Most, if not all, FTMs always dream of a perfect chest. Nothing beats running shirtless, feeling the wind whip on your skin. In that moment, you forget boundaries and feel like you can conquer the world.

When we snap back to reality, we realize that it is easy to say you want the “twins” out..but determining how is an entirely different prospect.

I’ve mentioned once or twice that the procedure I had is called peri-areolar mastectomy where the incision is done around the areola. The good things about this procedure would be keeping the nipple sensation, less to no visible scarring since the areola area is dark (and I produce dark scars) and much less overall trauma to the skin. The possible negatives would include no control over final nipple position, possible revisions and the sunken chest look where too much tissue is removed.

Please note that this is different from the keyhole type of surgery where in the incision is just below the nipple-areola complex

Luckily, due to the combination of the gym, healthy diet and T, I was able to downsize my chest a great deal thus qualifying for the procedure. I was a candidate for keyhole, however, I did not want to risk having extra loose skin due to binding previously. Since the peri-areolar method has a purse-string closure, it would “pull” the surrounding skin towards the center thus producing a tighter result. This is something that I discussed extensively with my surgeon to prevent future revisions.

So how would you know of qualify for the peri-areolar method? Based on the method by Dr. Scott Mosser, he bases his decision on the inframammary angle (the angle formed by the junction point below your breast). You can read all about it here but in a nutshell, if the angle falls between 90° to greater than135°, your are good with keyhole or peri-areolar. If the angle is less than 90°, then your best option is the double incision method where 2 incisions are made below the twins.


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