Top Surgery in Long Island & Suffolk County, NY

While the requirements for top surgery do vary from state to state, most places require gender dysphoria to be documented by a psychologist. All patients need to want top surgery for themselves because they want to have it. Learn more by visiting https://wpath.org/.

If you are a transgender or non-binary individual interested in top-only surgery, you may be an ideal candidate for top surgery. Dr. Epstein will meet you in private consultation to discuss your aesthetic goals. He will determine if you meet the criteria for top-only surgery and customize a surgical plan based on your aesthetic goals and overall health.

Every patient recovers differently. However, the recovery period for most top-only surgeries is several weeks. During this time, you will wear a compression garment around your chest. Physical activity will also be limited until Dr. Epstein clears you. Immediately after the surgery and during your recovery period, you may experience tenderness in your chest, swelling, and possible changes in nipple sensation. Dr. Epstein will advise you on post-op care, and follow-up appointments will be scheduled to assess healing.

With about one percent of gender-affirming surgery recipients having regrets about their decision, you can rest assured that the rate remains low. The study results only apply to gender-affirming mastectomies. Most people who receive transgender surgery are pleased with their decision long-term.

Before you can receive top surgery or another gender-affirming procedure, you must first meet requirements like passing a mental health evaluation.

You might need to have undergone hormone therapy for a specific period and have a medical record that dates back at least a year proving gender incongruence.

Like any medical procedure, complications may arise after gender affirmation surgery. You might notice redness and irritation around incisions, skin infections, and bleeding.

Top surgery isn’t one-size-fits-all, and the best technique depends on your chest size, skin elasticity, and goals. Some approaches include:

• Double incision: Often recommended for larger chests or extra skin. Allows for precise contouring.
• Peri-areolar: Uses an incision around the areola. May work well for smaller chests with good skin recoil.
• Keyhole: Typically for very small chests with minimal skin excess. Uses a small incision to remove tissue.

During your consultation, Dr. Epstein will recommend the method that best matches your anatomy and ideal outcome.

Whether you’ll need nipple grafts depends on your anatomy and the surgical technique used. With double-incision top surgery, nipple grafts are more common because breast tissue and excess skin are removed, and the nipple-areola complex is repositioned to create a more masculine shape. The final look depends a lot on nipple size, placement, and symmetry, which is why careful surgical planning is so important.

Dr. Epstein approaches top surgery with an artistic eye and a precise, anatomical approach to create natural-looking results. Your plan will include careful decisions about nipple position to match your frame and proportions.

Scars are a normal part of top surgery, but they typically fade and soften over time. Early on, scars may appear pink or raised, then gradually lighten over several months.

Scar placement depends on your technique. Double incision scars sit along the lower chest, while peri-areolar and keyhole scars may be less visible. To support healthy healing, you’ll want to follow your post-op instructions closely, avoid heavy lifting too soon, and protect scars from sun exposure. Dr. Epstein may also recommend silicone sheets, scar gel, or other options.

Most patients describe discomfort from top surgery as tightness, soreness, and pressure, especially during the first week. Pain levels vary, but many people feel significantly better after the first few days as swelling starts to decrease.

Dr. Epstein will talk you through a pain management plan that may include prescription medication early on, followed by over-the-counter options as you improve. You’ll also receive instructions on how to move safely, rest comfortably, and avoid strain while your body heals.

Shower timing depends on your surgical plan, dressings, and whether drains are used, but many patients can shower within a few days (once cleared). You’ll typically need to avoid soaking incisions in baths, pools, or hot tubs until you’re fully healed.

At home, incision care usually involves keeping the area clean and dry, avoiding harsh soaps, and following dressing instructions exactly. You may also need to wear a compression garment to help with swelling and support.

Dr. Epstein’s team will provide detailed post-op guidance so you feel confident caring for your incisions and knowing what’s normal during healing.

Drains aren’t always required, but they’re common with certain top surgery techniques — especially double incision — to help prevent fluid buildup during early healing. If you have drains, they typically stay in for about one to two weeks, depending on how quickly drainage decreases. Your care team will show you exactly how to manage them at home, including how to empty and measure fluid.