Top Surgery / Chest Reconstruction

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The mission of the UCLA Gender Health Program is to provide healthcare for the transgender or gender-diverse community that is sensitive to everyone’s individual needs. At UCLA, we understand that gender affirmation surgery is an important step in a person’s transitioning process, but not the only step. At UCLA we not only assemble an expert team of specialists in plastic surgery to work together to perform procedures for surgical gender transition, but also provide access to providers in behavioral health, hormone therapy and primary care. For patients seeking Chest / Top Surgery, these services include:

Bilateral mastectomy / chest reconstruction: To create a more masculine chest, transmasculine individuals can elect to have a bilateral mastectomy (top surgery) to remove unwanted breast tissue. A small amount of breast tissue is typically preserved and used to create a more masculine chest appearance.
Breast augmentation: To create a more feminine chest, transfeminine individuals can elect breast augmentation surgery, in addition to the breast development that has been achieved from long-term hormone therapy.

There are a number of options to consider for both chest reconstruction and breast augmentation, and the UCLA Plastic & Reconstructive Surgery specialists at the UCLA Gender Health Program will help determine which surgical technique is right for you.

The World Professional Association of Transgender Health (WPATH): a non-profit, interdisciplinary professional and educational organization devoted to transgender health care, that has published Standards of Care for the health and care of transsexual, transgender and gender diverse people. The UCLA Gender Health Program follows the WPATH Standards of Care Guidelines for our surgeries. The most recent version of WPATH’s Standards of Care can be found here >. It is available in 18 different languages >.

Photographs: Due to privacy considerations, we do not publish photos of our patients on our website. Surgery photos - both preoperative and postoperative - are available to be seen during your initial consult.

Case Management / Care Coordinator: At the UCLA Gender Health Program, we understand the unique challenges that gender-diverse patients face when searching for health care. Providing personalized care involves collaboration between specialty physicians, which is why we have a Care Coordinator as the first point of contact. Our dedicated Care Coordinator provides our gender-diverse patients with assistance in navigating the UCLA Health system, specifically including:

Providing information about UCLA’s Gender Health Program.
Taking an initial intake assessment in order to understand each person’s health care needs and goals.
Ensuring patients are established with a primary care provider.
Coordinating referrals for gender-affirming surgeries.
Identifying appropriate providers and coordinating referrals for other supportive services.
Coordinating insurance and benefits coverage.
Advocacy within UCLA Health in all aspects of care.
Providing linkages to UCLA and community-based resources.

Notice to patients seeking top surgery:
In order to facilitate the insurance authorization and surgery scheduling process, all patients should have a statement of support from a master’s or higher level behavioral health professional submitted prior to scheduling a consultation with one of our top surgery / chest reconstruction specialists. Referrals should specify the type of surgery you are seeking, “top surgery/gender-affirming chest surgery.” Please see the resources listed below for details about what a statement of support must include and information for finding a letter writer. Once the statement of support is received by our Gender Health Program care coordination team, a department scheduler will contact you to schedule a consultation with one of our surgeons. Statements of support can be emailed to: genderhealth@mednet.ucla.edu. Thank you for trusting the UCLA Gender Health Program to be your partner in health.

Resources:
The Gender Affirming Letter Access Project >
WPATH Standards of Care >
Best Practices for Mental Health Providers in Providing Gender Affirming Assessments for Surgery Referral Letters (Webinar) >