This piece is a part of In Transit, our sequence exploring the ins and outs of transitioning — and the way trans and nonbinary individuals outline it for themselves.

My binder was by no means tight sufficient for me. I struggled to place it on each morning, like a snake attempting to wriggle again right into a shed pores and skin. It was surgical-grade, ultra-thick elasticized cotton that smashed my breasts into flesh patties towards my ribcage, however it did not make the issue go away. I tugged and fussed, checking myself from the facet within the mirror. It doesn’t matter what I did, my breasts had been nonetheless there. Once I peeled the sweaty garment off hours later, they’d be ready for me — and I could not stand them. I used to be conscious of gender dysphoria, however the fixed, nagging irritation of my breasts was insufferable.

Late at night time, I’d comb by photos of ladies who’d undergone double mastectomies, their scarred chests adorned with tattoos, flowers, and empowering phrases. I felt responsible for wanting what that they had — or, slightly, what they did not have. Life with no binder appeared like a dream come true. However as a result of I wasn’t a most cancers affected person, a mastectomy wasn’t in my future. High surgical procedure, nevertheless, was an possibility: a dramatic reshaping of the chest that might assist me to create an aesthetic extra aligned with my desired gender expression or identification.

Within the Venn diagram of chest reshaping procedures, the overlap between the 2 surgical procedures is important. For me, high surgical procedure meant life in a physique that felt proper, finally. No binder wanted.

Photographer: Sire Leo Lamar

Mastectomy vs. High Surgical procedure: What is the Distinction?

In the event you’re a transgender or nonbinary affected person whose gender dysphoria is exacerbated by the presence of breast or chest tissue, you is perhaps considering your subsequent transfer. Mastectomies are extra broadly identified than high surgical procedure, making them a tempting path to eliminating your breasts. However this is not essentially the process that may enable you attain the look you need.

Whole Mastectomy

With a complete mastectomy, all of the breast tissue is eliminated, from the latissimus, to the armpit’s inframammary fold, all the best way as much as the clavicle, based on Tina Jenq, a board-certified plastic surgeon on the Oregon Beauty and Reconstructive Clinic. The strategy of this specific surgical procedure leaves thinner pores and skin flaps and a concavity on the lateral chest and might imply the overall removing of the areola, which some individuals change with tattoos.

High Surgical procedure

For these with gender dysphoria who’re contemplating surgical procedure, high surgical procedure is commonly extra in step with their aesthetic targets, because the method prevents the facet concavity and leaves some tissue that fills out the shadow or little fold in that space. Jenq says that, in contrast to mastectomy, the nipple and areola and their nerve constructions are sometimes retained with this process, although that is as much as the affected person.

The place the Two Overlap

A mastectomy might be part of high surgical procedure, however not each high surgical procedure is a full mastectomy. Generally used to deal with or forestall most cancers, mastectomy refers back to the removing of breast tissue. The sort of surgical procedure accomplishes three issues: altering the form and dimension of the chest’s pores and skin envelope, altering the situation of the nipple or areola, and eradicating breast tissue.


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