Female-to-Male (FTM)

What Is FTM?

An FTM procedure includes your choice of a few surgeries to change your body from female to male:

  • Top surgery (periareolar or double incision)
  • Facial masculinization
  • BioTE Hormone Replacement Therapy (BHRT)

As a specialist in gender affirmation and a top female cosmetic surgeon in the Baltimore area, Dr. Fischer and her team are experts at performing these transformation procedures, and understand the emotional and physical complexities that come with them. Together, we have helped countless people make this life-changing transition.

View Before & After Photos

Reasons to Consider


FTM Top Surgery Incisions

When considering top surgery at the Advanced Center for Plastic Surgery, Dr. Beverly Fischer will examine your breasts and determine if it is best to perform top surgery using a keyhole incision (peri-areolar incision around the nipple) or double incision (under the breasts). The incision type is usually determined by the size of your breasts. 


Requirements for Gender Reassignment Surgery

Gender affirmation surgery is a big step in your journey towards your true self. It is important to note that a mandatory requirement must be met for gender affirmation surgery:

  • Before surgery you will need a letter from your psychiatrist (or therapist) stating you are of sound mind and good judgment, understand this surgical procedure is irreversible, and it is the next step in your transition that is medically necessary.

Related Blog: A True Transformation: Preparing for Gender Affirmation

Pre-Op Consultation Videos and FAQs

As you prepare for an upcoming double mastectomy as part of gender affirming care, there's a lot to know before the procedure and a lot of questions you must have. Shannon Roeder, the Surgical Coordinator at ACPS, has taken the time to explain the FTM process at our practice and answer several frequently asked questions.


Watch Pre-Op Consultation and FAQ Videos

What to Expect

From the moment you walk through our doors you will feel welcomed, comfortable and truly excited to take the next step toward your transformation. Our easygoing and inviting space has been designed to offer a discrete, soothing environment with a relaxing vibe to get you ready for your new transition.

How to Prepare

Pre-Operative Appointment

Three weeks prior to your procedure, you’ll come to our offices to sign consent forms and receive pre- and post-operative instructions. You will also be given any forms you may need to take to your primary care doctor for medical clearance.

Date of the Procedure

The morning of surgery we will prep you and take your “before” photos. You will meet with the anesthesiologist and see Dr. Fischer for “marking up” - she will draw on you with a marker on the areas to be treated. We will administer general anesthesia and Dr. Fischer will transform you using her specialized state-of-the-art techniques. Afterward, we’ll make you comfortable with supportive bandages and a special compression garment designed to help you heal faster. Any discomfort can be treated with prescription medication.

Incision Types

There are a number of different techniques for performing top surgery and they vary according to where the incisions are made. The two most common incisions are periareolar and double-incision surgery, and the ACPS offers both.



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Learn more about incisions


Day 2

You will come to the office to get checked for any bleeding and to make sure your nipples are healthy.

Week 1

During the first week, you’ll need to rest frequently and avoid strenuous activities. You will be wearing a compression garment or vest, which you will not remove. You will have drains this week that require care and you will not be able to take a shower until the drains are removed.  You may not lift more than 5 lbs. and you will want to limit the range of motion in your arms (i.e.- no reaching or pulling)  You may not drive during this time since you’ll be taking pain medications.

Week 2

Once the drains are removed you can take that long-awaited shower! There are some VERY specific instructions about how to shower and how to keep your incisions clean and safe that we will cover. This week, you may lift up to 15 pounds and will need to continue wearing your compression vest.

Week 3

You will continue wearing your vest for this last week. If you lift something and it hurts…wait until next week.  If you lift something and it doesn’t hurt….carry on!

Week 4

You may return to the gym and work up to your previous exercise routine. Any small scars should recede within a year. Now you can enjoy looking and feeling like your true self!


An FTM gender affirmation or re-assignment surgery will vary in cost depending on your goals, desired outcomes, and the type of procedure chosen, which will all be discussed during your consultation.


We’d be happy to discuss pricing options and payment plans. Call our office at (410) 308-4700. Explore financing options through Care Credit today!


Check out our friend, Raegan Beast, talking about his FTM surgery experience with Dr. Beverly Fischer and her team.


"Dr. Fischer and the whole team were exceptionally sensitive, receptive and professional…100% trans-friendly and deeply caring.  We had a fantastic experience." - C. B.


"You gave me my life back after 12 years of binding & hating my body. 10/10 for all staff!  Keep doing what you are doing, your office and services saved my life." A. D.


"I have been meaning to send this note for some time! I am --- and I just wanted to write and officially thank you for the kindness and professionalism that you extended to ----. Before, during and after the surgery last summer. ---- has healed beautifully & is living a full life made more straightforward by the success of top surgery. The relaxed, caring atmosphere created by your office for people with gender dysphoria is a great experience in the most positive way. Thank you for your great work as ---- gets ready to celebrate the 1st anniversary of their top surgery on July 18! Warm Regards, - N.B.


"Thank you for being so supportive and making this process feel so easy and for taking such good care of me. You are all awesome." - A.B.

Questions about FTM/FTX top surgery?

Watch Gender Affirmation 101 - a Virtual Event!

Dr. Beverly Fischer and her team hosted a virtual event and answered all of your questions about FTM/FTX top surgery. Missed the event? Looking for more information about gender affirming top surgery? Not a problem! Sit back, relax, and watch the informational session.

Watch Gender Affirmation 101

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