A nonbinary chest does not have one correct shape. For some people, the goal is a flat, traditionally masculine chest. For others, it is a smaller chest, softer contour, retained nipples, or a result that feels intentionally outside male and female expectations. These nonbinary top surgery examples show why the procedure must begin with your individual goals, anatomy, and willingness to accept specific scars and trade-offs.
The strongest surgical result is not created by applying one technique to every nonbinary patient. It comes from a detailed consultation, a clear visual discussion of desired contour, and a surgeon with extensive experience creating masculinized chests across a wide range of body types.
Nonbinary Top Surgery Examples by Desired Chest Appearance
Nonbinary top surgery is an umbrella term, not a single operation. A patient may want less breast tissue, a flatter chest, a more androgynous shape, or a chest that remains visibly soft. The examples below describe common directions a surgical plan may take.
Flat chest with masculine contour
Many nonbinary patients seek the same degree of flatness requested in FTM top surgery. This generally involves removing breast tissue and addressing excess skin so the chest lies flat against the underlying muscle. For patients with moderate to significant tissue or skin laxity, double-incision top surgery is often the most reliable approach.
The final chest is not simply “flat.” Surgical contouring matters. A skilled plan considers the pectoral border, side-chest fullness, incision placement, and the transition from chest to underarm. The goal may be a distinctly masculine chest or a neutral flat chest with less emphasis on traditionally masculine definition.
Flat chest with no nipples
Some nonbinary patients choose nipple removal rather than nipple grafting or preservation. This can create a clean, smooth chest and avoids the healing variables associated with nipple grafts. It may also support a patient’s aesthetic preference or reduce dysphoria connected to nipple appearance.
This is a permanent decision. Nipple reconstruction or tattooing can be considered later, but neither fully recreates natural sensation or anatomy. Patients should be certain that a nipple-free chest aligns with their long-term goals before selecting this option.
Flat chest with resized or repositioned nipples
Other patients want a flat chest but prefer to retain nipples. In a double-incision procedure, nipple grafts can be resized and placed in a more masculine or neutral position. The exact placement is based on chest width, muscle shape, skin quality, and the desired visual effect.
Nipple grafting involves trade-offs. Sensation commonly changes, pigment can heal unevenly, and graft healing requires careful postoperative care. Yet for many patients, retaining nipples is an essential part of feeling at home in their chest.
Smaller chest with retained fullness
Not every patient wants complete removal of breast tissue. A nonbinary breast reduction can reduce volume while maintaining some fullness and a more traditionally breast-like shape. This may be appropriate for someone who wants less binding, reduced physical discomfort, or a more androgynous silhouette without a fully flat result.
A reduction is different from top surgery designed for chest masculinization. Residual tissue and skin are intentionally retained, which means the chest will not look or behave like a flat masculine chest. Future weight changes, hormones, and skin elasticity can also influence the long-term shape.
Androgynous contour with selective tissue removal
Some patients want a result between a breast reduction and a fully masculinized chest. They may request significant tissue removal while accepting a modest amount of contour, or they may prefer nipples that remain in a less traditionally masculine location. These plans require particularly clear communication.
Words such as “androgynous,” “natural,” and “not too flat” mean different things to different people. Reference photos can help explain preferences, but they are a starting point, not a guarantee. Every chest has different skin quality, breast width, tissue density, and healing behavior.
How Technique Changes the Result
The procedure chosen for nonbinary top surgery depends on anatomy as much as aesthetic preference. A surgeon cannot responsibly promise a specific scar pattern or nipple outcome without examining the chest and discussing the priorities behind the request.
For patients with smaller chests and good skin elasticity, keyhole or periareolar approaches may be options. These procedures use smaller incisions and can preserve the nipple on its blood supply, but they provide less control over excess skin and nipple position. They are not ideal for every patient seeking a flat chest.
Double-incision top surgery offers the greatest ability to remove tissue and skin, shape the chest, and resize or reposition nipples. The trade-off is visible horizontal scarring. For many patients, this approach provides the most predictable contour when there is more tissue, loose skin, or a need for substantial reshaping.
Liposuction may also be used to refine fullness near the underarms or along the outer chest. It is a contouring tool, not a substitute for removing dense breast tissue or excess skin. When used thoughtfully, it can help create a smoother transition across the chest.
Questions That Create a Better Surgical Plan
A consultation should go beyond asking whether you want to be flat. Patients benefit from describing what they do and do not want to see when they look in the mirror, wear a fitted shirt, raise their arms, or go shirtless.
Consider whether your priority is complete flatness, scar minimization, nipple preservation, nipple removal, a smaller chest, or a more masculine pectoral outline. These priorities can conflict. For example, the smallest possible scars may limit a surgeon’s ability to remove loose skin or reposition nipples. Preserving nipples may limit how much they can be resized or moved in certain techniques.
It is also useful to discuss binding history, weight stability, prior chest surgery, smoking or nicotine use, medications, and any history of difficult scarring. These factors can affect safety, healing, scar quality, and the range of procedures that may be appropriate.
At The Garramone Center, the consultation process is built around this level of surgical specificity. Patients should expect direct guidance about which goals are achievable with their anatomy, where compromise may be necessary, and which approach offers the best balance of contour, scar placement, and reliability.
Looking at Results With a Critical Eye
Before-and-after photographs can be valuable, especially when they show patients with a similar starting chest, build, and chosen procedure. Look beyond the first impression. Examine whether the chest appears balanced from side to side, whether the scars follow the chest naturally, and whether there is unwanted fullness near the underarms or center chest.
Also consider the stage of healing. Early results can include swelling, redness, firmness, and uneven scar color. A chest that looks refined at one year will not look the same at two weeks. Reputable surgical counseling makes room for this reality rather than presenting recovery as immediate.
No surgeon can guarantee perfect symmetry, invisible scars, or preserved nipple sensation. Revision is sometimes appropriate for contour irregularities, scar concerns, residual tissue, or changes that become apparent after swelling resolves. Choosing a highly specialized surgeon from the beginning can reduce avoidable problems, but every surgical decision carries risk.
Recovery Should Match the Procedure
Recovery varies according to the technique, extent of tissue removal, use of nipple grafts, and individual healing. Most patients need to limit lifting and strenuous upper-body activity early on, wear recommended compression, and attend follow-up visits. Patients traveling for surgery should plan carefully for nearby recovery time and follow the postoperative instructions provided by their surgical team.
The emotional adjustment matters, too. Relief from chest dysphoria can be profound, but it is normal to experience impatience while swelling resolves or scars mature. Give your body the time required to heal before judging the final outcome.
The most useful of all nonbinary top surgery examples is the one that helps you name your own priorities. Bring those priorities to a focused consultation, ask direct questions about the trade-offs, and choose a plan that is designed for the chest you want to live in for years.