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Mastectomy

The path to your
desired breast shape

Medically reviewed by: Dr. med. Timo Spanholtz
Specialist in Plastic and Aesthetic Surgery | Medical Director

A flat, masculine or neutrally contoured chest is an important step for many trans* men  and some non-binary people to alleviate dysphoria.

At the Praxisklinik am Rosengarten, we use state-of-the-art surgical techniques to achieve this goal safely and with high aesthetic standards.

Schedule an appointment with our experts

Which surgical technique is right for me?

This is the most common question in our consultations. The answer depends largely on your anatomy. Our teams in Bergisch Gladbach near Cologne and in Hamburg master all common techniques:

The periareolar incision
(The "small" method)

This technique is possible when only a small amount of breast gland tissue needs to be removed and the skin is elastic enough to retract on its own (shrinkage potential).
  • Advantage:
    Minimal scars, often only at the edge of the areola. Sensitivity of the nipple is usually preserved.
  • Disadvantage:
    Not suitable for larger cup sizes.
The periareolar incision

(Image generated by AI)

The Double Incision with free nipple grafting
(The "large" method)

With a lot of excess skin or a larger breast, this is the safest way to achieve a flat contour. Here, two horizontal incisions are made (usually in the breast fold), the tissue is removed, and the nipple is reduced and repositioned.
  • Advantage:

    We can completely reshape the chest and precisely determine the position of the nipples.

  • Disadvantage:
    Visible scars remain, but they fade over time and often lie within the area of the pectoral muscle shadows.
Double Incision with free nipple grafting

(Image generated by AI)

What about
Non-Binary patients?

Not everyone wants a typically "male" chest. If you identify as non-binary, we will discuss individually what your desired result looks like. We listen to you.

Frequently asked questions about Mastectomy

We are happy to answer your questions about the treatment here.

Do I need to take testosterone for the mastectomy?

No, this is not a medical requirement. We also operate on patients who do not wish to undergo hormone therapy or who identify as non-binary. However, if you take testosterone, this is often an advantage: The chest musculature develops more strongly, which helps us to align the incision precisely with the natural muscle contour.

When can I do sports again after a mastectomy?
  • Week 1–2: Rest.
  • Week 4–6: Light activity, but no arms above the head.
  • After 6–8 weeks: Start with fitness/jogging.
  • Chest muscle training: Only after full healing, to avoid stretching the scars.
What are "Dog Ears" in connection with mastectomy and how can they be prevented?

These are small excesses of skin at the outer ends of the scar under the armpits. We use special techniques to avoid them. Should they occur nonetheless, we can correct them later in a minor procedure (under local anesthesia).

Will I still have sensation in my nipples after the mastectomy?

That largely depends on the method.

With the small incision (Semicircular/Periareolar), the pedicle to the nipple is preserved, which is why sensitivity often remains very good.

With the large incision (Double Incision) involving a free nipple graft, the nerves are severed. Erogenous sensation is usually lost, but a rough sense of touch often returns a few months after the mastectomy.

How visible will the scars be after the mastectomy?

Every surgery leaves traces. With the Double Incision technique, we place the incisions as much as possible in the shadow of the chest muscle, so that they later appear like a natural contour. Scar maturation takes up to a year – with good care (silicone patches, massage) they usually fade very well.

How strong is the pain after Top Surgery?

Many patients are surprised that the pain is often less than expected (similar to severe muscle soreness). You will of course receive pain medication. Wearing the compression vest and sleeping on your back are often perceived as more bothersome.

Schedule an appointment

Get a non-binding consultation about mastectomy now. We will clarify all open questions and talk about your desired change.

Completely without pressure, completely non-binding, and above all on an equal footing and without prejudice!