Double Incision Top Surgery

This deserves a direct answer: free nipple grafts involve removing and reattaching the nipple-areola complex, which disconnects the nerves that provide sensation. Most patients experience permanently reduced or absent erotic sensation in the nipples, though some protective sensation (awareness of touch, temperature) often returns gradually as nerves regrow from surrounding tissue over months to a year or more — the degree varies widely between patients and can't be guaranteed. For many patients, the trade-off is well worth it for the flat chest and repositioned, resized nipples this technique makes possible; for those who prioritize sensation, techniques like keyhole may be an option depending on chest size. This trade-off is exactly the kind of thing Dr. Carboy walks through candidly at consultation.

Double incision leaves two horizontal scars across the chest, typically placed along the lower border of the pectoral muscle so they follow the chest's natural shadow line. They're real scars and will be visible, especially in the first year while they fade from pink toward a pale line; how much they ultimately soften depends on your skin and healing tendencies. Dr. Carboy places incisions with the final masculine chest contour in mind, and scar care guidance — silicone therapy, sun protection — helps optimize fading. Many patients come to see their scars as a feature of their chest rather than a flaw; either way, you'll know exactly what to expect before surgery.

Yes — revision is part of honest surgical practice. Minor asymmetries, residual tissue ('dog ears' at the incision ends), or scar concerns can typically be refined with smaller secondary procedures once healing is complete, usually after six to twelve months when the result has fully settled. At your follow-up visits, Dr. Carboy assesses healing with you, and if a refinement would meaningfully improve your result, she'll discuss what's involved. Revision policies and any associated costs are explained clearly before your initial surgery, so there are no surprises.

Light walking starts almost immediately — it helps recovery. Lower-body exercise can typically resume within two to three weeks, but chest, shoulder, and heavy lifting need more patience: most patients wait six to eight weeks before progressively returning to upper-body training, and longer before heavy pressing movements. Rushing this risks widening scars and compromising the result you just invested in. Dr. Carboy provides a phased return-to-training timeline based on your healing — worth following precisely, especially if the gym is a big part of your life.

Many insurance plans now cover gender-affirming top surgery as medically necessary care, and Oregon requires many state-regulated plans to do so. Coverage typically requires documentation consistent with WPATH standards — generally a support letter from a mental health or medical provider and relevant care records. Requirements and processes vary significantly by plan and by state, particularly for out-of-state patients. Our team can help you understand what your plan requires and what to gather; where coverage isn't available or you prefer not to use it, self-pay pricing and financing options are available.

Plan for roughly seven to ten days in Bend: pre-operative preparation, surgery, and the first post-operative visit — typically including drain removal — before you're cleared to travel home. Much of the process happens remotely: virtual consultations beforehand, and virtual follow-ups after you return home, with clear guidance on aftercare and warning signs. Our team supports traveling patients with scheduling, lodging suggestions, and coordination; see our Traveling Patients page for the full picture. Flying home is usually reasonable once drains are out and Dr. Carboy has cleared you.