How Much Does Top Surgery Cost in 2024?

The cost of top surgery can be a significant barrier in your transition journey. You know the surgery will be worth it, but what about the price tag? What hidden fees might be lurking? This article gives you the lowdown on everything from top surgery types and costs to insurance coverage and ways to fund your gender confirmation. No surprises, no stress—just the facts you need to take the next step.

Table of Contents

1. How Much Does Male-to-Female (MTF) Top Surgery Cost?
2. How Much Does Female-to-Male (FTM) Top Surgery Cost?
3. What Factors Affect the Cost of Top Surgery?
4. What is Included in the Cost of Top Surgery?
5. Does Insurance Cover Top Surgery?
6. How to Pay for Top Surgery
7. Takeaways

How Much Does Male-to-Female (MTF) Top Surgery Cost?

Male-to-female (MTF) top surgery, or breast augmentation, is a procedure that uses breast implants to create a more feminine chest. MTF top surgery cost ranges from $5,000 to $10,000. 

The table below compares average MTF top surgery cost ranges across several countries:

Types of implants

There are two primary types of breast implants used in chest feminization:

Saline implants

Saline implants contain sterile salt water. They're typically inserted empty and filled during surgery.

• 👍Pros: More versatile in terms of incision placement, require smaller incisions.
• 👎Cons: May feel less natural and are more prone to rippling.
• 💰Cost: Around $1,000 less due to the lower cost of filling material.

Silicone implants

Silicone implants come pre-filled with silicone gel and tend to have a soft, natural feel. 

• 👍Pros: Silicone implants offer a more aesthetic outcome, resembling natural breasts. They are softer, less prone to rippling, and preferred for those with little natural breast tissue.
• 👎Cons: Require larger incisions, fewer options for incision placement.
• 💰Cost: About $1,000 more expensive. Plus, regular MRIs recommended by the FDA to detect ruptures could add to the long-term expenses.

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How Much Does Female-to-Male (FTM) Top Surgery Cost?

Female-to-male (FTM) top surgery is a gender-affirming procedure that involves breast removal to create a masculine appearance. Also known as transmasculine chest reconstruction, this is the most popular procedure among transgender men. 

On average, FTM top surgery costs between $3,000 and $10,000. The cost depends on several factors, not least on the country where the surgery is performed. Take a look at the budget comparison across different countries:

Types of FTM top surgery

FTM top surgery cost also depends on the type of procedure. The surgeon will choose the best technique according to your contouring goals and physical condition. For smaller chests with minimal excess skin, a nipple-sparing subcutaneous mastectomy might be enough. However, patients with larger chests and bigger bodies might be better suited for a subcutaneous mastectomy with a free nipple graft. Let's look into the most common FTM top surgery techniques:

1. Double Incision top surgery with or without nipple grafts

Double Incision involves two horizontal cuts along the pectoral lines. The breast tissue is removed to create a flat chest, often with additional liposuction. Nipples are resized and grafted back onto the chest. Some opt out of nipple grafts or choose to tattoo nipples later. Choosing to have liposuction and nipple grafts will increase the total cost of the procedure. 

• 👌Ideal for: People with medium to large chests.
• 👍Pros: Offers significant contour control.
• 👎Cons: Can result in limited sensation, visible scarring, and the so-called "dog ears" — excess skin puckering at the incision lines.

2. Peri-areolar top surgery

This technique involves an incision around the areola and a second larger concentric incision. It allows for breast tissue removal without large scars and nipple repositioning.

• 👌Ideal for: Those with small to moderately-sized chests with good skin elasticity.
• 👍Pros: Preserves nipple sensation, minimal visible scarring.
• 👎Cons: Limited amount of tissue that can be removed, potentially higher revision rates.

3. Keyhole top surgery

The Keyhole procedure uses a small incision at the edge of the areola to remove breast tissue, leaving the nipple stalk intact. Generally, Keyhole and Periareolar surgeries are less expensive than the Double Incision procedure with nipple grafts, with a cost difference of up to $2,000. However, Double Incision without nipple reconstruction usually requires less technical skill and time compared to the Keyhole technique and can cost less.

• 👌Ideal for: People with small chest sizes and tight skin.
• 👍Pros: Least invasive, minimal scarring, can maintain nipple sensation.
• 👎Cons: Limited tissue removal, less control over nipple placement.

4. Inverted T or T-anchor top surgery

This technique uses two horizontal incisions with a vertical incision in the center, creating an inverted T. Nipples remain attached to preserve sensation.

• 👌Ideal for: Those who prefer retaining nipple sensation and are B-sized or larger.
• 👍Pros: Maintains nipple sensation, avoids free nipple grafts, has fewer potential complications.
• 👎Cons: The result will not be 100% flat because surgeons need to preserve some tissue to supply blood to the nipple area.

5. Buttonhole technique

The Buttonhole technique is similar to Inverted T but without the vertical incision. The method leaves more chest tissue intact to preserve sensation.

• 👌Ideal for: People with smaller chests who don't mind a fuller appearance.
• 👍Pros: Preserves nipple placement, sensation, and pigmentation, requires less skin removal.
• 👎Cons: Results in non-flat chest appearance.

6. Fishmouth or "Batwing" top surgery

This procedure uses incisions that radiate outward from the nipple to remove breast tissue while preserving nipple sensation.

• 👌Ideal for: Nonbinary or gender-non-conforming people who don’t mind non-anatomical scar patterns.
• 👍Pros: Better chance of maintaining sensation, results in flatter and tighter chest.
• 👎Cons: Visible scar patterns might not suit everyone.

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What Factors Affect the Cost of Top Surgery?

The cost of top surgery isn't one-size-fits-all; it's shaped by several key factors:

1. Type of surgery

The specific surgical procedure you choose has a significant impact on cost. In male-to-female top surgery, the choice between saline and silicone breast implants is key. For chest masculinization, the price varies based on the complexity and invasiveness of the chosen procedure. Moreover, the cost depends on your body shape and desired breast size.

2. Surgeon's experience and reputation

Surgeons who are highly experienced and well-regarded in the field of gender-affirming surgeries often charge more for their services. Their expertise can ensure a higher quality outcome, making it worth the additional cost.

3. Geographic location

The cost of top surgery varies significantly depending on where it's performed. Generally, surgeries in metropolitan areas or regions with a higher cost of living tend to be more expensive due to the higher overhead costs and market rates for medical services. This factor can often outweigh other cost influencers, such as the surgeon's expertise. For instance, Dr. Pichet Rodchareon, one of the most well-known names in gender-affirming surgery, charges 2-3 times less than surgeons in the United States despite his prominent reputation. 

4. Hospital fees

The choice of hospital or surgical center can affect the overall cost. Facilities equipped with advanced technology and higher service standards may charge more. Additionally, whether the surgical procedure is outpatient or requires an overnight stay can alter the cost.

6. Post-surgery care

Aftercare is crucial for a successful recovery and can include follow-up visits, dressings, medications, and sometimes additional corrective procedures. The extent of post-surgery care needed can impact the final cost.

7. Insurance coverage

Whether your insurance covers chest reconstruction can significantly affect your out-of-pocket expenses. Insurance policies vary widely; some cover the entire cost, others cover part, and some might not cover gender-affirming surgeries at all, depending on the policy and local laws.

8. Tests, consultations, and additional procedures

Pre-surgical tests and consultations required for gender-affirming surgeries can add to the overall cost, especially if not covered by insurance. Additionally, revision surgeries may be necessary to achieve the desired outcome or correct any issues from the initial procedure.

What is Included in the Cost of Top Surgery?

Understanding what your expenses will cover well before your surgery date can help prevent any unexpected financial surprises. Here's a breakdown of the typical components that make up the total cost of top surgery:

• Surgeon's fee. This is the payment for the surgeon’s expertise and time spent performing the surgery.
• Facility fees. These are the charges for the use of the surgery room and other hospital facilities during the procedure.
• General anesthesia fees. This covers the cost of the anesthetic provided during surgery and the services of the anesthesiologist or nurse anesthetist.
• Post-surgery garments. Specialized garments that help support recovery and enhance the shaping of the surgical area are sometimes included in the cost.
• Medical tests and x-rays. These pre-operative assessments ensure you are fit for surgery and may include blood tests, chest X-rays, or other diagnostic tests.
• Consultations. Initial consultations and any follow-up visits before surgery are sometimes included, but this can vary. For example, some clinics offer a free virtual consultation but charge for in-person visits.

It's crucial to get clear and detailed information about what is specifically included in the quoted price for your top surgery procedure. Be sure to ask each surgeon about all possible charges you might face. 

Additional costs of top surgery

To ensure no surprises along the way, you will have to factor some hidden fees into your overall budget. The following expenses may not be included in the initial quote or covered by insurance:

• Travel costs. If you need to travel for your gender reassignment surgery, consider expenses for flights, local transportation, and accommodations. These costs can add up, especially if a support person accompanies you.
• Additional medical tests. Depending on your health status and age, you may require additional testing. Patients with specific conditions need to undergo medical clearance. Additionally, mammograms are generally required for patients above 39.
• Prescription medications. Needed to manage pain and nausea in the first week after surgery. 
• Scar care. Silicone tape and gel help flatten and soften scars and cost between $15 and $150. Steroid injections reduce scar thickness, redness, and itching and cost about $150 per treatment. Over-the-counter scar treatments vary from affordable Vitamin E oil to more expensive cosmeceutical creams.
• After-surgery assistance. Recovering from chest reconstruction often requires some level of personal assistance, especially during the initial days post-operation when mobility is limited. Hiring help at home can be essential for tasks that involve lifting, stretching, or straining.
• Time off work. Recovery time can impact your income, especially if your job involves physical activity. Most patients are ready to return to desk jobs or engage in light activities about 7 to 9 days after surgery. However, to ensure safe healing, it's important to avoid any work that might involve chest impact for at least 4 weeks.
• Lifestyle adjustments. Post-recovery, you might need to purchase new clothing that better fits your new chest size, adding a fun but necessary expense to your budget. Additionally, local travel might require the use of car services if driving is uncomfortable.

Why choose all-inclusive packages for top surgery?

All-inclusive packages, widespread in medical tourism destinations like Thailand and Turkey, offer a hassle-free way to manage surgery logistics. These packages bundle various services that aren't typically included in the standard surgery costs. They often include:

• accommodation;
• transfers;
• meals;
• consultations and follow-up visits;
• all necessary medications and garments.

Opting for an all-inclusive package simplifies the entire process. You won’t have to worry about organizing each part of your trip; instead, you can focus on your recovery and health. This can make the experience much smoother and often more affordable.

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Does Insurance Cover Top Surgery?

Major health insurance companies acknowledge that gender-affirming care is medically necessary. In particular, insurers usually recognize chest reconstruction as essential for treating gender dysphoria. However, the extent of coverage can vary based on state regulations and the specific health plan. 

• 👨FTM top surgery. About 96% of insurance companies cover bilateral mastectomy for transgender men, recognizing it as a medically necessary reconstructive procedure. Insurance typically covers around 85% of the total costs for mastectomy, with the remaining 15% being out-of-pocket expenses.
• 👩MTF top surgery. Coverage drops to about 68% for breast augmentation in transgender women. Insurers not covering this procedure label it as 'not medically necessary.'

Insurance requirements

To be able to cover your top surgery cost with insurance, you must meet specific criteria, often based on the standards set by the World Professional Association for Transgender Health (WPATH). The most common requirements are:

• A letter from a healthcare professional confirming your chest dysphoria.
• Documentation detailing the duration and consistency of hormone therapy.
• Being at least 18 years old.

How to Pay for Top Surgery

If you don't have insurance or it doesn't cover your specific case, don't worry — there are plenty of other ways to fund your surgery. 

1. Payment plans

Transgender healthcare providers can offer payment plans that allow you to spread the cost of surgery over time. Bookimed also enables patients to pay for their surgery in interest-free installments.

2. Personal loans

You can apply for a personal loan to cover medical expenses. Depending on your credit score and income, loan amounts can range from $1,000 to $100,000.

3. Credit cards

Using a credit card provides access to a line of credit to cover medical bills, which you can pay off over time.

4. Medical credit cards

Cards designed specifically for medical expenses, like CareCredit, often offer no-interest plans for a set period. However, be cautious of high retroactive interest rates if you don’t pay off the balance within that period.

5. Home equity

If you own a home, consider using a home equity loan or line of credit (HELOC). These typically have lower interest rates but do use your home as collateral, which carries its own risks.

6. Loans from friends or family

Asking friends or family for financial assistance can be another option, often without the interest rates associated with bank loans.

7. Crowdfunding

Platforms like GoFundMe allow you to raise funds from a wider community. Crowdfunding can be particularly effective if you have a compelling narrative and engage actively with your supporters through updates and expressions of gratitude. This method offers a way to gather the necessary funds without the repayment burden.

8. Top surgery grants

Several nonprofits provide grants that can cover part or all of the surgery cost and don’t need to be repaid. Some organizations that offer such support include:

• Jim Collins Foundation;
• Point of Pride;
• The Loft: LGBTQ+ Community Center;
• Genderbands;
• Black Trans Men Inc.

Takeaways

➢On average, FTM top surgery costs from $3,000 to $10,000, while MTF top surgery varies from $5,000 to $10,000.

➢In the US, top surgery can cost between $6,800 and $15,000. In the UK, it usually amounts to $10,000-$15,500.

➢Both feminizing and masculinizing top surgeries tend to be more affordable in Thailand and Turkey. Patients can pay around $2,600-$7,000 in Thailand and $2,500-$5,000 in Turkey.

➢FTM top surgery encompasses several techniques, the complexity or invasiveness of which directly influences the cost. Keyhole and Periareolar top surgery cost around $2,000 less than the Double Incision top surgery with nipple grafts. However, the Double Incision top surgery cost can be lower if the patient chooses to forego nipple reconstruction since it will simplify the procedure.

➢For MTF top surgery, the choice between saline and silicone implants plays an important role: silicone implants are approximately $1,000 more expensive due to the costlier material. 

➢Insurance coverage varies; 96% of policies cover FTM top surgeries, but only 68% include MTF breast augmentation.

➢Top surgery can incur extra costs, such as travel, accommodations, medications, and post-op scar care. A package offer can cover some of these aspects.

➢In addition to covering the top surgery cost with insurance, patients can fund their surgery through payment plans, personal loans, medical credit cards, home equity, crowdfunding, and grants.

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