Keyhole Surgery with Peri-aeriolar Incision
The keyhole surgery procedure is a less invasive technique for chest reconstruction. In female to male transsexuals, keyhole surgery utilizes liposuction to remove the breast tissue.
The keyhole procedure is best reserved for transmen with smaller A-cup breasts. Some surgeons will accept patients with B-cup breasts. The keyhole procedure is not recommended for transmen with medium to large breasts because the surgery is not designed to remove a large amount of skin tissue. Thus, transmen with B cup or larger breasts who undergo the keyhole procedure may be left with sagging skin around the nipples.
The surgeon will make an incision around the nipple-aeriola complex and liposuction the breast tissue out. The surgeon may also need to reduce the size of the nipples so that they appear more like the nipples of a man. Post-surgery recovery is generally shorter that the bilateral mastectomy technique, and results in less complications. In transmen with very small breasts, this surgery can have fantastic results and result in little to no scarring.