Our Differences Make Us Human
As society grows to be more understanding and accepting of all the people around us, gender-affirming procedures and treatments are beginning to rise. Board-certified plastic surgeon Dr. Katherine B. Santosa supports the transgender community by offering Gender-Affirming Top Surgery. So many individuals who are transgender do not feel comfortable in their own skin, and that’s perfectly okay! Dr. Santosa wants to help you transition into self-love with her Gender Mastectomy and Gender Augmentation procedures. She strives to deliver the best Gender-Affirming Top Surgery Atlanta has to offer. She is located in Sandy Springs, Georgia, and accepts patients from all over the country. Schedule your Gender-Affirming Top Surgery with her today.
Inclusion is Important
Gender-Affirming Top Surgery is a procedure in which the breast tissue is manipulated to better represent an individual’s identified gender. These procedures are most commonly done on people who identify as transgender or non-binary. Chest masculinization removes breast tissue and reshapes the chest for transgender men, transmasculine people, and nonbinary people who want a flatter or more masculine contour. Chest feminization adds breast volume for transgender women, transfeminine people, and nonbinary people who want a fuller or more feminine shape. Dr. Santosa plans each procedure around the patient’s proportions, health, and preferences.
Two Directions, One Personal Plan
Top surgery can change your chest in two distinct ways. Chest masculinization removes breast tissue and contours the surrounding skin and fat. Chest feminization adds volume with breast implants or, for selected patients, fat transfer. Neither approach is tied to one narrow expression of gender. Your preferences for shape, projection, scars, nipple position, and sensation guide the conversation.
Chest masculinization may be appropriate if you want less breast volume and a flatter or more masculine chest contour. The surgical plan accounts for the amount of breast tissue and loose skin, chest width, skin elasticity, nipple position, preferred scar pattern, and the importance of nipple sensation. Liposuction may also be considered when fullness extends toward the sides of the chest.
Chest feminization is generally performed as breast augmentation with saline or silicone implants. Existing breast development, chest width, skin coverage, implant dimensions, and implant placement influence the finished shape. Fat transfer breast augmentation may offer a more modest increase for selected patients who have enough donor fat.
Built Around Your Chest
There is no single top surgery technique that suits every chest. A shorter incision can be appealing, but it also gives the surgeon less control over loose skin, nipple position, and areola size. Dr. Santosa will explain the trade-offs that apply to your chest before recommending an approach.
The double-incision technique is commonly considered when there is moderate or substantial breast tissue, loose skin, or a lower nipple position. Incisions extend across the lower chest so breast tissue and excess skin can be removed with greater control. The scars are longer, but this approach offers the most flexibility for flattening and shaping the chest and repositioning the nipple-areola complexes.
Periareolar top surgery uses an incision around the areola, sometimes with a second circular incision outside it, to remove breast tissue and a limited amount of skin. It tends to suit smaller chests with good skin elasticity. The scar follows the areolar border, although this method offers less control over loose skin and nipple placement than a double incision.
Keyhole top surgery places a short incision along the lower border of the areola. It is reserved for small chests with little or no excess skin because the technique does not remove a meaningful skin envelope. The nipple remains attached to its blood supply and nerves, but its size and position cannot be changed as freely. A tiny scar sounds lovely on paper; a clean contour remains the more important part of the decision.
A free nipple graft may be used with double-incision surgery. The nipple and areola are removed, resized if desired, and placed in a position that suits the new chest contour. Because the graft is separated from its original nerves and blood supply, sensation is commonly reduced and may not fully return. Pigment changes, delayed healing, or partial graft loss are also possible.
Periareolar and keyhole techniques keep the nipple attached, which may improve the chance of preserving sensation, although no technique can promise normal sensation. Your preferences for nipple size, placement, projection, sensation, and nipple preservation belong in the planning conversation.
A Caring, Compassionate Doctor
Sometimes, it is hard to find a caring, kind, compassionate doctor who is accepting of everyone. Dr. Katherine B. Santosa is here to end your search. Dr. Santosa makes it her mission to ensure every single one of her patients is taken care of properly and is satisfied with their results while maintaining their health and well-being. She is honest with you and will strive to help you bring your dreams to life.
A Procedure Tailored to You
Gender-Affirming Top Surgery can help people feel like they are in their proper bodies and show how they feel inside the world. Patients can identify more aesthetically with their identified gender by providing or removing their breasts. Candidates for Gender-Affirming Top Surgery typically have gender dysphoria, are in good health, and are adults who are done growing. You should not consider Gender-Affirming Top Surgery if you are pregnant, breastfeeding, or have underlying medical conditions. Schedule a consultation with Dr. Santosa to see if you are a good candidate today.
Looking Out For You
Dr. Santosa strives to make each one of her patients feel comfortable and confident in their decisions. She will never pressure you into getting a procedure or make you feel less about changing your mind. She and her team are here for you. Schedule your consultation today to see if Dr. Santosa is the right doctor for you.
Care With a Clear Point of View
Top surgery calls for careful breast surgery, direct communication, and respect for the person attached to the surgical plan. Dr. Katherine B. Santosa is a board-certified female plastic surgeon with advanced fellowship training in aesthetic surgery and experience across cosmetic and reconstructive breast procedures. That background supports the detailed work of tissue removal, implant placement, chest contouring, scar planning, and nipple-areola design.
Evelina Plastic Surgery is a women-owned practice where you can speak candidly about the details that are important to you. Dr. Santosa will explain what each option can accomplish, along with the trade-offs involving scars, skin removal, nipple sensation, implants, and possible revision. Kindness is part of good care here, but so is a straight answer.
Paperwork Without the Guesswork
Insurance requirements for gender-affirming top surgery vary by plan. An insurer may ask for prior authorization, a diagnosis of gender dysphoria, clinical notes, or a surgical-readiness letter from a qualified health professional. These are sometimes called WPATH letters because coverage policies may draw from the World Professional Association for Transgender Health Standards of Care. The number of letters and the information they must contain depend on the plan.
Look How You Feel
Four weeks prior to the procedure, our Atlanta Gender-Affirming Top Surgery patients will be advised to avoid smoking, drinking, anti-inflammatory drugs or herbs, and eating an unhealthy diet. If applicable, you should shave your chest the day before your procedure. Dr. Santosa will administer a general anesthetic that puts you into light sedation before numbing the areas where incisions will be made. Once numb and asleep, Dr. Santosa will begin making incisions for your Gender Mastectomy or Augmentation. During a Gender Mastectomy, the breast tissue will be removed and manipulated until it lays almost completely flat across the chest. During a Gender Augmentation, Dr. Santosa will use the incisions to slip a breast implant under the skin, creating a more womanly appearance. Once your desired complexion is achieved, Dr. Santosa will close your incisions, clean you up, and wake you.
Health Comes First
The first twenty-four hours after your procedure should be spent resting with the top half of your body elevated. After the first day, you will be advised to walk around and get used to moving again with your new changes. This promotes healthy blood flow in the body for faster healing. Avoid smoking, drinking, caffeine, strenuous activity, and picking up anything over five pounds for at least three weeks after your procedure. Bruises and swelling will subside within two to three weeks. You will see full results after about six weeks. Results of Gender-Affirming Top Surgery are permanent.
Your recovery setup depends on the operation and technique. Chest masculinization may involve drains to prevent fluid from collecting beneath the skin. If drains are used, the team will show you how to empty them, record the output, and care for the sites. A compression binder or surgical vest may also be prescribed to control swelling and support the tissues as they settle. Chest feminization patients generally wear a surgical support bra instead. Follow the garment schedule Dr. Santosa gives you rather than borrowing someone else’s routine from social media.
Many patients plan for one to two weeks away from desk work, although a physical job can require more time. Strenuous exercise and heavy lifting remain restricted until Dr. Santosa provides clearance. Nipple grafts need careful dressing care and may look dark or crusted before they heal. Contact the office promptly for fever, spreading redness, worsening pain, shortness of breath, one-sided swelling, calf pain, or drainage that concerns you.
Dr. Santosa will provide supplements for faster healing of bruises if necessary and will keep in touch with you throughout your entire experience, from consultation to recovery. Schedule your consultation today.
Planning the Investment
Top surgery cost depends on the type of operation, the selected technique, operating time, anesthesia and facility fees, implants, nipple grafting, and any additional contouring. Chest masculinization and implant-based chest feminization involve different materials and surgical work, so they should not be expected to carry the same fee.
Gender-Affirming Top Surgery costs can vary depending on the procedure and individual needs. Insurance may cover these procedures. During your consultation, Dr. Santosa’s team can discuss payment and financing options with you.
Unfortunately, scars are left behind in both kinds of Gender-Affirming Top Surgery. They will fade with time but will always be visible. Laser and other cosmetic treatments exist to help aid in the reduction of scar appearance.
Scarring, bleeding, blood clots, build-up of fluid beneath the skin, and minor nerve damage are all rare but possible risks of Top Surgery.
Your preferences are part of the consultation. Free nipple grafting allows greater resizing and repositioning, while keyhole surgery leaves the nipple attached and offers limited movement. Dr. Santosa will explain what is feasible for your chest and how each option may affect sensation.
Hormone therapy is not a universal requirement for every top surgery patient. Your surgeon and insurer may have separate criteria, and hormone-related chest changes can influence timing and planning. Bring your current medication list and any coverage policy to your consultation so the requirements can be reviewed accurately.
Discuss your personalized treatment with Dr. Santosa today
Dr. Santosa delivers a well-rounded treatment experience through combined science, compassion, and experience. Begin your journey with trusted board-certified Atlanta plastic surgeon Dr. Katherine B. Santosa in Sandy Springs, and rest assured that you have selected your best path to exquisite results.
At Evelina Plastic Surgery and Aesthetics, we are proud to be a women-owned practice committed to delivering exceptional care and outstanding results. Our dedication to excellence ensures that we stand out as a trusted choice for premier plastic surgery and aesthetic services in the Atlanta-metro area.
Please note Evelina Plastic Surgery does not accept insurance for this procedure.