Dr. Daniel Medalie performs FtM top surgery (double incision mastectomy with nipple grafting)

[VivaLaVieBoheme49]

see, i want top surgery, but now im scared XD Im having the same reaction then I watched what they did to my uterus :| Im a giant pansy lol

[itsmajda11]

ive always wanted to b a surgeon thts y i wattch these vids

[KAYELLEK]

Uhm this should be reported because YouTube doesn't allow nudity and that's still tenically a woman's body

[VivaLaVieBoheme49]

@KAYELLEK U should know that there are surgery videos all over youtube because they are educational, but they are also age restricted.

[StrawberrySparkless]

How much does this usually cost?? :O

[tabletka666]

why am i watching this?

[13jocularity]

Wow. Beautiful work, Dr. Medalie. Thank you for posting this.

[shelyna100]

Sorry but, what are the risks???

[1HitaDay]

I had my hands over my mouth the whole time you were slicing and dicing but the second I saw the pectoralis I very loudly went, "COOOOOOOOOOOOL."

[KrazyCatQueen]

Ouch ;0;

[zannadyke]

do the nipples still have sensitivity?

[KillTheFuckingHaters]

Ouch! -.-'

[happyhippos4449grrl]

I screamed when you cut off the nipple.

[DanniJules]

your in cleveland ohio??? omg. I live in lorain, i didnt know there was a doctor here that did top surgery. do u accept any type of insurance like medicaid? please reply asap

[reneeandlilia]

lol im gonna go get the nipple...and yes this is awesome thanks for sharing and best of luck to you!

[TheLYossarian]

This is amazing. Thank you for sharing.

[gonewildwithlovehjq]

amazing video, 6 more months till mine lol. Dr.Danile Medalie where are you? what state and couny? i dont care how far it is i have to have you do my top surgery. Im in orlando Florida.

[DrMedalie]

@gonewildwithlovehjq

I am in Cleveland, Ohio

[randomtobi]

teh inside of gurls boobies are odd

[AyuChan17]

I feel a little woozy @_@ I had to stop looking at the video for a while.

But i found myself wanting to see still so, I would scroll down then up then down xD!

[BrentLakies2007]

At first I almost turned it but then realized that I will be going through that in about a year... So I made myself sit through it and set my breakfast to the side lol amazing job btw

[campcoskuro]

oh god! i'm excited for my surgery but yiiiiikes! it hurts just watching >.< oh well. no pain no gain.

[Renkiraful]

I know it's probably a stupid question, but did it hurt them at all?

[DrMedalie]

@Renkiraful

Yes it hurts-like any surgery, but in general patients report that it is not as bad as they thought it was going to be.

[gtaloverfover]

Its worth it wen i start T :]

[Serena2583]

How long do the drains stay in? Also, if the drains are stuck inside during healing how would you get them out, I mean wouldn't they stick in the healing chest area so you couldn't just pull them out?

[DrMedalie]

@Serena2583

The drains stay in for 5-7 days and are made of a type of silicone that does not stick to tissue. They slide out very easily.

[tmaleification]

Is this surgery easier to perform on patients with some pectoral definition?

[DrMedalie]

@tmaleification

Yes this si easy to perform with or without pectoral definition

[amirul12ish]

@DrMedalie hi dr medalie do your patients in thisvideo male or female ?

[xtorie]

Wow, it's really fascinating to see how this is done. Approximately how long does the entire procedure take? I really appreciate that you took the time to make this video :)

[DrMedalie]

@xtorie

The surgery takes around 2 hours

[ACluelessKid]

..Oh dear, this made me squirm.

Interesting though. It's nice to see how its done.

[tutuboi69]

few questions..

how long can a clitoris extend? can you only get about 3 inches of it? nothing more? like at least five inches?.. and.. are you having erections like a biological man? and can you cum?hmmm

[xXTabithaa]

@tutuboi69 erm...i think it's about 2 inches, maybe 3 or 4 if you're lucky, about 5 years on T can get you around 4 inches i think......go look it up? i heard of this guy who got it to 6inches with a metoidioplasty. pretty damn impressive, im so jealous. xD ~this isn't my normal account, o3o im too lazy to log into mine~

[tutuboi69]

@xXTabithaa whoa.. cool.. 6 inches.. awesome! i wanna see it.. i mean i wanna know who she rather he is.. does he keep videos about his progress on T shots, top and bottom surgery? and im really curios how this penis of FTM really looks like.. i hope it also cums and erects like a normal one.. hehe

[xXTabithaa]

@tutuboi69 Not sure if he keeps vids about progress, i recall finding a vid of his once but i cant remember the name of it, it was just a usual update i think though, nothing about genitals. FTM penises, after "Meta" do look really realistic, if you ignore the size and with "Phalloplasty" It does look quite realistic after all the operations are finished. i think they can "cum" with meta atleast i think, i read about it somewhere but again my memory fails me.

[GunsNRosesTrans]

Thank you very much for this detailed video. Thank also for your replies to comments. Many of us do have the same questions and it is great to hear them answered by a Doctor who actually performs the surgeries. (many of us chat among ourselves and some of the facts become blurred through the grape vine.)

[Nettuno88]

what a tough job this must be! anyway it looks good except for the left side that seems to be saggy. i wonder if it'll fix itself after the procedure

[d0ggycamel]

why don't they use the excess breast tissue to make a penis

[porkynix]

I had to pause once. HAHA. I sure hope Dr. Medalie can take his practice all over the world so we can all be happy FTMs. Or at the very least, I wish there was someone like him in my country.

[Renskiiiiii]

i guess i know who im ganna go see this year then :)

[ABrotherOfThor]

Score, I live in Columbus. This looks good, glad to hear he takes precautions... Will most likely consider him after seeing this video, after a bit more research on the place...

[gothichero123]

dr.medalie is a great surgeon. i dont think i would ever be able to be a surgeon. its making me a bit sick watching this.

[Nick19FtM]

Thank you for showing us the procedure and treating your patient so.. Respectfully.

This was great. It looked pretty painful but definitely worth it, I have 3 years and 3 months until I am able to do this. Can't wait.

[CurtisFTM]

I had surgery with another surgeon and while the areola grafts took (albeit mishapen) I do not have nipples as they didnt take. I am now looking at cosmetic alternatives. Is there anything surgical that surgeons like yourself can potentially perform or is it a case of just accepting what I have?

[transshark06]

@CurtisFTM Ive had friends that have had the same issue. Their surgeon tattooed the nipples and areola areas.

[xXTabithaa]

how much is breast removal sugery? cause like. i kinda. poor. lmao.

[nicosiacat]

First, my boyfriend will be pursuing this procedure in the near future, so I'm really glad there was a video showing what happens and how it is performed. Thank you for your work and the respect you show your clients!

Secondly, out of curiosity, how does this differ from a female seeking a breast reduction for cosmetic/comfort? Are totally different procedures used?

[DrMedalie]

@nicosiacat

This is completely different. A standard breast reduction is designed to retain and even accentuate the natural feminine appearance of the breasts while making them smaller.

[The666Devils666Child]

what is the cost for a double incision?

[snaffalaffasaurus]

A few questions...

How much pain is there once the anesthesia wore off?

How noticeable are the scars afterwards?

How much feeling (if at all) will he have in the nipple area?

Thank you so much for this.

[DrMedalie]

@snaffalaffasaurus

This is a fairly well tolerated procedure. There is pain but it is easily controllable with pain medication. The scars take up to a year to fade, and will never fade completely. The nipples will have minimal feeling afterwards.

[Rekiztal]

i am equally envious and queasy

[hottathenwasabi]

ow...ouch!

[lukas9ftm]

Thank you for posting this. I cant wait for my top surgery, It looks good.

[sam0m1023]

I can't believe I watched the majority of that! It's just SO difficult to watch! I can't believe it's done like that, now I'm scared to get chest surgery DX but hey, at least your asleep as they're doing it~

[chxHUnterzihao]

ahm that Surgery has a complication ??

[MriBlinkie]

are you suppose to leave the breast tissue att the top or was that not breast tissue?

[MriBlinkie]

GFDJHGFHJG

[mayazareh]

Ohh Gosh this was too difficult to watch even more than Down Surgery . But was Quite Interesting !!!! ... i never thought This Surgery Would be in that much Details LOL .. Thanks for sharing !!!!

[GinnySingsforyou]

im so shocked youtube allowed this video to stay on.. buttysm this was cool to watch

[DrMedalie]

@VFlee

The tissue will not grow back, and I do perform surgery on patients who are not taking testosterone.Regards,

DM

[alettro17]

hey doc.... just luv u man...

thanks for this video its so helpful...

i have gone to a doctor who is suggesting me to have peri procedue..but i have large breasts ..i want to have double incision..but he says peri will be good..for me... but i am not sure about it...

wish i could have my surgery done from u.......

[TheYukon49]

Your an artist Dr. Medalie... really quite remarkable;} Lucas Salazar

[PandaValentine]

When cutting in it reminded me of the insides of a doll, until he started to bleed. I can't believe that's how it looks inside. Knowing I'm having top surgery in a year or two, it's cool to see what goes on! This was an amazing video! Absolutely beautiful work, looks like art. :)

[Thealexandershoow]

its soooo grotesk! D:

[DefyingNoodles]

How is top surgery different than a nipple-sparring mastectomy?

[Catpn]

wow

[Merrida100]

You do beautiful work. It would be such an honor to work with you.

[YeahThatOneKid]

So, why do you separate the nipple and areola?

[DrMedalie]

Sometimes I leave the nipple and areolar together if the nipple is not too big, but if it is very large, then I separate it and resize it to make it more similar to a natural male size

[TEE320]

jesus

[SeanJamesP]

omgomgomgomgomg.... I could never be a surgeon. I just kept looking at my chest and back at the video over and over and imagining being awake.

[xXMattoisXx]

@SeanJamesP same o_0

[ThatGILkid]

This is amazing. Thank you so much for posting this. After I finish residency, I plan to specialize in SRS.

[revolutionisnow]

My husband had his first pre-surgical consult yesterday. The doctor wants us to have nipples/areolae tattooed on rather than grafting, but his reason (beyond potential migration or necrosis) was that my husband's nipples are far larger than someone assigned-male-at-birth. He made no mention of being able to cut down the nipple. Is this reasonable? Should we be looking for another surgeon? I'm going to ask him to watch this video and talk to us about it!

[DrMedalie]

@revolutionisnow

A tattoo is never as good as the real thing. I would recommend talking to another surgeon for a second opinion.

Regards,

DM

[DrMedalie]

@revolutionisnow  I would speak to the surgeon-the nipples can be cut down and survive as separate grafts.

Regards,

DM

[AidenWeasley]

So did he need revisions for the dog-ears? Also, I really appreciate your use of male pronouns :)

[DrMedalie]

@AidenWeasley

No revisions were necessary. The liposuction helps to shrink the tissues

[AidenWeasley]

I want to go to there.

[Cotaphlox]

Also, I just wanted to thank you so much for posting this video. I've been looking all over for a decent video, and now I've found one.This has educated/helped me so much.

[anatoly86]

Why does the heart rate change so much when you burn?

[DrMedalie]

@anatoly86

The heart rate doesn't actually change, the monitor is merely picking up the electrical activity of the electro-cautery and is temporarily confused.

[musicalandrelee13]

Where are you located Dr. ?

[DrMedalie]

@musicalandrelee13

Cleveland, Ohio

[DoctorRainbow8321]

soo scary o___o

[hyperyoda1065]

Oh my god. I'm not a FTM, but I just want to thank you for all you do. There can never be too many understanding and supportive surgeons out there! Nevertheless I couldn't stop from hugging my boobs with sympathy the entire time. I hope his surgery went well!

[The0utkast]

I just have one question, when you are sewing the under tissue and the top layer of the chest, do they stay in forever or are they taken out later?

[DrMedalie]

@The0utkast

All stitches dissolve over time and do not need to be taken out

[feniceriascente]

I thing it's better periaerol mastectomy of that! Penso sia molto meglio la mastectomia periaereola del capezzolo che quatta fatta sotto il seno!

[TylynnBoi105]

It looks good, it does. But why is the patien's left lower side of his chest where is new nipple has been graphed on has a lump in it just about an inch to the side of his chest? -Branden

[DrMedalie]

@TylynnBoi105

Appearances in the video are deceiving because of swelling, differential amounts of local anesthetic in the tissues, and pressure on the tissues from the underlying operating table. The final appearance is not evident for at least 3-4 months.

[jjguerra48]

Why is there still fat left when he closes it?

[Cotaphlox]

@jjguerra48 Because if there was no fat, the skin would sit over a possibly small amount of muscle. That could lead to many complications. I'm no doctor, but I'm pretty sure all of your muscles have at least a thin layer of fat between them and the skin. Someone correct me if I'm wrong on any of this.

[DrMedalie]

@Cotaphlox

You are correct. Fat is a vital element of the subcutaneous tissues. The amount of fat left is dependent on the overall body weight of the patient.

[bbakur92]

I start t in 4 months and can not wait to get top surgery!!

[TaiSchenker]

Doc, you're a genius. And a hero of sorts.

Fascinating video.

[bleedinggoddess]

Holy shit that is hard to watch I'm an ftm and I really wanted to watch it but now I'm not so sureeee

[HappyHyperHippie]

@bleedinggoddess i've had the surgery done and that was still a little tough to watch! course i wasn't conscious for that part lol. it's really not that bad when you're under the anesthesia.

[bellabelieber95]

i'll be having this done as soon as i'm 18... i'm not transgender though, i'll be doing it for my own self image and confidence.

[memyselfngod]

I wonder how much pain he was in when he woke up. Oh, dear..

[aetuip]

omg xD 

[xXJoNsIeJiNxXx]

After seeing that I'm much less afraid of getting top surgery! Thanks for putting this up!! Haha. Where are you located by the way?? I'm really impressed by how that turned out.

[owainthorn]

beautiful work!

[TheTransNathan]

I love how the nipple graft was done there taking the areola separately, so clever!

[zebradancing]

i'm gonna go get the nipple, hahah xD

[TaiSchenker]

@zebradancing "Gone to get the nipple. Brb."

Hahahaha!

[BillyJoel1985]

Have you ever cut yourself during a surgery? The instrumenst are cutting the patient´s skin so close to your fingers..

[DrMedalie]

@BillyJoel1985

Every once and a while I cut myself, but it is very very infrequent.

[BillyJoel1985]

necrosis is higher when transplanting both parts seperately.

Are you performing a lot of bottom surgeries as well?

I have the meta with implants and will have the urethra but still have my vagina completely intact. It was difficult to find surgeons who wanted to perform such a surgery because most of them are used to performing complete meta with vaginectomy.

yours

James D.

[DrMedalie]

@BillyJoel1985

I do the metoidioplasty without urethral transposition since that is the part with the highest complication rate (urethral stricture and fistula). By doing it that way no bridges are burned and a vaginectomy is not performed

Regards,

DM

[BillyJoel1985]

Thank you so much for making this vid. It shows what kind of an art it is to change the breast from female to male. I usually just see the pictures before and after the surgery and criticize without thinking of how difficult it is to do the job. Interesting to see that you sometimes do a nipple graft inside of an areola graft. i guess that none of the surgeons in Germany do that. mine didn´t as well, but it is a good idea when ftms have a very prominent nipple. i wonder if the risk of a

[Avallore]

That actually made me almost hurl.. and I'm about to go through for my own surgery soon, but it didn't scare me away LOL. Geeze, I don't think I'd do well as a doctor or surgeon.

[janusace2003]

Dr.M how much its gonna cost if I'm gonna redo my top surgery,coz my is done but not the way you do it on your patients.i need nipple grafting and remove more tissue i guess.

[buildingawhale]

Demystified indeed! Thanks to you and your patient for sharing this video.

[shaun4000uk]

awesome video, I didn't realize that you use an actual stapler during surgery, you learn something new everyday :-).

[MrZackeroni]

omg, that was the scariest thing I have ever seen.

I'm still getting mine done though 8)

..just no video of it, Haha!

[jelly17000]

Good video 

[donth8mecuzu8ntme]

Dammet!!! You should have a warning!!!! DO NOT WATCH BEFORE TOP SURGERY!!!!!!

Ahh damn I'm scared lol

[DominoAyeJae]

I've always wanted to know how the procedure was done but I am really glad I didn't see this before surgery. I would have been terrified.

[fateofmind05]

@DominoAyeJae Haha I watched it before surgery, and it definitely make me nervous. He recorded my peri procedure and I'm nervous to watch it if he puts it up on here.

[christianHeck]

How much does this type of surgery cost with the liposuction?

[DrMedalie]

@christianHeck

Typically this surgery costs around $5500-6000 (this includes anesthesia and facility fee)

[Pinzist]

@DrMedalie

Good lord that's cheap! My surgeon only does it at 8000$ to 10,000$.

[MyGenesis122]

Thanks for posting this. I was wondering how the graft ends up being sewn over the skin. didn't make any sense to me. now it does haha.

watching the actual breast tissue removal, to me, being trans, is like watching a giant tumor getting removed...

[alexbikepunk]

wow. thank you SO much for posting this. i actually just contacted you about surgery recently and this makes me way more confident about choosing you as my surgeon.

[1363516]

so instructive 

[shanebecameinsane]

thanks god that we are narcotic^^

[LemonEHenry]

As overwhelming some of the sights may be, I am glad you posted this and were willing to walk us through the procedure. I know it helps me understand what is happening when I choose surgery. Thank you!

BTW, the gentlemen in the video is a lucky guy! That is one good looking chest. :)

[TyDy07]

wow this was so informative..

[hollymichigan]

So glad i'm going to be out of it when i do this lol.

[Julliaz]

OWWWWW EWWW OWWWW! OMG im scared XD i wish i hadnt seen this LOL now im gonna be terrified when i go in surgery ahahaha

[XxHeavellxX]

o _ o I'm sooo glad we have anesthesia

[timlump]

I'm glad that you posted this video. I am also a little relieved that it wasn't posted until a couple of weeks after I had surgery with you. It's very informative, but I think that I might have been a lot more nervous on the day of surgery if I'd seen it.

[trannykingtuck]

sweeet! i love you dr medalie!

[Geared4KosenRufu]

Man, not for the faint of heart...like myself. But I enjoyed the fact that I now have an idea whats going to happen to me hopefully really soon. Thanks!!!

[BecomingBosh]

I will be making an appt with you for March!!

[lateasharichardson]

Thank you for posting this!

[murkymidnight]

This video really put top surgery into perspective for me. Thank you.

[MikeFTM]

As a medical assistant, that was insanely cool to watch.

As an FTM, that was extremely informative. Gives me some idea of what I can look forward to if/when I find the funds for top surgery.

[tobyr3]

Beautiful work Dr. Medalie. It answered a lot of the questions I had. I hope this will help many others understand the procedures.

[DrMedalie]

I plan on posting a peri procedure video in the near future. Thanks for the nice comments

[kougafan]

Thank you very much for posting this. I feel like the surgery procedure makes more sense to me now.

[MTR06]

Dr M, you are completely awesome for this. Could you also make a video of peri procedure? I have a bit of a crease and a bit of redundant skin in the nipple area that makes it puffy so Im waiting to see what it looks like by Jan and if its not how I like then I will be interested in a revision with you. Thank you for everything you do for us guys :)

[Kioryu]

Very informative video, and it's totally opened my eyes to how the surgery process really works! Thank you Dr. Medalie.

[DrMedalie]

My pleasure- I hope this video will help demystify the whole surgery process.

[ctshaw84]

@DrMedalie This is a great video, thanx tons for posting. You have AWESOME results. I am still thrilled with how amazing my chest looks. :-D

[newjew83]

this is awesome! thanks for posting it!