Chest masculinization surgery is, for many trans people, an important step in their transition. It is often not just an aesthetic intervention but one with a deep impact on identity, self-esteem, and daily life. While not all trans people choose to undergo gender-affirming surgery, many see chest masculinization as essential to feeling in harmony with their bodies. In today’s article, we explain all the details about chest masculinization: what it is, what it involves, the different surgical techniques, and recovery.
What is chest masculinization in trans people?
Chest masculinization consists of modifying the shape of the chest to align it with a person’s gender identity. Its goal is to harmonize the torso with the experienced gender identity while respecting body proportions to achieve a natural result.
In Spain, this surgery is performed under the highest medical standards, in an inclusive social and legal context that recognizes the rights of trans people. Generally, no mental health assessment is legally required for adults to undergo this surgery.
This surgery is also known as trans mastectomy or male chest surgery. It is primarily sought by trans men, but it is also the most requested gender-affirming surgery among non-binary people assigned female at birth.
Chest masculinization in trans men and non-binary people
As mentioned, bilateral mastectomy is the most requested surgery among trans men and non-binary people assigned female at birth. It is often the first surgery that allows them to adapt their bodies to their gender identity.
Main techniques of trans mastectomy
Trans mastectomy is a gender-affirming surgery that removes the mammary gland and reshapes the chest to achieve a flat appearance that is aesthetically masculine. It is not only about removing breast tissue but also about redesigning the chest contour, adjusting the skin to the new shape, and adapting the areolas and nipples to proportions considered masculine.
It is perhaps the most requested gender-affirming surgery among trans men and non-binary people assigned female at birth.
There is no single surgical technique for mastectomy. The choice depends mainly on chest size, the amount of excess skin, skin elasticity, and the person’s goals. The main techniques are:
Periareolar technique
An incision is made around the areola to remove breast tissue. It is indicated for patients with small chests and good skin elasticity. The scar is hidden along the areolar border.
Double horizontal incision technique
The most common technique for large chests or those with excess skin. It involves a horizontal incision under the pectoral muscle, allowing removal of tissue, fat, and skin. It also includes reduction and repositioning of the areolas and nipples to a masculine size and position.
Minimal periareolar technique with Vaser lipo and radiofrequency (IM GENDER)
For small chests with good elasticity, IM GENDER offers an innovative procedure that combines Vaser lipo to remove breast fat through a minimal incision (which can be made in the armpit) with radiofrequency. Radiofrequency waves help the skin retract and adhere to its new position, resulting in a smooth, masculine torso. The incision is minimal, and through the periareolar approach the mammary gland is removed, leaving virtually unnoticeable scars.
This combination has the advantage of being minimally invasive, with more comfortable postoperative recovery and faster healing.
Recovery after chest masculinization surgery
Postoperative care after trans mastectomy is essential to ensure proper recovery, minimize complications, and promote good healing. By following medical recommendations, most patients can gradually and safely return to daily life. The main postoperative guidelines are:
- Maintain relative rest during the first days, avoiding strain and sudden movements.
- Care for the surgical drains, usually removed within 24–48 hours.
- Wear a compression garment for several weeks to reduce swelling and bruising, and help the skin adapt to the new contour.
- Keep scars clean, avoid direct sun exposure, and do not wet the area until authorized by the surgeon.
- Follow instructions for silicone creams or patches to improve scar healing.
- Sleep preferably on the back to protect the operated area.
- Avoid upper body strain during the first 4–6 weeks.
- Begin physical therapy between the second and third week with gentle exercises to restore shoulder and arm mobility.
- Take prescribed medication to control pain.
- Attend regular check-ups, which are essential for monitoring recovery and detecting complications.
Emotional and social impact of chest surgery
Chest masculinization is one of the most requested gender-affirming surgeries due to its impact on quality of life for those who undergo it. The most common reasons include:
-
- It may reduce gender dysphoria, especially in daily life and in how one relates to clothing and their body.
- It improves self-esteem and personal confidence, promoting psychological and emotional well-being.
- It allows many people greater social integration, as they feel their body better matches their gender identity.
Spain has become an international reference for this type of surgery thanks to highly specialized teams such as IM GENDER. Moreover, the social and legal context ensures that trans people do not need psychological health certificates to access these surgeries.
If you are considering taking this step in 2025, remember that you are not alone: you will have the support of an experienced team with international accreditations and comprehensive care at every stage of the process.
If you want more information about chest masculinization surgery or other gender-affirming procedures,
contact the IM GENDER team for a personalized assessment.
