FTM Top Surgery in Portland, OR
Respectful, precise, and deeply affirming care for your gender identity journey.
Whether you’re seeking a flatter, more masculine chest—or simply a body that feels right—FTM (female-to-male) top surgery with Dr. Hetal Fichadia offers a patient-first, expert-led approach rooted in respect, clarity, and individualized care. As a double board-certified plastic surgeon and one of Portland’s most trusted physicians with over a decade of experience, Dr. Fichadia combines surgical precision with emotional intelligence. She creates a space where your story matters and your goals guide the plan. Every step is designed to support you with clarity, dignity, and compassion.
I don’t see a procedure. I see a person finally stepping into alignment. That’s sacred work.
What Is FTM Top Surgery?
FTM top surgery—also known as masculinizing chest surgery—is a gender-affirming procedure that removes breast tissue and reshapes the chest to create a flatter, more masculine contour. It’s one of the most common and meaningful steps in a female-to-male or nonbinary physical transition.
Dr. Fichadia offers multiple surgical techniques based on chest size, skin elasticity, anatomy, and goals:
- Double Incision with Free Nipple Grafts (ideal for medium-to-large chests)
- Keyhole or Periareolar Technique (for smaller chests with good skin elasticity)
- Buttonhole or Inverted-T Approach (used in certain nonbinary or reduction cases)
She’ll guide you through each method with clarity, helping you choose the path that best affirms your vision.
Why Choose FTM Top Surgery with Dr. Fichadia?
Top surgery isn’t about aesthetics. It’s about alignment, embodiment, and identity. Patients frequently report:
- Greater comfort and confidence in clothing and movement.
- Reduced need for chest binding.
- Deep emotional relief and gender congruence.
- Alleviation of gender dysphoria.
- Empowerment and self-validation through transition.
With a patient-first philosophy rooted in honesty, education, and genuine care, Dr. Fichadia has been consistently selected by her peers as a Portland Monthly Top Doctor every year since 2018. Dr. Fichadia’s care is anything but one-size-fits-all. Your outcome is tailored—not only to your anatomy, but to your identity and expression.
Who’s a Good Candidate?
You may be a good candidate if you:
- Identify as transgender, transmasculine, or nonbinary
- Are 16+ and in good health
- Meet WPATH guidelines or have a diagnosis of gender dysphoria (if using insurance)
- Have a stable gender identity and realistic expectations
Dr. Fichadia provides affirming, individualized care regardless of your gender label. For self-pay patients, she practices an informed consent model focused on autonomy.
Cost and Insurance Coverage
Top surgery costs vary by surgical approach, facility, and whether you’re using insurance or self-pay. Dr. Fichadia’s office can:
- Help you navigate insurance pre-authorization
- Offer transparent self-pay quotes
- Discuss financing for qualified patients
Hetal Fichadia MD, FACS
Double Board-Certified Plastic Surgeon in Portland, OR
How FTM Top Surgery Works
Dr. Fichadia performs top surgery in accredited outpatient facilities such as East Pavilion Surgery Center with board-certified anesthesia teams. Liposuction may be added for enhanced contouring. Let Dr. Fichadia know if this is a goal.
Surgical techniques include:
Double Incision with Nipple Grafts:
Best for larger chests. Horizontal incisions are placed under the pectoral line to hide scars, and nipples are resized and repositioned as grafts.
Keyhole/Periareolar
Used for smaller chests with elastic skin. Less invasive with preserved nipple sensation in some cases.
Inverted-T or Buttonhole
Used selectively, often for nonbinary patients or those preferring reduced but not fully masculinized chests.
Surgery Day: What to Expect
On the day of surgery, you are welcomed into our friendly surgery center by our well-trained team, who have extensive experience with gender-affirming care. Your companion may stay with you while Dr. Fichadia performs your surgical markings. You are then taken to the operating room and later wake up comfortably in the recovery area. Dr. Fichadia updates your companion with details about your surgery and answers any questions. Most patients go home the same day.
In summary, these are the key steps on your surgery day:
- Pre-op consult and markings with Dr. Fichadia
- Meet with your anesthesia and surgical care team
- Procedure time: typically 2–4 hours
- Home the same day with detailed aftercare instructions
Recovery After Top Surgery
Recovery times vary, but most patients experience:
- 1–2 weeks off work for rest
- Compression garments and dressings
- Temporary soreness, swelling, and bruising
- Drain care (if used) for the first 5–7 days
- Gradual return to activity over 4–6 weeks
Follow-up visits occur at 1 week, 6 weeks, and 3+ months. Scar care and healing support are part of your journey.
Take the Next Step
If you’re ready to explore top surgery, we’re here to guide you every step of the way. We serve Portland, Lake Oswego, Beaverton, and beyond. Call us (503) 488-2344 or contact us online to get started.
FAQs: FTM Top Surgery in Portland, OR
Will I need drains?
Often used with a double incision mastectomy, drains are usually removed in 5–7 days.
Will I lose nipple sensation?
Nipple grafts may lose sensation. Some regain partial sensitivity over time.
Can I avoid large incisions?
If your chest is small and your skin is elastic, a keyhole technique may be an option.
Can nonbinary individuals get top surgery?
Absolutely. We welcome patients of all identities seeking chest contouring.
Will I have visible scars?
All surgery leaves some scars. Scar placement is discussed as part of preoperative planning. Dr. Fichadia places incisions strategically and provides scar treatment options.
Can I combine procedures?
Yes. Liposuction or body contouring may be added depending on goals.
Do I need letters or documentation?
We use WPATH criteria and ask for a letter of support from your mental health professional.
What support do I need after surgery?
You’ll need help at home for the first 5-7 days. Emotional and physical support matter.
How long do I need to wear a binder after top surgery?
Dr Fichadia recommends wearing a binder for 4 weeks after surgery to reduce swelling, support your healing tissues, and prevent fluid buildup.
Can I go flat without nipples?
Yes. Nipple removal (nipple nullification) is an option for a flat, smooth chest.
How long do results last?
Top surgery is permanent. Some patients opt for minor revisions over time.