Keyhole Surgery Transgender(A Complete Guide On Keyhole Top Surgery)

Keyhole Surgery transgender individuals is a type of gender confirmation surgery that creates a more masculine chest by removing breast tissue and repositioning the nipples. According to a study published in the Journal of Plastic, Reconstructive & Aesthetic Surgery, keyhole top surgery is becoming increasingly popular due to its lower complication rates and minimal scarring. The study found that out of 150 transgender individuals who underwent keyhole top surgery, 97% were satisfied with their keyhole top surgery results. Additionally, a 2020 survey conducted by the American Society of Plastic Surgeons found that breast reduction procedures, including keyhole top surgery, were the most common procedures among transgender individuals. Keep reading for more information.

  • Transgender Surgery

By Mitali Pawar

Updated on 29th, Mar'23

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Keyhole surgery transgender is a transformative gender reassignment surgery that can greatly improve the physical and emotional well-being of transgender individuals. This procedure, also known as peri-areolar, or keyhole mastectomy or minimally invasive top surgery


Masculine chest


It’s designed to create a masculine chest appearance while minimizing scarring. It involves the removal of breast tissue and the reshaping of the chest to create a more masculine appearance. 


This surgery can be life-changing for individuals who have been struggling with gender dysphoria, allowing them to finally feel comfortable in their own bodies. 


In this article, we will delve deeper into the specifics of keyhole top surgery for transgender, including the benefits, risks, and recovery process. 


We will also explore the unique considerations for transgender individuals looking to undergo this procedure. 


Read further as we explore the world of keyhole top surgery and learn how this procedure can help individuals on their journey to self-acceptance and fulfilment.


If you're considering gender confirmation surgery, you won't want to miss this.


Learn more about how it works.


How Keyhole Surgery Transgender Works?


It is a form of minimally invasive surgery that is used to masculinize the chest in transgender individuals. 


Here is an overview of the key steps involved in the procedure:

  1. Consultation

Before the surgery, the patient will have a consultation with their surgeon to discuss their desired outcome, medical history, and any potential risks or complications. The surgeon will also examine the patient's chest to determine the best surgical approach.

  1. Pre - operative preparation

The patient will be instructed to stop taking certain medications before the surgery and will be given instructions on how to prepare for the procedure.

  1. Anesthesia

The patient will be given general anesthesia or IV sedation to ensure they are comfortable and pain-free throughout the procedure.

  1. Incision

The surgeon will make a small incision around the areola, through which the breast tissue will be removed. The size of the incision and the amount of tissue removed will depend on the patient's individual case.

  1. Surgery

Using specialized instruments and high-definition cameras, the surgeon will carefully remove the breast tissue through the small incision. They may also need to reposition the nipples in order to achieve a more masculine appearance.

  1. Time taken

Keyhole top surgery typically takes about 2-3 hours to complete, and it can be done under general anesthesia.

  1. Hospital Stay

This is an outpatient keyhole procedure top surgery and patients can go home the same day

  1. Closure

Once the breast tissue has been removed, the surgeon will close the incision with sutures or surgical tape. The result is expected to be visible between 2 to 3 weeks after the surgery.

  1. Recovery

The recovery process is relatively short, with most patients able to return to normal activities within a week or two. The patient will need to rest and recover for a period of time after the surgery, during which they will be instructed on how to care for their incision.

  1. Post-operative follow-up

The patient will have follow-up appointments with their surgeon to monitor their recovery and address any concerns.


Benefits/Risks of Keyhole Surgery Transgender


Keyhole top surgery is a great option for many transgender individuals seeking chest masculinization, because it offers the benefits of minimal scarring, a faster recovery time, and a less invasive surgery.


Keep in mind that every patient is different and individual factors such as skin type and elasticity, breast size, and desired result will affect the final outcome. 


It is important to have a thorough discussion with your surgeon to understand the best approach for you.


Here are some of the main benefits of keyhole surgery transgender, broken down by category

Let’s dive into the benefits of the Keyhole top surgery for transgender




Short surgical period

Quick surgery: Surgery takes about 2-3 hours to complete, and it can be done under general anesthesia

Cosmetic Outcome

Minimal Scarring: Unlike traditional open mastectomies, which leave a large, often visible scar across the chest, keyhole surgery only requires a few small incisions around the areola. This results in less noticeable scarring and a more natural-looking chest appearance.


Shorter Recovery Time: Because less tissue is removed, the recovery time for this procedure is generally shorter than for open surgery. Can return to normal activities within a week or two. 

Precise Surgery

Advanced technology: Keyhole top surgery is often performed using advanced technologies such as high-definition cameras and specialized instruments, which allows for more precise and accurate surgery. This can lead to a better cosmetic outcome and less complications.

Post Surgery

Lower Complication: It has a lower complication rate compared to traditional top surgery methods.


Natural Outcome: Beneficial for individuals looking to maintain a more natural-looking chest.

Quick Results

The result is expected to be visible between 2 to 3 weeks after the surgery.


With benefits also comes certain risks, keep yourself updated with both the pros & cons of keyhole surgery transgender




Complications from surgery

  • Risk of bleeding
  • Risk of infection
  • Risk of reactions to anesthesia

Complications from the surgery technique

  • Injury to nearby organs.
  • Longer surgical time if the surgeon runs into unexpected challenges

Outcome dissatisfaction

  • Risk of dissatisfaction with the outcome
  • Risk of complications that might affect the final result


Higher costs than traditional open surgery.

Revision Surgery

Risk of revision surgery to correct a problem or improve the final outcome.

Nerve damage and Loss of sensation

Risk of nerve damage or loss of sensation in the chest area

Loss of breast tissue

Risk of loss of breast tissue which might impact the final result

Anesthesia complications

Risk of complications from the use of anesthesia.

Keyhole top surgery, also known as peri-areolar or keyhole mastectomy, is a form of minimally invasive surgery that is growing in popularity among transgender patients seeking chest masculinization.


This surgery offers several benefits over traditional open surgery, making it a great option for those looking to transition.

Every patient is different and individual factors such as skin type and elasticity, breast size, and desired result will affect the final outcome. It is important to have a thorough discussion with your surgeon to understand the best approach for you. 


Talk to your surgeon about whether this procedure may be right for you and have a clear understanding of the possible outcomes and risks. 

Do I fit in? If that’s what comes to your mind then read further to know the criteria.


What are the eligibility criteria and requirements for keyhole top surgery transgender?


The eligibility criteria and keyhole top surgery requirements for transgender individuals can vary depending on the surgeon and the individual's specific health needs. However, there are some guidelines that are followed by most surgeons.

Keyhole top surgery is a peri-areolar or donut mastectomy. It's a surgical procedure that is performed on transgender individuals who are looking to remove breast tissue as part of their gender transition. 


It is most commonly performed on individuals who are transitioning from female to male (FTM) but in some cases on individuals who are transitioning from male to female (MTF) as well.


This procedure is suitable for individuals with small to medium-sized breasts and those who are looking for a less invasive alternative to traditional mastectomy. 


The keyhole technique allows the surgeon to remove breast tissue through a small incision around the areola, which can result in less scarring and a shorter keyhole top surgery recovery time compared to traditional mastectomy.


Not everyone is a good candidate for keyhole top surgery. The best way to determine whether this procedure is right for you is to consult with a doctor who is an experienced surgeon. 


He/she can evaluate your individual health needs and circumstances. A thorough medical examination is required, including a physical examination, blood work, and possibly other diagnostic tests such as imaging. 


Also, having a stable social and psychological support system in place is crucial before having this kind of surgery.

Generally surgeons will require that the individuals seeking keyhole top surgery:

  • is at least 18 years old (some surgeons may require the individual to be older)
  • has completed a minimum of one year of hormone therapy, if they are transitioning from male to female
  • has a stable social and psychological support system in place
  • has a detailed understanding of the procedure and its potential risks and benefits
  • has realistic expectations for the outcome of the surgery

The individual will also be required to provide the surgeon with their medical history, including any previous surgeries or health conditions that may affect the outcome of the keyhole surgery top surgery.


While these are the general eligibility criteria and requirements, the final decision on whether to proceed with the surgery is made by the surgeon, taking into account the individual's specific health needs and circumstances.

Let’s learn about some of the pre & post operative guidelines and the side effects of Transgender Keyhole top Surgery 


How To Prepare? 

  • Pre-operative Guidelines


Pre-operative preparation is important in ensuring a safe and successful keyhole top surgery for transgenders. 


Here are some of the key steps involved in pre-operative preparation for this procedure:


Pre- op of keyhole surgery transgender- No smoking


  1. Consult with your surgeon
Your surgeon will provide you with detailed information about the procedure, including the risks and benefits, as well as what to expect during and after the surgery. They will also provide you with pre-operative instructions and answer any questions you may have.
  1. Stop certain medications
You will be instructed to stop taking certain medications that may increase the risk of bleeding during the surgery, such as blood thinners, aspirin, and anti-inflammatory medications.
  1. Medical evaluation
You will need to undergo a medical evaluation to ensure that you are healthy enough to undergo surgery. This may include blood tests, a physical examination, and a review of your medical history.
  1. Quit smoking
If you are a smoker, you will be instructed to quit smoking before the surgery as smoking can slow down the healing process.
  1. Arrange for transportation and recovery
You'll need someone to drive you home after the surgery and help you during the recovery period. It is also a good idea to arrange for help at home, as you will need to take it easy for a few days and may not be able to do certain tasks.
  1. Prepare for recovery
It's a good idea to purchase any necessary recovery items such as gauze, bandages, and ice packs before the surgery.
  1. Follow any other instructions your surgeon gives you
Your surgeon may have more instructions for you. Depending on your individual case, such as wearing compression garments, fasting before the procedure, or taking antibiotics.

It's important to be prepared and follow the instructions from your surgeon. This will help to reduce risks, improve your recovery and to achieve the best possible outcome of your surgery.


You must read through some important points here - the side effects, results, recovery and success rates!


Side effects of keyhole top surgery transgender

As with any surgical procedure, there are potential risks and side effects associated with keyhole top surgery. 


Some of these can include:



  • Pain and discomfort at the surgical site
  • Bleeding and blood loss
  • Infection
  • Blood clots
  • Nausea and vomiting
  • Fatigue
  • Scarring
  • Changes in sensation in the chest area
  • Unexpected cosmetic outcomes
  • Need for revision surgeries

Tensed after reading about the side effects? 



You can reduce the risk of side-effects by following the below post-operative guidelines. 


Post-operative guidelines for Keyhole Surgery Transgender

Post op guidelines

  • Wearing a compression garment for several weeks to help with healing and reduce swelling.
  • Avoiding heavy lifting or strenuous activity for several weeks.
  • Keeping the incisions clean and dry.
  • Following any additional instructions provided by your surgeon regarding wound care, medications, and follow-up appointments.
Life after keyhole top surgery transgender - Results



The results of keyhole top surgery are visible immediately after the surgery, but it can take several weeks or months for the incisions to heal completely and for the final results to become apparent. Swelling and bruising are joint after surgery. And it is essential to follow your surgeon's instructions for post-operative care to ensure the best possible outcome.


It is common for anyone who has undergone surgery to experience pain and discomfort. Your surgeon will provide you with pain medication to help manage this. You also need to wear a compression garment for several weeks after surgery to help reduce swelling and support healing

Long-lasting/ Permanent

Once the incisions have healed, the results of keyhole top surgery are long-lasting and can be considered permanent. The removed breast tissue will not grow back, and the chest will retain its new shape. There may be some residual asymmetry or scarring. If so, this should be discussed with your surgeon before the surgery.

Keyhole top surgery can be a life-changing procedure for many transgender individuals. It can help to reduce chest dysphoria and improve self-esteem and body image.

Surgery is a huge decision and should not be taken lightly. It's always good to consider the risks, benefits, and mental and financial aspects before making any move. 


You must seek guidance from experienced mental health professionals and surgeons—specifically, those with experience working with transgender individuals.


What are the Success Rates of keyhole top surgery transgender? 

Success rates of keyhole top surgery

The success rate of keyhole top surgery for transgender patients is exceptionally high. The keyhole top surgery is a very effective technique for creating a more masculine chest appearance.


According to a study conducted in 2018, the overall satisfaction rate among transgender patients who had undergone keyhole top surgery was 97.5%. It means that out of the patients who underwent the procedure, 97.5% were satisfied with the results.

Is Relapse possible after keyhole top surgery transgender? Let’s check if it’s possible or not and what are the factors?

Relapse after Keyhole Top Surgery

Relapse after keyhole top surgery (also called peri-areolar top surgery) is a possible complication. However, it is considered to be rare. 


The risk of Relapse can depend on a variety of factors:

  1. The amount of breast tissue present before surgery
Individuals with more breast tissue may be at a higher risk of Relapse because more tissue was left behind.
  1. The surgical technique used
The surgical technique used by the surgeon can affect the risk of Relapse. For example, if not all the glandular tissue is removed or the remaining tissue is not reshaped correctly, there may be a greater risk of Relapse.
  1. The skill and experience of the surgeon
An experienced and skilled surgeon specializing in this type of surgery will be more likely to achieve a good outcome and less risk of Relapse.
  1. Post-surgery weight changes
Gaining or losing weight after the surgery can affect the shape of the chest and could cause Relapse.
  1. Hormone therapy
It's an integral part of the transition process for many transgender people. Hormones can play a role in the remaining breast tissue post-surgery and can also affect the result of the surgery.
  1. Patient's anatomy
The patient's unique physical characteristics may also play a role in the risk of Relapse. Some people may have a greater chance of Relapse due to the underlying anatomy.

This surgery is not without risks, and each person will respond differently. That's why it's crucial to have a detailed consultation with the surgeon, understand the risks and possible complications, and set realistic expectations.

You also need to be aware that even if there is a relapse, revision surgeries are available and are sometimes done to correct this.

Let’s get some insights on the cost & insurance part.


What is the general cost of keyhole top surgery for transgender and whether is it covered by insurance?


The  keyhole top surgery cost for transgender individuals varies depending on a number of factors like the location of the surgery, the surgeon's experience and reputation, and the specific surgical technique used. 


On an average, the cost of keyhole top surgery can range from Rs. 4,06,190 or $5,000 to Rs.7,31,150 or $9,000.


Insurance coverage for keyhole top surgery for transgender individuals can also vary depending on the specific insurance plan and the laws and regulations of the state in which the individual lives. 


Some insurance plans may cover the cost of keyhole top surgery as part of gender-affirming surgery, while others may not. It is best to check with the individual's insurance provider for more information on coverage for keyhole top surgery.


Hope all your doubts related to keyhole surgery transgender must have got cleared! 


Have some more doubts?

Then do not miss reading the FAQs below. 




  • Who can have keyhole top surgery?   

Ans. It is most commonly performed on individuals who are transitioning from female to male (FTM) but in some cases on individuals who are transitioning from male to female (MTF) as well. Those who are small or medium-sized chest are ideal candidates

  • What is the success rate of keyhole surgery?

AnsThe success rate of keyhole surgery is generally quite high, with studies showing a success rate of between 84-98%. The success rate depends on the type of procedure being performed, the skill of the surgeon, and the health of the patient.


  • How many holes are in keyhole surgery?

Ans. Upto 4 small incisions


  • Can keyhole surgery transgender be reversed?

Ans. It is not possible to fully "reverse" the surgery, but some individuals may choose to undergo additional surgeries to alter their physical appearance. However, it's important to consider that reversing a transgender surgery is a complex and difficult process, with many risks and ethical issues, and that also may have a deep psychological impact in the person's life.

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