Top surgery is a life-changing, gender-affirming surgery, and the cost of the surgery can vary. Factors such as the surgical procedure, the surgeon, and health insurance all affect the final price. Beyond the surgeonโs fee, facility fees, and other medical costs, many patients also face out-of-pocket expenses.
Knowing what shapes top surgery costs helps people prepare for FTM top surgery and plan for their gender affirming care.
Average Cost of Top Surgery
The surgery cost for top surgery can span a wide range depending on several factors. Most sources estimate the typical cost for FTM top surgery in the U.S. to lie between $8,000 and $16,000.
For cash-pay patients (no insurance coverage), some practices quote $14,000 to $17,000 or more, before factoring in facility fees, anesthesia fees, and other hidden costs.
In cases with insurance coverage, the out-of-pocket expenses tend to drop significantly. It’s important to note, though, that the actual coverage depends on your insurance plans, deductibles, co-pays, and whether your insurer recognizes gender affirming surgery as covered care.
Costs vary based on the surgical procedure used (for example, the double incision method is more involved than less invasive options), surgeon experience, geographic location, the amount of breast tissue to be removed, and the presence of excess skin.
When estimating total cost, always reserve room for associated expenses like imaging, lab work, post-op care, travel, and accommodations.
What’s the Cost of Top Surgery Without Insurance
Without insurance, the costs of surgery can be high. Many cash-pay or self-pay rates for gender affirming top surgery fall in the $14,000 to $17,000 range. For some procedures, like double incision, that estimate is a common benchmark.
However, the cost can fluctuate depending on several factors. Some surgeons list base rates (just the surgeonโs fee) within the $8,000 to $11,500 range, although this doesnโt include facility costs, anesthesia fees, or other associated costs.
In more conservative estimates or smaller-scale procedures, you may see out-of-pocket costs ranging from $3,000 to $10,000 (although these are rare and often associated with minimal procedures).
Because the surgery cost can include many components such as facility fees, anesthesia, post-op garments, lab tests, and possible travel and lodging, many people preparing for surgery budget well above the base quote to avoid hidden surprises.
Cost of Top Surgery with Insurance
When health insurance includes coverage for top surgery, the overall surgery cost is reduced; however, there are still expenses to plan for. Approval usually requires paperwork showing medical necessity related to gender dysphoria and gender identity.
Even with approval, most patients must meet deductibles and pay co-pays or coinsurance. Final bills depend on whether the surgeon and hospital are in-network, as out-of-network care often results in higher charges.
Insurers may cover a large portion of the surgeonโs fee, facility costs, and anesthesia, while smaller items, such as prescriptions, compression garments, or travel costs, can be the patient’s responsibility.
In some cases, the remaining out-of-pocket costs are a few thousand dollars; in others, they may be higher. Some insurers classify gender affirming top surgery as reconstructive plastic surgery, which can improve coverage, and several states now require public health plans to include gender affirming procedures in their benefits.
What to Expect at Your Gender Affirming Care Free Consultation
During a consultation, you meet with the surgeon and discuss your goals for top surgery. The conversation typically covers health history, gender identity, and which approach might be best suited for your chest. For some, the double incision method is recommended. Others may hear about an inverted T or smaller changes depending on how much breast tissue needs to be removed.
The surgeon will outline the surgery cost. That includes the surgeonโs fee and any facility costs. Youโll also find out what part of the bill might count as out-of-pocket costs if your insurance coverage is limited.
This visit is also an opportunity to discuss timing. A surgery date can be set, and the team will explain how to schedule it. Youโll leave knowing what recovery looks like, from wearing compression garments to planning follow-up appointments and understanding possible changes in nipple sensation.
Understanding What Gender Affirming Top Surgery Is
Gender affirming top surgery reshapes the chest to match a personโs gender identity. For many trans men, this means the surgeon will remove breast tissue to create a flatter shape.
The type of procedure depends on the body. Some people require a double incision or an inverted T, while others may be eligible for a smaller incision if less tissue is involved. Each top surgery comes with different scars, changes in nipple sensation, and healing times.
Because results and top surgery costs can vary depending on the method, the surgeon explains which option best suits your body type and goals for a new chest.
Double Incision Top Surgery
The double incision method is the most common surgery procedure for trans men with larger amounts of breast tissue. During this approach, the surgeon makes two cuts across the chest to remove breast tissue and create a flatter shape. This technique is often chosen when smaller options are not possible, since the surgery varies based on body types and tissue levels.
The operation is usually done in a hospital or an accredited surgical center. It involves a longer recovery period than a small incision technique, but it allows the surgeon to create a more natural chest contour. For many, this procedure results in a strong, masculine-looking new chest.
Because the top surgery is more complex, the total cost can be higher than that of other methods. In addition to the surgeonโs fee and facility fees, patients may incur other costs, such as anesthesia, supplies, and follow-up care. Each estimate will look different, but most agree this method provides lasting results that support long-term gender affirmation.
Additional Procedures in Addition to FTM Top Surgery
Some patients need more than one top surgery procedure. Extra steps may involve removing excess skin, addressing scars, or adding contour. An inverted T can be used when the double incision method is not enough.
These changes bring extra bills. More time in the room, more anesthesia, more supplies. Each one adds to the surgery cost. Sometimes, the charges are reflected later as revisions or other fees.
If you are on hormone therapy, the surgeon may suggest waiting or matching the surgery date with changes from treatment. Top surgery results and healing vary depending on the person.
Bottom Surgery
Bottom surgery is part of some peopleโs transition-related care. It is separate from top surgery and more complex. The overall cost is higher. Bills come from the hospital, anesthesia, and long stays. Higher fees are common. Even with insurance, there can be out-of-pocket costs.
Many surgeons ask for hormone replacement therapy or ongoing hormone therapy before approval. Policies differ, and some exclude gender affirming procedures. For some, these steps are necessary for full gender affirmation and long-term transgender health.
How to Best Acquire Insurance Coverage for FTM Plastic Surgery
Insurance companies want proof before approving a procedure. That usually means letters from a doctor that confirm gender dysphoria and explain your gender identity. Most follow rules from the World Professional Association for Transgender Health.
Your top surgeon sends details about the top surgery procedure and the expected cost of the surgery. This is needed before they set a surgery date or add you to the schedule.
Coverage rarely pays for everything. Patients often encounter hidden fees, such as garments, travel, or medications. Ask early so you know what to expect.
If a claim is denied, file an appeal. Some individuals turn to grants, state assistance, or payment plans as more affordable options. Keeping records of top surgery costs and other expenses helps with appeals and reimbursement.
Top Surgery Cost FAQs
What is the buttonhole technique for top surgery?
The buttonhole technique is a top surgery method that removes chest tissue through horizontal incisions at the pectoral muscle base while keeping nipples attached to underlying tissue via a thin dermal pedicle. This preserves nipple sensation, pigmentation, and projection without requiring free nipple grafts, resulting in a masculine chest with maintained mound-like contours rather than complete flatness.
What is the Average Cost of FTM Top Surgery?
The surgery cost for FTM top surgery usually falls between $8,000 and $16,000 before insurance coverage. This range can vary depending on the surgical procedure, surgeonโs fee, and facility fees. Additional out-of-pocket expenses, anesthesia, and follow-up care may raise the total. When insurance is applied, most patients pay significantly less.
Does My Geographic Location Affect Coverage or Price?
Yes. Top surgery costs and insurance approval rules often vary depending on where you live. States have different laws about transition-related care, and some require insurance plans to cover gender affirming procedures. In major cities, prices may run higher due to demand and hospital rates, while smaller areas may offer more affordable options. Always confirm what your insurance covers before setting a surgery date.
Can Top Surgery be Covered by Insurance?
Most insurance companies do not inherently cover top surgery. However, some plans do offer coverage for surgery in some instances, so it’s best to check with your specific insurance provider. Many policies require documentation from mental health professionals and letters of support demonstrating medical necessity before they’ll consider approving coverage.
Is FTM Top Surgery Worth it?
Top surgery is generally worth it for anyone who has struggled with gender dysphoria and other avenues have had little to no results. You’ll need to weigh the costs associated with the surgery and determine if it’s worth it for you, personally. Studies show that the vast majority of patients report significant improvements in quality of life and reduced dysphoria following the procedure.
Ready for Your FTM Top Surgery Consultation?
Take the next step toward your goals with Dr. CV Chegireddy at Aesthera Plastic Surgery. Schedule your consultation today to discuss options, review your surgery cost, and plan the path to your procedure with expert care.
