periareolar incision on the underside of the nipple combined with liposuction is performed to achieve a permanent flat chest shape.
For voluminous breasts with tight skin, a mastectomy with a circular cut around the nipple, with circular tightening of the skin envelope around the nipple combined with liposuction can be carried out.
For a voluminous breast with low-standing nipples and noticeable skin excess, a horizontal cut in the breast crease is necessary. Here, the nipples are reduced in size and repositioned above the scar. At the patient's request, the nipple graft can also be omitted. With this procedure, the breast can be permanently shaped flat. The scars are located in the breast fold and are usually inconspicuous after complete maturation.
If the goal is a more feminine breast shape with significantly reduced volume, we can surgically create a flat but still "feminine" recognizable chest shape (known as non-flat top surgery). An inverted T-shaped scar is used to shape the breast as desired. The goal of this technique is to achieve a small, tight breast, without the need to wear bras or binders in everyday life.
The procedure is performed under general anesthesia and usually takes 1.5-2 hours. A hospital stay of 1 to 5 days is common. Postoperatively, compression clothing should be worn for at least 6 weeks and physical activities such as sports should be avoided.
5. What are the risks and complications of the procedure?
Every surgical procedure carries risks, and it's important that you are aware of these to make an informed decision. The main risk of this procedure is the possibility of a surgically relevant hemorrhage. This refers to the accumulation of blood in the surgical area, usually occurring within the first 48 hours post-operation. In such cases, often another surgical procedure is required to remove the blood clot. Thanks to the continuous optimization of our surgical techniques, we have been able to reduce the probability of this risk to less than 1%.
Complications can also arise with wound healing or scar formation. Most of the time, such problems can be treated without the need for further surgery. However, in some cases, minor corrective procedures are necessary to ensure an aesthetically pleasing and satisfying result.
6. Which patients can we currently offer this procedure to?
As we operate in private practice and provide care for our patients in a private clinic, the care of patients with statutory health insurance is currently only possible after individual application submission and corresponding approval by their health insurance company.
For patients from abroad, we cannot generally make any statements as to the extent to which their health insurance companies in their home country may cover the costs.
Privately insured patients and self-pay patients are always welcome to receive care in our partner clinic. In this case, feel free to arrange your individual consultation in our practice for further information.
Schedule Your Consultation Now
Are you interested in learning more about Top Surgery? We are ready to answer all your questions in an initial consultation in Düsseldorf. Simply call us on +49 211 87630240
or use our convenient online appointment scheduler.
7. Aftercare & healing after a mastectomy
To alleviate pain and swelling, you will wear a compression vest for six weeks after the mastectomy. This mainly supports the retraction of the skin and alleviates the normal postoperative swelling, which helps to form a flat and even contour.
For the removal of dressings and suture material, we will provide you with corresponding check-up appointments in our practice or in our video consultation. In addition, we will provide you with a detailed written instruction in case you would like to have these steps carried out by your general practitioners.
Please refrain from sports and lifting heavy loads for 4 - 6 weeks. Mechanical stimuli in the upper body area can lead to the formation of seromas, which are accumulations of wound fluid in the wound cavity. For optimal scar care, we will provide you with precise instructions during the follow-up appointments. The final result of the surgery can only be assessed three months later, during the final check-up.
8. Cost and financing of top surgery
The cost of the treatment is based on the complexity of the surgical procedure chosen for you and ranges between 5,500 and 7,000 euros. We will provide you with a cost estimate, which, in addition to the medical fees, also includes the cost of the hospital stay, medical material costs, use of the operating room as well as inpatient nursing care, meals, and accommodation.
For additional costs not listed in our cost estimate, the expenses for anesthesia, any applicable flight and travel costs, and the accommodation of accompanying individuals must be taken into account.
Currently, financing options through our financing partners are only available for patients with German residence and a steady income.
