Getting top surgery is a priority for many transmen (but not all!). And while most of us understand the differences between the different surgery types like Double Incision (DI), the Peri-Ariolar, Keyhole, the Purse String technique - something that is recurring throughout all of these surgeries is the question of the size, shape, and placement of your new (or old) nipples! While having a perfectly flat chest, sometimes with scars, sometimes with smaller ones, is certainly a concern; the persistent worry is about our nipples. And with good reason! There are a lot of things happening with those things!
10 good questions to ask your surgeon about nipples:
1) Will you be leaving my nipple intact or will you use a graft?
2) How do you decide where to place the nipple?
3) Do you typically create smaller-sized nipples? (or what is your preference for size of nipple?)
4) What are my chances for [tactile] sensation?
5) What are my risks for losing a nipple?
6) What are ways that I can reduce pulling and scaring on my nipples?
7) Does your technique account for possible pink/redness surrounding the nipple after it is healed?
8) How long should I wait until I can go back to doing (insert whatever it is you like to do with your nipples here)?
9) Are you able to do more oval-shaped nipples or just symmetrical circular ones?
10) Do you have any reference photos of individuals who have had surgery with you as to be able to better visualize surgery results?
It is best to be as informed as possible when considering what type of top surgery you have and which surgeon you choose to perform the operation. But also consider the vast variation in body types that exist in nature. Even people with naturally flat chests exhibit variation in nipple placement, size, color, texture, etc.
According to DaVinci’s Vitruvian Man, and other similar concepts involving ideal proportions, canon of proportions, there is an “exact” or “ideal” location for male nipples. You can do the math and figure that out for yourselves, that’s besides the point.
The point is that rarely do things in nature exist in such “perfect” of proportions and even if they did, would they be any more valuable or beautiful? My answer is, no. We should celebrate our differences and scars and quirks while understanding that our issues that we have with our chests are not uniquely ours and recognize that we are not so different from people who matured with flat chests.
Below are a few pictures to highlight the vast differences in nipple size, placement, color, and texture in people who matured with flat chests. I apologize for not having photos with much variation in skin tone, we didn’t have a large selection of photos to chose from.
So while being as informed and educated as you can possibly be about your surgeon, and the technique, and the predicted outcomes - you may not have the “perfect” nipple in terms of size, shape, location, and texture…but does it really matter? Knowing now, that people who mature with flat chests have virtually indistinguishable chests from a lot of transguys who have top surgery, you can make strides to becoming happy with your outcomes of surgery and value your chest for its potential deviations from the canon of proportions.
This is a really great post, and actually a topic I’ve been thinking of discussing for a while. How my nips were going to look after top surgery was a huge deal to me, in terms of both the placement and the appearance of the nips themselves.
The question is not really “Who is the best surgeon?”; the question is “Which surgeon’s methods are most compatible with how I want my chest to look?”. There are a lot of excellent top surgeons out there. I think that Medalie, Garramone, Brownstein, and a number of others are all excellent surgeons. And I know there are quite a few lesser-known surgeons out there who are really great, too. I chose Medalie because I liked the way that he does nipple placement and that he seems able to often retain the definition of the nipple itself; I thought his method would be the best for my body. In terms of what I wanted my body to look like after surgery. I liked that his nipple placement is not quite as wide set as others (such as Dr. Garramone), and that he doesn’t make the nipples particularly small. These were both things that I wanted in my results. But does that mean that there is something wrong with Dr. Garramone’s method? Absolutely not!! All it means is that the way he does chests wasn’t as compatible with what I wanted as Dr. Medalie’s methods were. It all depends on what you want your chest to look like.
I’d really like to see folks who want top surgery or have had top surgery stop insulting other people’s results. It’s shitty and hurtful. You’re talking about someone else’s body. Knock it off.