Indications and Surgical Techniques for Gender Affirming Mastectomy

Gender-affirming mastectomy is an ambulatory procedure with a short recovery, favorable risk profile, and high satisfaction among transmasculine and non-binary patients. Choice of surgical technique depends on patient preference, skin elasticity, glandular tissue volume, and ptosis. Regardless of anatomy, the surgical approach is highly customizable to meet individual gender affirmation goals. Recent modifications to standard techniques are described, including neurotization of the nipple-areolar complex, which improves sensation after mastectomy and free nipple grafting.