FTM Top Surgery in Las Vegas
Masculinizing chest surgery planned to your chest size, skin, and scar goals by Dr. Robert J. Troell, MD, FACS
What FTM Top Surgery Is
FTM top surgery — masculinizing chest surgery, clinically a subcutaneous mastectomy — removes breast tissue and reshapes the chest to a flat, masculine contour, repositioning the nipple-areola complex to match. At Troell Cosmetic Surgery in Las Vegas it is performed by Dr. Robert J. Troell, MD, FACS, whose three decades of chest-wall surgery — breast reduction, breast lift, male chest contouring for gynecomastia, and VASER body sculpting — are the exact skill set this operation is built from.
For most transmasculine patients, top surgery is the highest-impact procedure available: it changes how clothes fit, how swimming and summer feel, and how the mirror reads. It deserves a plan built on your chest — size, skin quality, nipple position, scar priorities — not a one-technique practice’s default.
Two Families of Technique — and How the Choice Is Made
Double-incision with free nipple grafts is the workhorse for medium and larger chests or where skin has stretched: breast tissue is removed through horizontal incisions placed along the pectoral fold, excess skin is excised, and the nipples are resized and grafted into masculine position. It delivers the flattest, most reliably masculine contour, at the cost of a longer scar and reduced nipple sensation.
Periareolar (“keyhole”) approaches suit smaller chests with elastic skin: tissue is removed through an incision at the areola’s border, the nipple stays on its own blood and nerve supply, and scarring is minimal. The trade-off is that skin must shrink to the new contour on its own — ask more of it than it can do, and the result ripples.
The technique decision is anatomy, not preference: chest size, skin elasticity, and nipple position decide which approach can actually deliver a flat chest. Dr. Troell examines, explains the trade-offs on your body, and where useful pairs the excision with VASER liposuction at the chest borders and axilla so the new contour blends into the frame around it.
Why Choose Dr. Troell for Top Surgery
A masculine chest is a contouring result, not just a removal: the flat plane, the pectoral-fold scar line, the nipple proportion and position all have to be judged against the frame they sit on. Dr. Troell’s decades of breast reduction, lift, gynecomastia, and VASER contouring work are precisely that judgment, applied daily.
Dr. Robert J. Troell, MD, FACS is a Diplomate of the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS), a Diplomate of the American Board of Cosmetic Surgery (ABCS), and a Diplomate of the American Board of Otolaryngology – Head and Neck Surgery, with over 30 years in practice and training at the University of South Florida and Stanford University, where he later served as a Clinical Professor. He has held an active Nevada medical license since 2001 and has practiced in Las Vegas for more than 20 years. You can review his published work and credentials and decide for yourself.
Consultations are with Dr. Troell himself — he is the only surgeon at the practice, and the person who examines you is the person who operates. Consultation, surgery, and every follow-up visit happen at the same office on South Fort Apache Road.
Insurance, Said Plainly
Troell Cosmetic Surgery is a self-pay specialty surgical practice and does not bill insurance — for top surgery or any procedure. Many patients pursue insurance coverage for top surgery; if that path matters to your plan, an in-network hospital program is the honest recommendation, and we would rather tell you here than after a consultation.
What self-pay means at this practice: one all-inclusive written quote at a free consultation — surgeon, anesthesia, facility, follow-ups — no insurance-imposed constraints on technique, and financing options if you want them.
The Recovery Arc, Honestly Described
Expect a compression vest for several weeks and drains for the first week or so — typically removed between days five and ten at your first follow-up. If your surgery included nipple grafts, dressing changes and graft checks land in that same first fortnight. Desk work resumes around one to two weeks; lifting and chest exercise wait roughly six weeks so the contour heals flat. Scars mature from pink to pale over twelve to eighteen months, with scar care built into your follow-up plan.
Every one of those visits — drain removal, graft checks, scar reviews — happens with Dr. Troell in the same Las Vegas office where you had surgery.
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FTM Top Surgery FAQs
The one your anatomy earns — decided at an exam, not from a menu. Smaller chests with good skin elasticity may qualify for periareolar (“keyhole”) approaches that hide the incision at the areola’s edge; larger chests or looser skin generally get a better contour from the double-incision approach with nipple grafts, which trades a longer, deliberately placed scar for a flat, masculine chest wall. Dr. Troell walks you through the trade-offs on your own chest at a free consultation.
It depends on technique. Periareolar approaches preserve the nipple on its natural nerve and blood supply, keeping more sensation; double-incision surgery repositions the nipple as a graft, which reliably changes and reduces sensation. This trade-off — contour versus sensation — is one of the central decisions of top surgery, and it deserves an honest conversation rather than a promise.
Double-incision scars run horizontally along the line of the pectoral fold — placed deliberately so they sit where a masculine chest naturally shadows. They mature from pink and visible to pale and flat over twelve to eighteen months. Periareolar scars trace the areola’s border. Scar care is part of your follow-up plan, and every follow-up is with Dr. Troell himself.
Eighteen. Troell Cosmetic Surgery operates on adults; candidacy, health history, and readiness are reviewed one-on-one with Dr. Troell at consultation.
More than any other part of recovery: drains typically come out between days five and ten, and if your surgery included nipple grafts, the first dressing changes and graft checks land in that same window — the moment when an experienced eye distinguishes normal healing from something that needs attention. That is precisely when fly-out patients are already home, managing it by photo. Dr. Troell has held an active Nevada medical license since 2001 and has practiced in Las Vegas for more than 20 years; he is the practice’s only surgeon, and those week-one and week-two visits happen with him, in the same South Fort Apache Road office where you had surgery.
Troell Cosmetic Surgery is a self-pay practice and does not bill insurance — we say that plainly because many patients pursue insurance coverage for top surgery, and if coverage is essential to your plan, an in-network program is the honest recommendation. Here, pricing is a single all-inclusive written quote at a free consultation, shaped by technique, chest size, and anesthesia plan, with financing options available.
Related Procedures & Guides
Transgender Cosmetic Surgery
The full gender-affirming picture — face, chest and body
Breast Reduction
The reduction foundation — technique and recovery
VASER Liposuction
The contouring tool used at the chest borders
Cosmetic Surgery for Men
How masculine anatomy changes the surgical plan
Custom Jawline Implants
Masculinizing the face — jaw and chin structure
Awake Cosmetic Surgery
Anesthesia options at the practice
FTM Top Surgery Across the Las Vegas Valley
Dr. Troell’s office is at 5375 S Fort Apache Road in Spring Valley, minutes from Summerlin and the western valley. Patients come from across the metro area:
A Flat Chest, Planned to Your Frame
Meet Dr. Troell, see which technique your anatomy earns, and leave with a written plan and a written all-inclusive fee — no obligation.