Gender reassignment surgery at Leicester Hospital

What is gender affirmation (confirmation) or sex reassignment surgery?

Gender affirmation surgery refers to procedures that help people transition to their self-identified gender. At Nuffield Health Leicester Hospital, we offer the below the below gender-affirming options:

• Top\Chest Surgery

It’s important to understand that, for most people, surgery is only one part of the transitioning process.

Starting your journey with Nuffield Health Leicester Hospital

Prior to your surgery, you will be referred by the team at the transgender service clinic (NHS) or your independent consultant, once your referral has been received our dedicated team will be in contact to start your journey. After surgery, you should continue to work with your therapist or counsellor. This professional can support you with social transitioning and your mental health.

Surgical Techniques used by the surgeon

1. Double Incision with Free Nipple Graft (Bilateral Mastectomy): Best suited for persons with larger breasts. Two horizontal incisions are made across the chest, and the breast tissue is removed. The nipple and areola are resized and repositioned as grafts to a more masculine location.
2. Peri-areolar (or Circumareolar) Top Surgery: Ideal for individuals with small to medium-sized breasts and good skin elasticity. Incisions are made around the areolas, and excess skin and tissue are removed. The nipple and areola may be resized and repositioned without detaching them entirely.
3. Keyhole Top Surgery: Best for individuals with small breasts and minimal excess skin. A small incision is made, typically at the border of the areola, through which breast tissue is removed. This method leaves minimal scarring and does not involve resizing or repositioning the nipple and areola.
4. Inverted-T (or T-Anchor) Top Surgery: A combination of the double incision and peri-areolar techniques. Suitable for individuals with larger breast size who desire nipple and areola preservation but also need significant skin removal. All patients will require the insertion of a drain

Preparing to visit us for the first time

You may want to think about what you want to ask before your visit. You can then jot down a few questions, or simply ask us anything that springs to mind on the day. We want to make sure that you are fully informed before deciding whether to go ahead with treatment or surgery. If you have a question, we’ll answer it. If certain medical terms aren’t clear, we’ll explain them. If you’d like to bring a friend or family member for support to your appointments, please bring them.

To ensure you receive the best possible advice and support you will be required to have two face-to-face appointments prior to surgery. If you live within 2 hours of the hospital your initial appointment will be held face-to-face with a consultant surgeon. For persons that live further than 2 hours away, your initial appointment can be held via an MS Teams or Virtual Appointment if you prefer. If you choose this option, you will receive a questionnaire that will need to be completed and returned to the consultant prior to your appointment following this appointment you would then need to see the consultant face to face at least once prior to surgery.

Arriving at the hospital

When you arrive at the hospital please enter through the main doors at the front of the hospital this will bring you to our main reception. If you use or require a wheelchair, and need assistance with it, you can also ask here.

When you get to the main reception, let a member of staff know you have arrived before you take a seat. We will need to make sure we are up-to-date with all your details, and you may need to complete a registration form, if you haven’t already done so.

It’s normal to feel a bit anxious or unsure. We are here to help and care for you. If you have any concerns, do let us know and we will help you.

Meeting your consultant

Our Consultants are here to listen, answer any questions and tell you all about the treatment or procedure you are considering. They are highly experienced – you can trust in the care and attention you will receive from them.

Your consultant will continue to look after and support you throughout your journey at Nuffield Health Leicester Hospital.

How soon will I recover?

After the operation, you will be given intravenous fluids and antibiotics as per your surgeon's recommendations.

• You may have dressings and drains (plastic tubes) coming out of the side of your chest
• The drains are usually removed within 24 hours post-surgery and you will be discharged home
• At the time of discharge, you will be recommended to wear a pressure garment which you will be required to purchase prior to surgery
• You will be given post-operative painkillers

You will be given an appointment to return for a wound check 7 – 10 days following discharge, during this time it is important that you:

• Rest as much as possible
• Normal walking in and outside avoiding extreme weather including cold
• Drink plenty of non-alcoholic fluids
• Wear stocking up to 7 days
• Avoid driving until your follow-up appointment or until you are completely pain-free

Your surgeon will arrange a further appointment approximately 8 weeks following surgery.