How Long Should You Be on Testosterone Before Top Surgery?

January 24, 2025

Why Testosterone Matters Before Top Surgery

For FTM (female-to-male) and non-binary individuals, testosterone therapy is often a vital step in gender-affirming care. It not only aligns physical traits with gender identity but also impacts chest tissue, which can influence the aesthetic outcomes of top surgery. Understanding how long to be on testosterone before surgery can help achieve optimal results.

What the Medical Community Recommends

Most healthcare providers recommend being on testosterone therapy for at least 6 months to 1 year before undergoing top surgery. This recommendation is based on several factors:

Chest Tissue Changes: Testosterone therapy can reduce breast tissue volume and increase skin elasticity, which helps surgeons create a flatter and more natural chest contour.
Hormonal Stability: A consistent period on testosterone allows for hormone levels to stabilize, ensuring your body is prepared for surgery and recovery.
Mental and Emotional Readiness: Time on testosterone often enhances confidence and reduces dysphoria, helping individuals feel prepared for surgery.

Factors That May Influence Timing

While 6 months to 1 year is a general guideline, the ideal timing can vary depending on individual circumstances:

Chest Size: Individuals with larger chests may benefit from a longer period on testosterone to reduce tissue volume.
Health Considerations: Pre-existing health conditions or contraindications may influence the timeline for surgery.
Personal Goals: Some individuals prioritize surgery before or without starting testosterone, which is a valid choice depending on their preferences and needs.

What If You’re Not on Testosterone?

While being on testosterone is beneficial for many, it is not a requirement for top surgery. Many surgeons perform the procedure for individuals who have not started hormone therapy. In these cases, the focus shifts to surgical techniques and post-operative care to achieve the best results.

Optimizing Aesthetic Outcomes

To achieve the best aesthetic results, consider the following tips:

Consult Early: Meet with a gender-affirming surgeon to discuss your goals and timeline.
Follow a Healthy Lifestyle: Maintain a balanced diet, exercise regularly, and avoid smoking to support healing.
Work with a Supportive Team: Partner with a healthcare provider who understands your needs and can guide you through the process.

Finding Expert Care

Top surgery is a deeply personal journey. TransMD connects you with experienced surgeons who specialize in gender-affirming care, ensuring you receive compassionate and expert support tailored to your needs.