Professor Ben Miranda | Leading Plastic & Cosmetic Surgeon in London & Essex
FTM & MTF Gender-Affirming Breast & Chest Surgery
Professor Ben Miranda provides Top Surgery in the UK for transgender patients. This may include breast or chest surgery as part of gender affirmation.
Top Surgery can involve different procedures.
Female-to-Male Top Surgery (FTM Top Surgery) aims to create a flatter, more masculine chest. Male-to-Female Top Surgery (MTF Top Surgery) aims to create or enhance a more feminine breast shape.
For some patients, concerns about the chest or breasts may be associated with gender dysphoria. Surgery is a personal decision. The appropriate approach depends on individual anatomy, medical history and goals.
Professor Miranda will assess the chest or breasts and listen to the changes the patient would like to achieve. He will then explain whether Gender-Affirming Breast Surgery or Gender-Affirming Chest Surgery may be suitable.
What Is Top Surgery?
Top Surgery is a term used to describe breast or chest surgery performed as part of gender affirmation.
The type of surgery depends on the changes the patient would like to achieve.
For patients seeking a more masculine chest, surgery may involve removing breast tissue and reshaping the chest.
This may be described as FTM Top Surgery, Female-to-Male Top Surgery, Chest Masculinisation Surgery, Masculinising Top Surgery, Gender-Affirming Mastectomy or Gender-Affirming Chest Surgery.
For patients seeking a more feminine breast shape, treatment may be described as MTF Top Surgery or Male-to-Female Top Surgery. MTF Breast Augmentation and Gender-Affirming Breast Surgery are also used terms.
Different terms may be used for these procedures. The important points are the change the patient would like to achieve and the approach that may be suitable.
FTM Top Surgery and Chest Masculinisation Surgery
FTM Top Surgery, also known as Female-to-Male Top Surgery, aims to create a flatter, more masculine chest.
The operation may involve removing breast tissue and excess skin before reshaping the chest. The nipple and areola may also need to be resized or repositioned, depending on the anatomy and technique used.
Chest Masculinisation Surgery is planned around the overall shape and proportions of the chest, not tissue removal alone.
Factors that may influence the surgical plan include:
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Breast volume
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Chest width and shape
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Skin quality and elasticity
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The amount of excess skin
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The size and position of the nipple and areola
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Existing asymmetry
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The shape the patient would like to achieve
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The likely position and length of scars
The choice of technique depends on anatomy and the agreed goals. The same operation is not suitable for every patient.
Surgical Techniques for FTM Top Surgery
Recognised approaches include double-incision mastectomy, keyhole mastectomy and peri-areolar mastectomy. Liposuction may sometimes be combined with another technique to refine the shape of the chest.
Double-Incision Top Surgery
Double-incision surgery removes breast tissue through incisions across the chest. Excess skin may also be removed.
Where appropriate, the nipple and areola can be resized and repositioned, including through free nipple grafting.
This approach may be considered for patients with a larger chest or reduced skin elasticity. Nipple grafting can result in reduced or complete loss of nipple sensation.
Keyhole Top Surgery
Keyhole surgery may be considered for selected patients with a smaller chest and good skin elasticity.
Tissue is removed through a relatively small incision, usually at the edge of the areola. Little or no excess skin is removed, so the skin must be able to contract well.
Peri-Areolar Top Surgery
Peri-areolar surgery removes tissue through an incision around the edge of the areola, the darker area of skin surrounding the nipple. It can also allow some skin tightening.
It may be appropriate for selected patients with moderate breast volume and good skin elasticity.
Professor Miranda will assess the chest during consultation and explain which surgical options may be appropriate.
MTF Top Surgery
MTF Top Surgery, or Male-to-Female Top Surgery, may involve surgery to create or enhance a more feminine breast shape.
For suitable patients, this may involve breast implants and may also be described as MTF Breast Augmentation.
Professor Miranda already performs breast implant surgery as part of his cosmetic breast practice. In selected patients, fat transfer may also be considered for breast reshaping.
The surgical plan may take account of:
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Chest width
-
Existing breast volume
-
Skin and soft-tissue coverage
-
Breast shape and symmetry
-
Implant size, profile and position
-
Nipple and areola position
-
Body proportions
-
The changes the patient would like to achieve
The aim is to plan surgery around the individual patient and the agreed goals.
Breast Implant Position
In Professor Miranda’s existing breast augmentation practice, implants may be placed beneath the breast or beneath the chest muscle. A combination of both positions may also be used.
The appropriate position depends on chest dimensions, available soft-tissue coverage and the intended result. Implant selection and position will be discussed after assessment.
MTF Top Surgery, or Male-to-Female Top Surgery, may involve surgery to create or enhance a more feminine breast shape.
For suitable patients, this may involve breast implants and may also be described as MTF Breast Augmentation.
Professor Miranda already performs breast implant surgery as part of his cosmetic breast practice. In selected patients, fat transfer may also be considered for breast reshaping.
The surgical plan may take account of:
-
Chest width
-
Existing breast volume
-
Skin and soft-tissue coverage
-
Breast shape and symmetry
-
Implant size, profile and position
-
Nipple and areola position
-
Body proportions
-
The changes the patient would like to achieve
The aim is to plan surgery around the individual patient and the agreed goals.
Who May Be Suitable for Top Surgery?
MTF Top Surgery, or Male-to-Female Top Surgery, may involve surgery to create or enhance a more feminine breast shape.
For suitable patients, this may involve breast implants and may also be described as MTF Breast Augmentation.
Professor Miranda already performs breast implant surgery as part of his cosmetic breast practice. In selected patients, fat transfer may also be considered for breast reshaping.
The surgical plan may take account of:
-
Chest width
-
Existing breast volume
-
Skin and soft-tissue coverage
-
Breast shape and symmetry
-
Implant size, profile and position
-
Nipple and areola position
-
Body proportions
-
The changes the patient would like to achieve
The aim is to plan surgery around the individual patient and the agreed goals.
Top Surgery may be considered by transgender patients who would like to change the appearance of their chest or breasts as part of gender affirmation. For some patients, this may be related to gender dysphoria.
Professor Miranda will consider the patient’s goals, chest or breast anatomy, general health and relevant medical history. Previous surgery, current medication, expectations, potential risks and limitations will also be reviewed.
The appropriate procedure and surgical technique will be based on an individual assessment.
Top Surgery Consultation with Professor Ben Miranda
MTF Top Surgery, or Male-to-Female Top Surgery, may involve surgery to create or enhance a more feminine breast shape.
For suitable patients, this may involve breast implants and may also be described as MTF Breast Augmentation.
Professor Miranda already performs breast implant surgery as part of his cosmetic breast practice. In selected patients, fat transfer may also be considered for breast reshaping.
The surgical plan may take account of:
-
Chest width
-
Existing breast volume
-
Skin and soft-tissue coverage
-
Breast shape and symmetry
-
Implant size, profile and position
-
Nipple and areola position
-
Body proportions
-
The changes the patient would like to achieve
The aim is to plan surgery around the individual patient and the agreed goals.
The consultation is an important part of planning Top Surgery in the UK.
Professor Miranda will assess the chest or breasts, listen to the patient’s concerns and discuss the changes they would like to achieve. He will also review the relevant medical and surgical history.
For FTM surgery, the assessment may include breast volume, chest shape, skin elasticity and excess skin. Nipple and areola position, asymmetry and the likely scar pattern may also be reviewed.
For MTF surgery, the assessment may include chest dimensions, existing breast volume, soft-tissue coverage and breast proportions. Implant options and positioning may also be discussed.
He will explain whether surgery may be suitable and what may realistically be achieved. The proposed approach, likely scars, recovery and potential risks will also be discussed.
Patients are encouraged to ask questions and understand the proposed treatment before making a decision.
There is no obligation to proceed, and no decision needs to be made on the day.
Top Surgery Results and Scars
MTF Top Surgery, or Male-to-Female Top Surgery, may involve surgery to create or enhance a more feminine breast shape.
For suitable patients, this may involve breast implants and may also be described as MTF Breast Augmentation.
Professor Miranda already performs breast implant surgery as part of his cosmetic breast practice. In selected patients, fat transfer may also be considered for breast reshaping.
The surgical plan may take account of:
-
Chest width
-
Existing breast volume
-
Skin and soft-tissue coverage
-
Breast shape and symmetry
-
Implant size, profile and position
-
Nipple and areola position
-
Body proportions
-
The changes the patient would like to achieve
The aim is to plan surgery around the individual patient and the agreed goals.
The intended result depends on whether masculinising or feminising surgery is being performed.
For Chest Masculinisation Surgery, the aim is generally to create a flatter and more masculine chest.
For MTF Top Surgery, the aim is to create or increase breast volume. The planned shape should also be proportionate to the patient’s frame.
Surgical results vary between patients, and no specific outcome can be guaranteed.
Scars After MTF Top Surgery
In Professor Miranda’s existing breast augmentation practice, implants are commonly inserted through an incision within the natural fold beneath the breast.
Other approaches may be considered according to the individual patient’s requirements.
All surgical procedures produce scars. Their position and final appearance vary between patients, and scars cannot be made completely invisible.
Scars After FTM Top Surgery
The scar pattern following Gender-Affirming Mastectomy depends on the technique used.
Double-incision surgery involves longer incisions across the chest. Keyhole and peri-areolar approaches use more limited incisions but are suitable only for selected patients.
If the nipple and areola need to be repositioned or grafted, the final scar pattern may change. Nipple sensation may also be affected.
Risks, Limitations and Possible Complications
All surgery carries potential risks.
Possible complications of breast or chest surgery can include:
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Bleeding or haematoma
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Infection
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Pain
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Delayed wound healing
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Noticeable or problematic scarring
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Asymmetry
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Changes in sensation
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Changes affecting the nipple or areola
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Contour irregularity
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The possibility of further surgery
Additional risks depend on the procedure performed. For example, masculinising surgery involving a free nipple graft can result in reduced or complete loss of nipple sensation.
Breast implant surgery has additional risks, including capsular contracture, implant rupture and the possibility of further surgery. These will be discussed during the consultation.
There are also limitations to what surgery can achieve, and the final result may differ from the patient’s expectations.
Professor Miranda will explain the risks and limitations relevant to the proposed operation before the patient decides whether to proceed.
Recovery and Aftercare Following Top Surgery
Recovery depends on the type and extent of surgery performed.
Patients may experience swelling, bruising, tightness or discomfort following breast or chest surgery. Dressings and a supportive or compression garment may be required depending on the procedure.
Post-operative advice may include:
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Wound and dressing care
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Support or compression garments
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Showering and sleeping position
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Driving and returning to work
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Exercise and heavy lifting
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Scar care
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Follow-up appointments
Recovery varies between patients. Professor Miranda will provide advice based on the individual operation and the patient’s progress.
How Much Does Top Surgery Cost in the UK?
The cost of Top Surgery in the UK depends on the operation required and the individual surgical plan.
FTM and MTF procedures are different. Costs may vary with the type and complexity of surgery, the technique used, hospital and theatre requirements, anaesthetic requirements and breast implants where needed.
An accurate fee can only be provided after the patient has been assessed. The proposed treatment plan also needs to be discussed.
The full cost will be confirmed following consultation once an individual treatment plan has been agreed.
MTF Top Surgery, or Male-to-Female Top Surgery, may involve surgery to create or enhance a more feminine breast shape.
For suitable patients, this may involve breast implants and may also be described as MTF Breast Augmentation.
Professor Miranda already performs breast implant surgery as part of his cosmetic breast practice. In selected patients, fat transfer may also be considered for breast reshaping.
The surgical plan may take account of:
-
Chest width
-
Existing breast volume
-
Skin and soft-tissue coverage
-
Breast shape and symmetry
-
Implant size, profile and position
-
Nipple and areola position
-
Body proportions
-
The changes the patient would like to achieve
The aim is to plan surgery around the individual patient and the agreed goals.
Why Choose Professor Ben Miranda?
Choosing a surgeon for Gender-Affirming Breast Surgery or Gender-Affirming Chest Surgery is an important decision.
Professor Ben Miranda is a Consultant Plastic Surgeon who has been listed on the GMC Specialist Register for Plastic Surgery since 2018. He holds the FRCS(Plast) qualification and is a member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).
He completed further specialist training in cosmetic surgery at The Wellington Hospital, The London Clinic and King Edward VII Hospital.
Professor Miranda also holds a PhD and has a strong academic interest in plastic surgery. He has more than 120 published journal papers, features, books and national and international presentations, including peer-reviewed research.
His specialist interests include Cosmetic Surgery, Breast Surgery and Body Contouring. His cosmetic practice includes breast augmentation, breast reduction, breast uplift, breast implant removal or replacement and gynaecomastia surgery.
His existing cosmetic surgery service also includes mastectomy for gender surgery.
He performs consultations personally and plans treatment around each patient’s medical history, concerns and individual needs.
During the consultation, he will explain what may be achievable, how surgery may be performed, the likely recovery, potential limitations and risks before the patient decides whether to proceed.
Frequently Asked Questions About Top Surgery UK
What is FTM Top Surgery?
FTM Top Surgery, or Female-to-Male Top Surgery, aims to create a flatter, more masculine chest. It may also be described as Chest Masculinisation Surgery, Masculinising Top Surgery or Gender-Affirming Mastectomy.
What is MTF Top Surgery?
MTF Top Surgery, or Male-to-Female Top Surgery, refers to surgery intended to create or enhance a more feminine breast shape. For suitable patients, this may involve MTF Breast Augmentation using breast implants.
Is Gender-Affirming Mastectomy the same as Chest Masculinisation Surgery?
The terms are closely related, but they do not mean exactly the same thing. Gender-Affirming Mastectomy refers to the removal of breast tissue, while Chest Masculinisation Surgery also considers the overall shape and contour of the chest.
Skin, chest shape and the size and position of the nipple and areola may also form part of surgical planning.
What techniques can be used for FTM Top Surgery?
Options can include double-incision, keyhole or peri-areolar techniques, sometimes with liposuction. The most appropriate option is discussed during consultation.
What is Gender-Affirming Breast Augmentation?
It is breast augmentation performed as part of feminising surgery. For suitable patients, implants may be used to create or increase breast volume and develop a more feminine shape.
Does MTF Top Surgery always involve breast implants?
Breast implants are one option for increasing breast volume. Professor Miranda’s existing cosmetic breast practice also includes fat transfer in selected patients. The appropriate treatment requires individual assessment.
Can Top Surgery form part of treatment for gender dysphoria?
For some patients, surgery may form part of their care. Whether it may be suitable depends on the individual and should be discussed as part of a clinical assessment.
Will there be scars after Top Surgery?
Yes. All breast and chest surgery produces scars. Their position and length depend on the operation and technique used. The anticipated scar pattern will be discussed during consultation.
Where does Professor Ben Miranda provide Top Surgery consultations?
Professor Miranda provides private cosmetic surgery consultations in London and Essex. His existing cosmetic surgery service also lists mastectomy for gender surgery among the procedures within his practice.
Book a Top Surgery Consultation
Patients considering Top Surgery in the UK can arrange a consultation with Professor Ben Miranda. The appointment can be used to discuss masculinising or feminising breast and chest surgery.
Professor Miranda will assess the relevant anatomy and listen to the changes the patient would like to achieve. He will then explain whether surgery may be suitable.
The consultation provides an opportunity to understand the proposed procedure, likely scars, recovery, limitations and potential risks before making a decision.