Top Surgery in Thailand: Chest Masculinization & Breast Reduction

Breast reduction or top surgery can be life-changing, offering relief from physical discomfort or aligning your body with your true identity.

For many, especially within the transgender community, this procedure is a vital part of gender-affirming care, supporting a transition from female to male.

Navigating this journey can feel overwhelming, but you’re not alone. Understanding your options, risks, and recovery process is key to making an informed decision.

In this guide, we’ll break down everything you need to know. We’ll explore different surgical techniques, address concerns like the long-term effects of binding, and highlight the latest advancements shaping top surgery in 2025.

Plus, we’ll break down the costs and explain why Rattinan Medical Center in Thailand stands out as the top choice for breast reduction surgery, combining world-class expertise with patient-centered care.

Breast reduction surgery is about more than appearance—it’s about comfort, confidence, and feeling at home in your body.

For some, it’s a key step in their gender-affirming journey, helping trans men and nonbinary individuals achieve a chest that aligns with their identity.

For others, it’s about relief. Overly large breasts can cause back and shoulder pain, discomfort, and self-consciousness. Surgery can ease these struggles while creating a more balanced, natural look.

While both procedures reduce breast size, their goals and techniques can differ.

Aesthetic breast reduction focuses on relieving discomfort, reshaping the breasts, and maintaining a natural, proportionate appearance. It may also include adjustments to the nipples and areola.

For gender-affirming surgery, often called top surgery, the goal is typically a flatter, more masculine chest. This may involve removing more breast tissue, repositioning or resizing the nipples, and contouring the chest for a masculine look.

Whatever your reason, this procedure is deeply personal. It’s not just about change—it’s about reclaiming your body and feeling like yourself again.

Review of laparoscopic breast surgery: No scars, hides wounds under the armpits By mefoy transtender

Before undergoing top surgery, it’s important to have a detailed consultation with a qualified doctor. This step ensures that the best surgical method is chosen based on factors like breast size, skin elasticity, and sagging.

Top surgery typically falls into two main categories:

1. Subcutaneous Surgery (Less Invasive Options)

These methods remove breast tissue while preserving as much natural skin structure as possible. They may be ideal for those seeking minimal scarring and a more subtle change.

• Areola-based surgery – A smaller incision around the areola for minimal scarring.
• Laparoscopic (Endoscopic) Surgery – A modern, advanced technique performed through the armpit using a small camera for precision.

2. Total Breast Amputation (More Extensive Surgery)

For those requiring complete breast removal, this method involves a longer incision and can include techniques to optimize chest aesthetics.

• Free nipple grafting – The nipple is removed, resized, and repositioned for a natural appearance.
• Nipple-preserving techniques – Keeping the nipple attached when possible, based on skin elasticity.

Every method has its unique considerations, and your doctor will work with you to determine the best approach. 

Book a free consultation with expert surgeons at Rattinan Medical Center, Bangkok to discuss any potential risks, expected outcomes, to ask questions, and gain clarity on the procedure, aftercare, and pricing.

Breast areola surgery is a deeply personal procedure that helps reshape the breasts, often as part of top surgery or breast reduction. It focuses on achieving a natural, proportionate appearance while minimizing visible scarring.

Understanding the Procedure

1. Incision Around the Areola
   A precise incision is made around the areola, carefully designed to provide access to the breast tissue. Depending on individual needs, the incision may extend vertically or horizontally.
2. Nipple Reduction (if desired)
   For those wanting a smaller nipple size, the procedure can include nipple reduction, ensuring a more balanced and natural result.
3. Reshaping Breast Tissue
   Through the incision, the surgeon removes or reshapes breast tissue to achieve the desired contour. The scar typically blends into the areola, making it less noticeable after healing.

Healing and Scarring

Scarring varies based on technique and individual healing, but the areola incision method keeps scars subtle. Many patients experience a smoother, more contoured chest with minimal visible scarring. Recovery is often quick, helping individuals feel more comfortable and confident in their bodies.

The areola incision method is an excellent option for individuals looking for precise breast reshaping with minimal scarring. This technique is particularly beneficial for those with specific breast characteristics, allowing for a natural-looking enhancement while maintaining the aesthetic balance of the areola and breast.

You may be an ideal candidate for this procedure if you:

• Have small breasts (A cup) with a large areola – This approach allows for discreet incisions and effective reshaping.
• Have medium-sized breasts (B cup) with a large areola – In these cases, the procedure can be used for both breast reduction and areola resizing, creating a more proportionate and balanced look.

Since everyone’s body is unique, a consultation with a qualified surgeon will help determine if this method is the best fit for your goals.

There are different incision techniques for top surgery, each designed to balance aesthetics, healing, and your personal goals.

Omega-Shaped Scar

This method creates an incision around the areola, extending slightly to the side. It helps reduce breast size while keeping scars minimal.

T-Shaped Scar

This technique involves a horizontal incision across half the areola, continuing downward in a T shape. It’s often preferred for larger reductions.

Circular Incision

A circular incision is made around the areola, extending straight down. This approach helps achieve a natural, balanced look.

Each of these techniques is selected based on your unique body shape, goals, and the surgeon’s expert recommendation

In 2025, breast reduction/top surgery have evolved with a groundbreaking, minimally invasive technique. Using an endoscopic approach through a small incision under the armpit, this method leaves your chest area scar-free and natural-looking.

With less scarring and a smoother recovery, this approach prioritizes both your well-being and confidence. You don’t have to compromise between relief and aesthetics—modern surgery is making both possible.

• This advanced technique gives surgeons a clear view of the breast’s internal structures, allowing for more precise surgery.
• It also reduces bleeding and lowers the risk of muscle injury compared to traditional methods.
• Recovery is faster, with less downtime and quicker healing.
• The best part? You get natural-looking results with no visible scars on your chest.

While this option may cost more than other breast reduction methods, many find the benefits well worth it.

• Small breast size (cup A), large areola
• Small breast size (cup A), small areola
• Large breasts or large breasts (B cup), large areola
• Medium breasts, large breasts or large breasts (B cup), small areola

Some surgeries in the armpit area can be performed without endoscopy because they involve minimal tissue manipulation. Procedures like certain breast augmentations allow surgeons to create a cavity and place implants with a direct approach, reducing the need for advanced visualization tools.

However, for top surgery, endoscopy becomes essential. This procedure requires precise removal or reconstruction of breast tissue while preserving important structures like blood vessels and muscles. Without endoscopy, there’s a higher risk of excessive bleeding, nerve damage, or uneven results.

By using endoscopic techniques, surgeons can navigate delicate tissues with greater accuracy, leading to safer outcomes and better aesthetic results.

Breast amputation involves the complete removal of the breast, with a long incision that stretches from the middle of the chest to nearly the side of the torso. It’s not always suitable for every patient and may be considered for various reasons, such as:

• Low or sagging breasts, often from aging or childbirth.
• Genetics, where women have naturally large breasts causing discomfort.
• Health issues caused by very large breasts, like back or shoulder pain.
• Breast deformities, sometimes due to long-term use of tight undergarments.

During this procedure, the nipple may be relocated to a new position, which may result in a loss of sensation. This technique, known as Nipple Grafting, helps restore a more natural, masculine chest appearance, boosting confidence.

The doctor will also assess the skin’s condition to minimize potential complications, like unsightly scars. People with fair or darker skin tones, like many Asians, are more prone to developing darker or keloid scars compared to those with European descent.

• Semicircular Areola Surgery
  Minimally invasive via armpit incision.
  For: A-cup, level 1 sagging, good skin elasticity.
• Transareolar Breast Reduction
  Reduces breast tissue and areola.
  For: A-cup, level 1 sagging, good skin elasticity.
• Concentric Circular Reduction
  Removes tissue, skin, and areola (not nipple).
  For: A-cup (moderate/severe sagging), B-cup (level 1-2 sagging), good skin elasticity.
• Extended Concentric Reduction
  Extra incision for more reduction.
  For: B-cup (poor elasticity), C-cup (drooping, no full removal).
• Free Nipple Graft
  Removes the entire breast; nipple relocated.
  For: C-cup, severe sagging.

Surgery Type

Semicircular Areola Surgery (Laparoscopic under armpit)

Description

A minimally invasive surgery for reducing the breast size through the armpit incision.

Suitable For

A-cup with normal to level 1 breast sagging and good skin elasticity.

Transareolar Breast Reduction

Involves both breast tissue and areola reduction.

A-cup with normal to level 1 breast sagging and good skin elasticity.

Concentric Circular Breast Reduction

Reduces excess breast tissue, skin, and areola, but not the nipple (or nipple reduction is done later). Suitable for those with small nipples but large areolas.

A-cup with moderate to severe breast sagging, B-cup with breast sagging level 1-2, and good skin elasticity.

Extended Concentric Breast Reduction

Adds an additional incision to the Concentric Circular technique for more reduction.

B-cup with moderate to poor skin elasticity, C-cup with drooping or deformed breasts, but not requiring total breast removal.

Free Nipple Graft or Breast Amputation

Removal of the entire breast with the nipple being relocated.

C-cup or severe breast sagging.

It’s important to remember that each person’s breasts are unique, and surgery isn’t a one-size-fits-all solution. For some, large breasts may not require a long incision, and small breasts might not need surgery through the areola. 

The key first step is to consult with a doctor to evaluate the shape and characteristics of your breasts before choosing the right method. For example, if you have small breasts and large areolas, surgery might be done through the areola. 

In contrast, if you have large breasts and small areolas, a larger incision may be necessary, or a newer option like endoscopic surgery through the armpit combined with areola surgery can help reduce visible scarring, leaving only a discreet scar around the areola.

1. Obtain Psychological Clearance:

• Request a medical certificate from at least one psychologist or psychiatrist before proceeding with the surgery.

2. Check Blood Concentration (Hemoconcentration):

• If you are on testosterone therapy, ensure your blood concentration is tested prior to surgery.
• The hematocrit (HCT) level or red blood cell count should not exceed 40%.
• If levels are high, stop taking hormone pills 2 weeks to 1 month before surgery as advised by your doctor for safety during surgery and anesthesia.

Preparing for top surgery is a big step, and taking the right precautions helps ensure a smooth procedure and recovery. Here’s what to keep in mind:

Fasting is Essential

For at least eight hours before surgery, avoid eating or drinking anything. Clear liquids like water or fruit juice (without pulp) are okay during this time, but skip carbonated drinks, tea, coffee, and alcohol.

No Smoking or Drinking

To support healing, stop smoking and drinking alcohol at least two weeks before surgery. Smoking reduces blood circulation, while alcohol increases the risk of complications like poor wound healing.

Skip the Supplements

Certain vitamins and dietary supplements can interfere with anesthesia or your recovery. It’s safest to avoid them leading up to your procedure.

Limit Fluids Before Surgery

Refrain from drinking any fluids for at least three hours before surgery. This helps reduce the risk of aspiration while under anesthesia.

No Caffeine on Surgery Day

Caffeinated drinks like coffee and tea can affect your body’s response to anesthesia. It’s best to avoid them before your procedure.

At Rattinan Medical Center, liposuction is more than just a procedure—it’s a step toward confidence, self-care, and feeling your best. Your journey matters, and we are here to support you every step of the way.

• Avoid water activities until your stitches are removed.
• Wear a special breast binder for at least 3-6 months, depending on your individual recovery.
• Precautions: Avoid strenuous exercise, heavy lifting, or any activity that stresses the surgical area. Be cautious of impact, as this could lead to bleeding or wound complications.
• Your doctor will schedule a checkup and stitch removal in about 1-2 weeks.
• Take prescribed medications strictly as directed by your doctor.
• After 2 weeks, you can begin light exercise, and after 4-6 weeks, you can resume regular gym workouts.
• If you plan to resume hormone therapy, it’s best to wait until after your stitches are removed or until the wound has fully healed for optimal recovery.
• You can start taking vitamins 2 weeks to 1 month post-surgery.

If your nipple and areola were involved in the surgery, nerve recovery may take up to 6 months.

• Breast reduction surgery will result in a permanent reduction in size; your breasts won’t grow back.
• Surgical scarring depends on your breast size and individual skin type.
• After areola surgery, the areola may darken in color or become hard.
• Some individuals may develop keloids, which might require continuous laser treatment until healing improves.

1. Our skilled doctors have a deep understanding of your anatomy and are highly experienced in surgery.
2. We have access to modern tools and state-of-the-art equipment for the best results.
3. We offer a wide range of surgeries to meet diverse needs.
4. Our chest wall contouring surgery is designed to create a natural, masculine appearance.
5. If excess breast tissue is due to fat, we may use liposuction to achieve the most natural, satisfying results.
6. Our team of doctors and anesthesiologists strictly follow safety standards to ensure your well-being.
7. We have a spacious, fully certified operating room, approved by the Ministry of Public Health.
8. Our facility is free from COVID-19 risks and meets rigorous cleanliness and safety standards from the Department of Health and THAISTOPCOVID+.
9. We proudly hold AACI certification, recognizing us as the first outpatient plastic surgery center in Asia Pacific to achieve U.S. international service quality standards in the “Ambulatory Plastic Surgical Center” category.

After nipple surgery, you can expect to retain sensation in the nipples. While it may not be at full sensitivity right away, it typically improves over time, with normal sensation returning in about 6 months or longer, depending on the individual. This is because the procedure only affects the external area of the areola or nipple, leaving the nerves and blood vessels intact.

However, in the case of a Free Nipple Graft, where the nipple is removed and reattached, the nipple will not have any sensation.

Although breast stays may appear to flatten the breasts, medically, they are not recommended. 

Prolonged use can lead to distorted shapes or ptosis—sagging and stretched breasts—because the skin struggles to return to its original form. This condition is difficult to correct, and if breast correction surgery is needed, it typically involves breast amputation (removal of the breast tissue and repositioning of the nipple), leaving a significant scar along the center of the chest.

Breast reduction surgery for tomboys is a procedure that addresses gender identity and beauty, aiming to create a more masculine chest appearance. Unlike breast surgery for breast cancer treatment, which typically removes all breast tissue for medical reasons, breast reduction for tomboys leaves some mammary gland tissue behind. These surgeries are distinct, each with its own purpose and approach.

Breast reduction surgery and gynecomastia treatment are two very different procedures, tailored to the distinct physiological differences between men and women.

In gynecomastia treatment, surgery typically removes excess breast tissue through the areola, as men’s breast tissue is smaller and concentrated around that area. The procedure is less invasive because the tissue is localized and doesn’t require extensive reshaping.

On the other hand, breast reduction surgery for women addresses a more complex structure. Women’s breasts have tissue and mammary glands spread throughout the chest, which makes the surgery more involved. Even with hormone therapy, these glands often remain, requiring a more extensive procedure to remove the tissue and create a smooth, natural breast shape.

Frequently Asked Questions: Breast Reduction Surgery for Tomboys (2025)

Top Surgery or Breast Reduction Price?

The cost of breast reduction surgery for tomboys in 2025 varies by provider, influenced by factors such as the surgeon’s technique, experience, and the clinic’s standards. It’s essential to do thorough research and consult with a doctor to ensure safety. At Rattinan Medical Center, Bangkok, we offer breast reduction surgery for 5,555 Thai Baht.

After Top Surgery, How Long Does It Take to Recover?

After top surgery, including breast reduction at Rattinan Medical Center, recovery begins right away. You’ll need to rest in bed for 3-5 hours post-surgery so our nurses can closely monitor your symptoms and ensure there are no side effects. Once everything is stable, you can go home to continue your recovery.

Where Can You Get the Best Top Surgery Performed?

When exploring treatment options, it’s important to first gather information about the services available and the methods that interest you. Then, consult with a doctor for professional advice. Be sure to choose a clinic that is AACI certified for your safety. At Rattinan, we are proud to be AACI certified and have experienced surgeons who specialize in caring for international patients, ensuring you receive the highest level of care.

Is a Drain Necessary for Tomboys After Breast Surgery? And How Long Does It Last?

After breast reduction surgery, a drain is placed to remove blood and lymph from the chest area, preventing blood clots. The length of time you’ll need the drain depends on your doctor’s recommendation. Some people may have it removed a few hours after surgery, while others may need to keep it in until the bleeding stops, with a follow-up appointment for removal. It varies from person to person.

How Painful Is Breast Reduction Surgery for Lesbians?

At Rattinan Medical Center, our breast reduction surgery is performed under the care of a specialist anesthesiologist. While some pain or discomfort is to be expected, we use the advanced laparoscopic surgery technique with incisions under the armpit. This method leaves minimal or no visible scarring on the chest, with a small wound under the armpit only. Compared to older methods, this approach is less painful, has a faster recovery time, and ensures a quicker return to your daily activities.

When Is It Safe to Resume Hormone Therapy After Breast Surgery?

If you’re considering resuming hormone pills, your doctor will likely recommend waiting until after your stitches are removed. To be extra cautious, it’s best to wait until the wound is fully healed before starting the medication again.

Is It Possible for Breasts to Revert to Their Original Form After Reduction Surgery?

No, because the breast tissue and glands have all been removed.

Can Breast Reduction Surgery Help Prevent Breast Cancer?

Tomboy surgery, or breast reduction surgery, can’t prevent breast cancer. It’s a procedure that reduces the size of the breasts by removing some of the mammary tissue. However, it doesn’t eliminate the possibility of breast cancer in the remaining tissue; it only lowers the overall risk.

Is It Possible to Fix Dented Breasts After Surgery Elsewhere?

If you’ve had breast surgery elsewhere and are left with dents or hollows, it’s possible to fix it with fat injections. However, results aren’t guaranteed as they depend on the condition of the breasts and the severity of the dents. It’s important to consult with a doctor to evaluate your situation and determine the best solution. Always take the time to research the clinic and the doctor providing the treatment before making any decisions.

Does Wearing a Bra for Long Hours Raise the Risk of Breast Cancer?

While there’s no specific research on this issue, it’s clear that wearing breast stays for extended periods can have negative effects. Over time, this can cause the breasts to sag, droop, or even become deformed, which can be difficult to correct.

Is It Possible to Use Silicone Implants for a Masculine, Muscular Chest Look?

It can be done but it is not very popular yet.

Why Aren’t Minimally Invasive Surgeries Suitable for Women with Breasts Larger Than an A-Cup?

For women with medium-sized breasts (B/C) or larger, small-incision surgeries through the areola or underarm may not always be suitable. This is because certain areas, like the side of the breast, might be difficult to access or fully address with smaller incisions, potentially requiring a larger incision that could result in a longer scar.

However, combining an underarm endoscopic technique with areola surgery offers an effective solution. This approach minimizes scarring on the areola, avoiding the need to extend the incision to the side. It also ensures smooth, natural contouring, creating a result that closely resembles male chest aesthetics.

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