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Don’t hesitate to contact McLean Clinic today to learn more about double incision top surgery and other types of FTM top surgery. A member of our staff will be more than happy to assist you.

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Keyhole Top Surgery

The GraceMed x McLean Clinic has helped thousands of patients feel more confident in their bodies through gender affirming keyhole top surgery. We prioritize patient-centered care to ensure every person who walks through our doors feels safe, comfortable, and happy!

Are you ready to start your surgical gender confirmation journey?

Trusted by
2,500+ Clients
in Canada
Since 1988

35+ Years

Plastic Surgery experience

25+ Years

Top Surgery


Gender Affirming
Surgeries Performed

How Keyhole Top Surgery Works

Also referred to as periareolar top surgery, a keyhole mastectomy is an outpatient surgical procedure that lasts approximately two hours. It’s a chest reconstruction technique that involves creating a tiny incision at the border of the areola. Through this small opening, the breast tissue is carefully taken out.

In some cases, keyhole top surgery may preserve the patient’s natural nipple sensitivity because, unlike other top surgery operations, the nipple stalk and the areola are left untouched. Depending on your surgeon and your individual case, your nipples may or may not be resized during the operation.

Aside from offering a higher chance of maintaining nerve sensation, another benefit of a keyhole mastectomy is that patients tend to heal faster and experience very minimal scarring. The surgical incision is barely visible and typically ranges half the length of the areola’s border, plus there is no grafting involved.

On the other hand, a known disadvantage of keyhole top surgery is that the inframammary fold (IMF)—or the boundary between the chest and the breast—is not taken out. That is why this particular surgical procedure is not suitable for all types of patients.

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Right Candidate for Body Masculinization Surgery - McLean Clinic

Are You the Right Candidate for Keyhole Top Surgery?

In keyhole top surgery, no excess skin is surgically removed. For this reason, a keyhole mastectomy is only recommended for patients who have naturally small breasts and/or high skin elasticity around the treatment area.

An ideal candidate for keyhole top surgery would be someone considered to be more flat-chested in the range of an A-B cup breast size.

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How to Prepare for Your Keyhole Mastectomy

Proper preparation plays a pivotal role in achieving phenomenal results in any medical procedure, and keyhole top surgery is no exception. Here are some practical pre-surgery tips, which are centred on boosting your body’s natural healing ability and minimizing potential risks of adverse reactions.

Additionally, GraceMed x McLean Clinic will provide you with detailed instructions on how to prepare for keyhole top surgery prior to your procedure.

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Physical Preparation

In order to help with the post-op healing process, it’s important to eat healthy and exercise before your keyhole mastectomy. You will also need to give up smoking a month in advance and limit your caffeine and alcohol consumption as well.

Some medications may also need to be stopped prior to surgery. Consult your doctor to find out which medications you should avoid.

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Mental Health

A little nervousness is normal before any surgery, especially one as life-changing as top surgery. You may wish to get help from your therapist to reduce stress and anxiety, as will connect with family and friends for support.
During your consultation, your surgeon will answer any questions you might have about the surgery, the procedure, and what to expect afterward.

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After periareolar top surgery, the recovery process varies from patient to patient. Depending on your job, you may need to take extended time off from work. Most patients are able to return to desk work one week after surgery.

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Required Documents

Check with your insurance provider if gender affirmation surgery is covered. make sure you know what documents you need to submit. Your primary care physician may also order a physical examination and laboratory tests for you. Provide a copy of the results to the clinic prior to your pre-operative appointment.

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Recovery Space

You should purchase any medication prescribed by your doctor before your procedure. It's also a good idea to put toiletries and essentials on a lower shelf so that you won't have to reach for them.

Keyhole Top Surgery Post-Op Care & Recovery

Every patient has a unique healing process. Some may recover faster than others. For the first 24 to 48 hours post-surgery, the effect of anesthesia will gradually start to wear off so it’s expected to feel a certain level of discomfort and soreness, especially around the surgical site. Your movement will be limited.

For a speedy and smooth-sailing recovery experience, here are some things for you to know:

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Rest and Recovery at Home

If you are having keyhole top surgery, you won't be able to drive, so make arrangements for someone to pick you up after the procedure. You may also want to arrange for someone to help you with tasks such as preparing meals, doing your laundry, etc. during your recovery. Ask your clinic if they can make special arrangements for a caregiver if you are living alone or travelling from abroad to have your top surgery in Canada.

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Compression Binder

Following your top surgery, you will be asked to wear a compression binder for up to six weeks. There are many benefits to wearing a chest binder after a keyhole mastectomy, including:
• Preventing fluid discharge
• Minimizing scarring
• Lessening discomfort
• Keeping the sutured skin together and • stopping it from stretching

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NO Drains and Tubes

At McLean Clinic, while drains are not necessary for all gender affirming procedures they are required for keyhole top surgery. This medical device draws out any fluid that collects under your surgical incisions to reduce the risk of seroma. This fluid will need to be emptied 2-3 times a day and logged for your surgeon’s assessment. It only takes 15-30 seconds to empty each drain. Your drains will be removed once your fluid levels are below 30 ml for more than 2 days consecutively, which will be about a week post-op.Any visible scarring from medical drains is minimal and can be found under the patient’s arms. Additional detailed instructions on proper drain care will be provided to you prior to your procedure.

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Getting Back to Work

When it comes to recovery time, there is no one-size-fits-all solution. People heal at different rates and some may recover faster than others. If you work in an office and sit at a desk all day, you may be able to return to your job after a week of rest. You might be able to do some light walking as well. Take it slowly. For up to six weeks post-op, it's best not to do heavy lifting or other strenuous activities, as this can result in bleeding.

Potential Complications & Risks

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Similar to any medical procedure, there are some risks involved with a keyhole mastectomy and other types of top surgery. During your initial consultation, your plastic surgeon will talk about this subject in detail and explain to you the strategies and precautions they can take to execute the procedure safely and effectively.

Some keyhole top surgery side effects may include:
• Fluid buildup
• Infection
• Distorted nipples
• Decreased nipple sensation
• Keloid or scarring
• Nausea and vomiting
• Distorted nipples
• Decreased nipple sensation

Why Choose GraceMed x McLean Clinic for Your Periareolar Top Surgery?

people of four who had either FTM or MTF surgeries.

Keyhole top surgery is a life-changing gender affirming procedure. Sadly, transgender discrimination still exists in healthcare, and being harassed or misgendered can discourage patients from seeking the medical care they need.

GraceMed x McLean Clinic has garnered a reputation as one of the most welcoming and accepting surgical centres for the LGBTQAI+ community—not just in Canada, but worldwide. As a result of our extensive experience, we have a keen understanding of how gender affirming surgical procedures can improve the lives of folks in the transgender and non-binary community. The results of keyhole top surgery performed by our expert surgeons have changed the lives of thousands of patients. With McLean Clinic's kind and caring staff, you can rest assured that your surgical experience will be safe, comfortable, and stress-free.

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Frequently Asked Questions

What is keyhole top surgery?

Can I get a nipple reduction at the same time as top surgery?

How do I sleep after keyhole top surgery?

What will my top surgery scars look like?

Book A Consultation - McLean Clinic

Request a Consultation

Don’t hesitate to contact McLean Clinic today to learn more about double incision top surgery and other types of top surgery. A member of our staff will be more than happy to assist you.

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.