Anchor Resection vs. Double Incision: Understanding Top Surgery Techniques
Top surgery is a deeply personal and transformative procedure. The two most common techniques—Anchor resection and Double incision—offer unique benefits and considerations.
Choosing the right approach depends on the patient’s anatomy, goals, and understanding of the surgical options.
Dr. Francis Jeon, a WPATH member and leading expert in gender-affirming surgeries, stresses the importance of education and collaboration:
“The best surgical approach isn’t just about anatomy. It’s about aligning the patient’s goals with a method that delivers safe, satisfying, and personalized results.”
Key Differences Between Anchor Resection and Double Incision
| Aspect | Anchor Resection | Double Incision |
|---|---|---|
| Nipple Sensation | Preserves sensation by keeping nerves and blood flow intact | Higher risk of sensation loss due to free nipple graft |
| Nipple Necrosis Risk | Lower, as the nipple remains attached to blood vessels | Higher, because the nipple is detached and grafted |
| Scar Appearance | Inverted T-shaped scar (vertical and horizontal) | Two horizontal scars along the pectoral fold |
| Dog Ear Formation | Rare, as vertical excision removes excess side skin | Possible, but correctable later under local anesthesia |
| Chest Contour | Flat and smooth | Masculine with emphasis on pectoral definition |
Anchor Resection: Smooth and Natural Contour
The Anchor resection technique is particularly suited for individuals with larger or sagging chests. This approach involves both vertical and horizontal incisions, allowing precise removal of excess skin and tissue. The result is a smooth, flat chest contour.
- Preserving Sensation: Because the nipple remains connected to its natural blood supply and nerves, this method significantly reduces the risk of necrosis and loss of sensation.
- No Dog Ear Issues: Vertical excision also eliminates the excess side skin near the armpits, preventing the formation of “dog ears.”
Dr. Jeon explains, “Anchor resection is an excellent option for those who value a flat, natural appearance and want to preserve nipple function as much as possible. It’s particularly effective for patients with significant tissue or sagging.”
Double Incision: Masculine and Defined Appearance
The Double incision technique is ideal for individuals seeking a masculine chest with a muscular contour. This approach uses two horizontal incisions aligned with the natural fold of the pectoral muscles, creating a defined and aesthetically masculine result.
- Free Nipple Graft: To achieve ideal nipple positioning, the nipples are detached and grafted onto the chest. While this allows for optimal placement, it increases the risk of necrosis and sensation loss.
- Dog Ear Correction: Horizontal-only excision can leave lateral bulges of skin (“dog ears”). However, these can be corrected in a minor procedure under local anesthesia.
Dr. Jeon notes, “Double incision is a great choice for patients who prioritize a defined, masculine contour. While it comes with trade-offs, the results can be transformative for the right candidates.”
Recovery and Care
Both techniques require careful post-operative care to ensure optimal healing and results:
- Rest and Activity: While recovery typically begins in two weeks, patients should avoid heavy lifting, chest exercises, or other strenuous activities for at least four weeks.
- No Smoking: Smoking before and after surgery is strictly prohibited, as it impairs blood circulation and can lead to complications such as delayed healing or necrosis.
Dr. Jeon emphasizes,
“Good circulation is critical for recovery. Patients need to follow their aftercare plan diligently to avoid complications and achieve the best results.”
Which Technique is Right for You?
Choosing between the two methods depends on your body and goals:
- Anchor Resection:
- Best for those seeking a flat, natural chest contour.
- Ideal for patients with larger or sagging chests.
- Preserves nipple sensation and reduces the risk of necrosis.
- Double Incision:
- Perfect for those desiring a defined, masculine chest with visible pectoral contours.
- Suitable for patients comfortable with the risks of a free nipple graft.
- Minor contour corrections (dog ears) can be addressed later.
Empowering Patients Through Knowledge
Dr. Jeon believes in a patient-centered approach:
“Surgery is more than just technique—it’s about helping each patient achieve their vision of themselves. When patients understand the options, they can make choices that feel right for their goals and lifestyle.”
By combining surgical expertise with a collaborative decision-making process, Dr. Jeon ensures every patient receives care tailored to their needs. Whether through the flat and smooth contour of Anchor resection or the defined masculinity of Double incision, the goal is to provide results that enhance confidence and align with each individual’s identity.
Through meticulous planning, thoughtful aftercare, and a commitment to each patient’s vision, Dr. Jeon delivers outcomes that are both physically and emotionally transformative.