Achieve a chest that aligns with your gender identity through top surgery at Transitions. Our board-certified surgeons, Dr. Leif Rogers and Dr. Walter J. Joseph, offer expert care for transgender and gender-diverse individuals seeking masculinizing or feminizing chest procedures. We’re here to help you embrace your authentic self.
Achieve Contours That Feel Right for You
Top surgery is a gender-affirming procedure that reshapes the chest to create a traditionally masculine or feminine contour, depending on your goals. For transmasculine individuals, this typically involves bilateral mastectomy to remove breast tissue and create a flatter chest. For transfeminine individuals, breast augmentation is performed using implants or fat grafting to achieve a fuller, feminine shape.
At Transitions, we understand that top surgery is more than just a physical transformation—it’s an important step in affirming who you are. Our surgeons use take the time to understand you and curate a personalized surgical plan tailored to your body, goals, and transition journey—ensuring results that look and feel right for you.
Top Surgery Can Address These Concerns:
- Feeling discomfort or distress with the appearance of your chest
- Difficulty achieving a flat or contoured chest through binding or padding
- Desire for a more traditionally masculine or feminine chest shape
- Physical discomfort from prolonged binding or compression garments
- A mismatch between your chest appearance and gender identity
- Limitations in clothing choices due to chest shape or size
- Emotional or social dysphoria related to chest anatomy
- Lack of confidence in social, intimate, or public settings
Do I Qualify for Top Surgery?
You may be a suitable candidate for top surgery if you’re a transgender, nonbinary, or gender-diverse individual seeking to align your chest appearance with your gender identity. The ideal candidates should be in good general health, have realistic expectations, and feel emotionally ready for a permanent surgical change. During your consultation at Transitions, our surgeons will take time to understand your goals and assess your unique anatomy.
They’ll review your medical history, discuss surgical options, and ensure you’re fully informed about the procedure. Our team also considers your mental and emotional well-being and offers support throughout the decision-making process. We’re here to ensure your experience is affirming and centered around your authentic self.
What Are the Benefits of Top Surgery?
Top surgery can be a life-changing step in aligning your physical body with your gender identity. Whether seeking a flatter chest or enhanced breast volume, the procedure offers emotional and functional benefits that extend far beyond appearance. Many patients report increased comfort, freedom, and confidence in their daily lives. Benefits of top surgery include:
- Creating a chest that better reflects your gender identity
- Reducing or eliminating the need for binders or padding
- Improving self-confidence and body image
- Enhancing comfort in clothing and physical activities
- Alleviating gender dysphoria related to chest anatomy
- Promoting a stronger sense of authenticity and self-alignment
- Allowing for greater ease in social and intimate situations
Choose Your Ideal Top
Surgery Technique
Top surgery at Transitions is highly personalized—each procedure is tailored to your body and goals. Whether you're seeking masculinization or feminization, our surgeons will help you select the right technique for your anatomy, desired outcome, and surgical preferences. Below, we explain the top surgery options available.
Breast Augmentation
For transfeminine individuals seeking a more traditionally feminine chest, breast augmentation adds volume and contour using implants or, in some cases, fat grafting. Implants are placed beneath the chest muscle or breast tissue to achieve a natural-looking shape and projection. Your surgeon will work closely with you to choose the ideal implant size, profile, and placement. If you have limited existing breast tissue, augmentation may be paired with skin expansion or staged procedures to ensure a beautiful, proportional result.
View Breast Augmentation
Mastectomy
For transmasculine individuals, top surgery typically involves a mastectomy to remove breast tissue and create a flatter chest. There are several mastectomy techniques, including double incision with free nipple grafts, periareolar (donut), and keyhole approaches—each suited to different chest sizes and skin elasticity. Double incision is the most common and allows for extensive contouring, especially in larger chests. Your surgeon will recommend the best approach to achieve masculine contours with minimal scarring.
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Nipple & Areola Resizing/Reconstruction
Nipple and areola changes are often included in top surgery to refine the chest’s appearance. In masculinizing procedures, the nipple-areola complex is resized, repositioned, or reconstructed entirely using grafts. The goal is to create smaller, oval-shaped nipples that sit naturally on a flat chest. For feminizing surgery, nipple projection and areola diameter may be enhanced to complement the new breast shape. Our surgeons use cutting-edge surgical techniques to ensure the most natural and affirming results possible.
View Nipple & Areola Resizing/Reconstruction
The Day of Your Top Surgery
On the day of your top surgery, you’ll arrive at our accredited in-house surgical center, where our team will ensure you’re comfortable and fully prepared. After reviewing your surgical plan, your surgeon will carefully mark your chest to guide the procedure. You’ll then receive general anesthesia, so you’ll be completely asleep throughout the operation.
Depending on your chosen technique, your surgeon will either place implants (for breast augmentation) or remove breast tissue (for mastectomy), with precise attention to symmetry and aesthetic contouring. If nipple and areola resizing/repositioning is planned, it will be performed during the same session. The entire procedure typically takes 2-4 hours. Once complete, you’ll recover in our post-operative care suite, where our staff will monitor you closely before you’re discharged or moved to our aftercare facility for extended healing support.
Your Recovery Experience After Top Surgery
After your top surgery, you’ll spend the first few days resting, with light activity and careful monitoring of your healing progress. You’ll wear a compression garment to minimize swelling and support your new chest contour. Some soreness, bruising, and tightness are normal, but we’ll provide medication and detailed aftercare instructions to keep you comfortable.
Most patients return to non-strenuous activities within 1-2 weeks, though full recovery can take several weeks. You must attend follow-up visits so we can monitor healing, remove sutures if needed, and guide you through each phase of recovery.
Transition Into Your Authentic Self…
Transitions is a sanctuary for gender-affirming care, where we offer expert top surgery for transgender and gender-diverse individuals. Our board-certified surgeons combine advanced techniques with compassionate, individualized treatment to help you feel at home in your body. Whether you’re seeking a flatter chest or enhanced curves, we’re here to support your vision. Schedule a consultation for top surgery in Pasadena and Beverly Hills—and take the next step toward living confidently and authentically.
Redefining
Gender-Affirming
Care & Aesthetics
Transitions: Where Your True Self Emerges
BEVERLY HILLS: 310.860.8915PASADENA: 626.537.3737
