FTM Top Surgery / Mastectomy in Bangkok, Thailand by Dr. Jaray Krainam, MD
FTM Top Surgery (bilateral mastectomy with chest masculinization) is a key gender-affirming surgery that helps transgender men and non-binary individuals achieve a masculine chest. Thailand is widely recognized as a global leader in gender-affirming healthcare, offering high-quality surgery with experienced surgeons and modern hospital facilities. Among them, Dr. Jaray Krainam, MD is known for his precision, aesthetic focus, and compassionate care for international transgender patients.
Overview of the Surgery
FTM Top Surgery removes breast tissue and reshapes the chest to create a natural masculine contour. The chosen surgical technique depends on chest size, skin elasticity, and patient goals. Common methods include:
- Double-Incision Mastectomy with free nipple grafting — ideal for medium to large chests.
- Peri-Areolar (Keyhole) Technique — best for small chests with good skin elasticity.
- Buttonhole Technique — suitable for moderate breast volume with ptosis (sagging).
Goals of surgery include:
- Masculine chest definition
- Proper nipple size and placement
- Minimizing visible scarring when possible
- Improving self-confidence and gender congruence
Preparation Before Surgery
To ensure safety and optimal results, patients will complete:
Medical Evaluations
- Comprehensive health assessment
- Blood tests and imaging as needed
- ECG for cardiac screening
- Psychological support letter when required
- Review of medications and allergies
Lifestyle Requirements
- Quit smoking 4–6 weeks before surgery
- Pause blood-thinning medications if advised
- Maintain a healthy weight and diet
- Prepare assistance for the first days after discharge
Pre-Surgical Instructions
- Stop chest binding 1–2 weeks before surgery
- Shower with antibacterial wash as instructed
- Plan at least one week of recovery time in Bangkok
Surgical Procedure
FTM Top Surgery is performed under general anesthesia and typically takes 2–4 hours, depending on the technique.
The procedure generally includes:
- Creation of incisions based on surgical plan
- Removal of breast tissue and chest contouring via liposuction if needed
- Nipple resizing and repositioning to a masculine location
- Placement of surgical drains to prevent fluid accumulation
- Layered closure of incisions to support scar control and chest shape
Dr. Jaray focuses on symmetry, sculpted chest lines, and well-healed incision placement.
Post-Operative Care
Recovery varies per patient but follows common stages:
- Hospital Stay: 1–2 nights for monitoring
- Drain Removal: Usually 5–10 days post-op
- Compression Garment: Wear continuously for 4–6 weeks
- Return to Work: Light activities in 2–3 weeks
- Full Physical Exercise: Avoid strenuous upper-body workouts for 6–8 weeks
Patient self-care includes:
- Sleep on the back to protect healing chest
- Avoid lifting arms above shoulder height initially
- Keep incisions dry and clean
- Follow scar care instructions from medical team
- Attend all follow-up appointments for progress checks
Proper aftercare plays a major role in achieving smooth contours and optimal nipple graft healing.
Possible Risks and Complications
While experienced surgeons significantly reduce risks, all surgery carries potential complications:
- Infection or bleeding (hematoma)
- Seroma (fluid buildup requiring drainage)
- Nipple graft loss or reduced sensation
- Asymmetry or contour irregularities
- Prominent scarring (keloid/hypertrophic)
- Poor wound healing or necrosis in rare cases
Early medical assistance and proper post-operative care help prevent or manage these issues successfully.
Why Choose Dr. Jaray Krainam?
- Specialized focus on transgender chest reconstruction
- Advanced aesthetic techniques for natural masculine contour
- International-standard hospital environment in Bangkok
- Supportive and respectful care for LGBTQ+ individuals
- Affordable compared to Western countries with equal or superior quality
Many choose to combine surgery with a comfortable recovery period in Thailand’s welcoming medical tourism environment.
