• Top surgery types


    Something I’ve been thinking about for a while – gathering together all the information I have about kinds of top surgeries you can have. I may fuck something up – so this post will be edited periodically.

    Double incision with nipple grafts

    This is the most common and most spoken about kind of surgery. It’s recommended for people with larger and saggier tits. During this surgery, the fat and the mammary glands are removed together with extra skin. You need to have your nipple removed and later reattached, because it ends up on the part of the skin that leaves your body. 

    This surgery can be good because it fits well with all body types, it’s possible to choose the position of the nipple and its size in advance, and you also have some choice when it comes to scar shape – one of the options includes having the scar follow the chest muscle shape, also referred to as muscle border incision. Its downsides include potential loss of nipple sensation and large visible scars. This surgery also achieves the most flat and tight end result.

    Double incision with nipples preserved

    A variant of the above, mostly for people whose nipples are positioned high enough (as in, their chest doesn’t sag as much), but there is still a lot of fat and skin tissue to be removed. The cuts are made diagonally on the outer sides of the tits.

    This surgery has way less complications with nipple sensation, but you don’t have any control over the nipple size. It’s also suitable for fewer body types.

    Inverted T (anchor)

    There is a horizontal cut, like in a classic double incision, plus a vertical cut connecting it with the nipple. One version of the surgery of this type preserves the nipple in its place, another includes nipple grafts.

    This type is suitable for large and saggy tits, like the standard double incision. It has better chances for nipple sensation if you don’t have nipple grafts, allows you the same control over nipple size, but somewhat less control over its position on the chest. The end result may also turn out less flat, which can be both an upside and a downside.


    Buttonhole incision is similar to inverted T, but lacks the vertical cut.

    As such, it has the same pros and cons in regards to nipples, is suitable for fewer body types, and results in less scarring.


    Fishmouth is a cut in the middle of the chest. Extra skin can be removed, nipple stays in place, but can be resized. 

    This surgery allows similar flatness to standard double incision, control over the size of the nipple, somewhat less nipple sensation than during buttonhole of inverted T. You will also end up with atypically positioned visible scars.


    This surgery includes two circular cuts around the nipple. The nipple itself stays in place, but may be resized, the extra skin and the tissue are removed from the area between the cuts, and the skin is later connected. This surgery is suitable for you if the angle between your breast while you’re standing upright and your body is between 110-145 degrees.

    This surgery is suitable for fewer bodies, but preserves nipple sensation better and creates less visible scars, because in the end they just go around the nipple.


    A variant of periareolar that includes a vertical cut under the nipple. 

    It allows to remove some more skin, but adds one more scar.


    This is possibly the minimal cut you can have that still allows the surgeon to remove all the tissue from the inside. It goes right under your nipple in a semicircle. You qualify for it if the angle your tit forms with your body is over 135 degrees. No skin is removed during this procedure, nipples aren’t resized or moved from their position. 

    This procedure has the smallest scarring, but is suitable for fewer people. Nipple sensation has a high chance to be preserved, but you don’t control nipple size or position. 

    In addition to that, in some cases when it is unclear whether keyhole will work out or no, it is possible to first receive keyhole and then have periareolar done later. Sometimes this surgery is considered a subtype of periareolar.

    Minimal scar

    This surgery resembles keyhole, but with an added cut to the side of the chest, that is also used to extract tissue. 

    In addition to all of the above, it is possible to have nipples removed completely. An optional next step after it is tattooing them on in a realistic fashion. Some surgeons also provide implants that imitate the amount of fat, typical for an average cis male chest.  


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