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Female-to-male top surgery and non-binary top surgery are gender-affirming surgeries. They take a female chest and transform it into a male or flat one. This can help treat gender dysphoria, contribute to a safer environment for the patient, and prevent injuries from unsafe binding practices, among other benefits. The majority of top surgeries in the United States are performed on adults. However, many teenagers also seek top surgery to better match their identities.
Unfortunately, in many states, this is met with complete bans on minor FTM top surgery and others have extreme requirements or poor gender care. Dr. Javad Sajan at Allure Esthetic Plastic Surgery in Seattle, WA welcomes patients from around the US including minors and adults.
Can Minors Get Masculinizing Top Surgery?
Yes, however, this answer will vary from state to state. In Washington State, minors can seek gender affirming care, including FTM top surgery. Like any surgery candidate, they must be in relatively good health and be a good candidate for general anesthesia. Allure Esthetic often requires additional documentation when a minor seeks a gender affirming surgery, even though Washington State does not necessarily require it.
All surgery centers and hospitals have certain requirements that minors must meet in order to have surgery. Some require that the patient has lived in their identity for a year, or that they have started or are currently on hormone therapy. The specific requirements will vary between offices and centers.
What Does The Process Look Like?
At Allure Esthetic Plastic Surgery, the process of undergoing FTM surgery for a minor generally starts with a consultation. One parent or guardian is required to attend all appointments, including the consultation.
FTM Top Surgery Consultation With Dr. Sajan
At a private consultation, the patient and their guardian will meet with Dr. Sajan. He will ask about the patient’s specific identity, gender dysphoria symptoms, reasons for seeking out the surgery, and their desired outcome. He will evaluate the patient’s medical history and perform a physical examination to determine if the patient is a good candidate for the procedure. Dr. Sajan uses medical history and WPATH guidelines to determine if a patient under eighteen is a candidate for FTM top surgery.
Dr. Sajan and the Allure Esthetic team will also discuss the next steps and how to proceed with scheduling surgery if the patient so chooses. If the patient plans to utilize insurance, they are likely already in contact with our insurance team. Otherwise, the insurance team will reach out. Depending on your medical history, Dr. Sajan may request medical clearances. Though, for minors, this is less common than in adult patients.
Letters Of Support & Parental Consent
For minor top surgery patients, Dr. Sajan usually requests a letter of support from a mental health professional. If they already see a mental health provider, this is not usually a problem. Though, if the patient does not currently see a mental health professional, you may need to see one—for at least one appointment—to receive an adequate letter of support.
Mental health evaluation is one of the differences between minor top surgery and adult top surgery. Children who show gender dysphoria sometimes do not experience it in adulthood. With that said, if puberty begins or the patient is seeing continued feelings of gender dysphoria or different gender identity in their mid-to-late teens, a mental health professional will evaluate them and likely provide the letter.
In Washington, minors aged thirteen and above do not need parental consent to proceed with gender affirming care. However, each clinic may make its own determination. Dr. Sajan encourages parents to be involved whenever possible.
Insurance & Pre-Authorization
Our insurance team is here to support our patients from consultation onward. Upon confirming that Allure Esthetic accepts the patient’s insurance for transgender procedures, they may start the process of getting a pre-authorization. This is essentially the insurance company agreeing that the surgery is medically necessary and meets the criteria. This often means they will pay for most, if not all, of the surgical cost.
The insurance coordinators will also discuss whether there may be any out-of-pocket costs. Depending on the insurance plan, patients may be required to pay copays for certain services or appointments. Unfortunately, we cannot predict how much insurance will cover. If something unexpected happens, our insurance coordinators work with patients and the insurance company to help get it settled quickly. Most of the time, this is not a problem.
Minors are generally on their parent or guardian’s insurance plan and it usually works just like a regular insurance plan. However, the process can sometimes take longer for patients who are minors.
FTM Top Surgery
The top surgery itself works similarly to one performed on an adult. After getting prepped for surgery and meeting with Dr. Sajan for surgical markings, the patient will then be placed under general anesthesia. Top surgeries are completed in around one hour. Some cases can take longer if extensive liposuction is involved or if the patient has a lot of excess breast tissue.
Some minor patients may be candidates for a keyhole top surgery. This surgery does not involve repositioning the nipples. Instead, it requires a small incision near the areola. A candidate for this procedure must have a very small amount of breast tissue and good skin laxity. Skin laxity is better in younger people. As such, more minors and young adults may be candidates for a keyhole top surgery with Dr. Sajan.
Frequently Asked Questions
Why Go Through A Private Surgery Clinic For Transgender Surgery?
A private, outpatient surgery center like Allure Esthetic, offers many benefits to transgender patients seeking top surgery. Getting surgery scheduled at a hospital or specialist clinic can take months up to a few years. FTM top surgery patients can get their surgery scheduled at our facility sooner than if they went through a large hospital or gender clinic.
Dr. Sajan also performs a very high volume of top surgeries. This makes him among the best surgeons for top surgery in the country. His experience has allowed him to refine his techniques. He can offer customization options that are often not available outside of Allure Esthetic.
What FTM Top Surgery Techniques Are Available For Minors?
All chest masculinization surgery techniques are available to minor patients. These techniques include the double incision, the keyhole incision, and although rare just by liposuction alone. The double incision chest reconstruction surgery involves a surgical technique known as a “free nipple graft.” This involves taking the nipple off the chest and reattaching it onto the chest with ideal size and positioning.
Non-binary or gender non-conforming patients sometimes choose not to have nipples on their new chest. In cases like these, the free nipple graft technique is not needed and the traditional top surgery technique is continued from there.
Can You Take Out Of State Insurance?
It depends. Sometimes, we are able to bill out-of-state health insurance out of network. Patients are also welcome to pay out of pocket or seek out other financing options regardless of if they have insurance or not.
How Much Is Top Surgery Out Of Pocket?
At Allure Esthetic, the price of top surgery will vary based on the type of top surgery and other factors. The starting cost of FTM top surgery at Allure Esthetic is $8,500.
Can You Get FTM Top Surgery Without Testosterone?
For transmen and non-binary people seeking the removal of their breasts, being on hormones is not necessary. If a patient is on testosterone, that is perfectly fine. Patients do not need to stop hormones before surgery as long as they have no other comorbidities.
Dr. Sajan Performs The Best FTM Top Surgery For Minors
Dr. Javad Sajan is a world-renowned plastic surgeon who has performed hundreds of top surgeries for transgender, nonbinary, and agender people. He works with the patient to create their perfect chest by giving them three incision shape options. He often uses liposuction to sculpt the chest to the patient’s existing body contours. Dr. Sajan also offers his proprietary scar system, Scar Protocol, to help reduce scarring over the first year of healing.
Allure Esthetic welcomes transgender and gender-nonconforming patients to our office. Our staff is trained to use your correct name and pronouns at all times. They are compassionate, friendly, and supportive of all patients who trust Dr. Sajan and Allure Esthetic with their gender affirming care.
To learn more and schedule a consultation, call us at 206-209-0988. You can also reach out directly via email at contactus@allureesthetic.com. Chat, contact form, and Price Simulator options are available on our website.