Breast removal or breast amputation (mastectomy)

A comprehensive consultation with our board-certified specialists in Plastic and Aesthetic Surgery, Dr. Andrea Wolff and Dr. Isabel Edusei, is an essential part of the preparation process. During this appointment, all questions and concerns are addressed, and your individual wishes and expectations are discussed in detail. Dr. Wolff and Dr. Edusei take the time to inform you thoroughly about the different techniques and options for mastectomy and to develop the most suitable individualized treatment plan together with you.

 

At the Wolff & Edusei outpatient clinic, we are committed to taking the individual wishes of transgender and non-binary individuals into account as fully as possible within the scope of medical and technical feasibility. Some patients, particularly those with a fluid gender identity, wish to retain a portion of their breast tissue. In certain cases, care is taken during the mastectomy to preserve a small amount of glandular tissue in order to achieve a more even contour of the chest area. It should be noted that this approach is not comparable to a complete breast removal, such as that performed in the context of a prophylactic gland removal due to an increased risk of breast cancer. Rather, the aim is to realize the aesthetic goals of the patient while taking medical requirements into consideration — always within the limits of what is medically achievable.

 

Depending on anatomical conditions and personal preferences, various mastectomy techniques are available:

The most common surgical approach is a mastectomy with a horizontal incision, in which the nipples are grafted as free nipple transplants. This means they are precisely removed and, after the breast gland has been excised, transplanted to their new position on the chest wall.

 

One disadvantage of this surgical method is that the original sensitivity of the nipple cannot be preserved. In some patients, a certain degree of deep sensitivity may return over time.

 

Alternatively, the nipple can be completely removed together with the breast gland, which is a common preference particularly among non-binary individuals.

 

The so-called keyhole technique, in which the breast gland is removed through a small incision at the edge of the areola, is another frequently requested mastectomy method. Tightening procedures, for example around the nipple, can be performed either immediately or at a later stage if necessary. This technique is often requested and, in suitable cases, may result in discreet scarring; in some cases, partial nipple sensation can also be preserved. However, it can only be performed under certain conditions. These include a small breast size and firm skin that is capable of retracting maximally after the removal of the glandular tissue beneath it.

 

We often combine mastectomy with additional contouring procedures.

For example, the shape and size of the nipples (nipples or papillae) can be adjusted if desired.

Liposuction of adjacent areas (for example, localized fat deposits along the lateral chest wall or above the armpit), or to loosen the glandular body and adapt the skin-soft tissue envelope in the keyhole technique, may be beneficial in certain cases to further refine the aesthetic contour.

 

Complete removal of the nipples is also possible upon request.

 

We work closely with an experienced network of psychologists, gynecologists, urologists, and endocrinologists who can also provide support and consultation. In a personal consultation at our Berlin outpatient clinic, we will discuss together which gender-affirming procedures best align with your goals.

 

Dr. Wolff and Dr. Edusei take the time to understand your concerns and create an individualized treatment concept. You can easily book your appointment online.