Double Incision Top Surgery: Technique, Recovery, Cost and Choosing Where to Go


By Neda Deniz, FTM patient advocate · Last updated 29 September 2026
For many trans men and non-binary people, double incision top surgery is the procedure that finally makes the chest in the mirror feel like their own. It is the most widely performed form of transgender top surgery, and it is often the only technique that can create a genuinely flat, masculine contour on a medium or larger chest. This guide explains how double incision top surgery works, who it suits, what recovery looks like, what top surgery prices really include, and how to compare top surgery UK options with top surgery Turkey and the rest of Europe.
Table of Contents
- What is double incision top surgery?
- Who is a good candidate?
- Double incision vs keyhole and periareolar
- The procedure step by step
- Recovery timeline
- Cost: UK, England and Turkey compared
- Best place to get top surgery
- Further reading from our blog
- FAQ
Key takeaways
- Double incision top surgery removes breast tissue and excess skin through two horizontal incisions under the pectoral muscle.
- It is the standard technique for a double mastectomy transgender patients choose when the chest is larger than a B cup or the skin has lost elasticity.
- Nipples are usually resized and repositioned as free grafts; top surgery without nipples is also an option.
- Most patients return to desk work in two weeks and to the gym in six to eight weeks.
1. What Is Double Incision Top Surgery?
Double incision top surgery is a chest masculinisation surgery in which the surgeon makes two horizontal incisions along the lower border of the pectoral muscles, removes the breast tissue and surplus skin, and closes the chest so the scars follow the natural shadow of the muscle. It is sometimes called a bilateral mastectomy with free nipple grafts, and many people search for it as breast removal surgery for transgender patients.
The difference from a cancer mastectomy is intent. Double incision top surgery is sculptural: the goal is not just to remove tissue but to build a male-contoured chest with correct nipple size, placement and a clean lateral line under the arm.
Why it is the most common FTM top surgery
Because it controls both skin and tissue, double incision top surgery gives predictable results on almost every body type. You can read the wider picture on our female to male surgeries page.
2. Who Is a Good Candidate for Double Incision Top Surgery?
You are generally a good candidate for double incision top surgery if you have moderate to large breast tissue, noticeable skin laxity, or nipples positioned low on the chest. Your surgeon will also assess general health, smoking status and BMI.
Do you need to be on testosterone?
No. Many surgeons perform double incision top surgery for non-binary patients and trans men who are not on hormones. Our guide can I get top surgery without being on T explains the details.
3. Double Incision Top Surgery vs Keyhole and Periareolar
Not every chest needs double incision top surgery. The right technique depends on chest size and skin quality:
| Technique | Best for | Scars | Revision risk |
|---|---|---|---|
| Double incision top surgery | B cup and larger, loose skin | Two horizontal lines | Low |
| Periareolar | Small chest, good elasticity | Around the areola | Moderate |
| Keyhole top surgery | Very small chest, firm skin | Small, under the areola | Moderate to high |
Patients who push for keyhole on a larger chest often end up needing revision surgery. With double incision top surgery the scar is longer, but the contour is flatter. Compare all options in which top surgery procedure is for you.
4. The Double Incision Top Surgery Procedure Step by Step
Double incision top surgery takes around two to four hours under general anaesthesia.
Top surgery consultation
Your top surgery consultation covers goals, photos, medical history and nipple preferences. This is where your double incision top surgery plan, including incision height and nipple position, is drawn up.
In the operating room
The surgeon marks the chest standing, then makes the incisions, removes glandular tissue and fat, and contours the sides. During double incision top surgery the nipples are reduced and grafted to a masculine position, then the chest is closed in layers.
Drains and binder
Small drains may be placed for a few days, and you wear a compression vest for four to six weeks after double incision top surgery.
5. Double Incision Top Surgery Recovery Timeline
Top surgery recovery after double incision top surgery follows a fairly predictable path:
| Stage | Timing | What to expect |
|---|---|---|
| Hospital stay | 1 night | Pain control, drain check |
| Early recovery | Days 2–10 | Rest, limited arm movement, graft check |
| Back to routine | Weeks 2–4 | Desk work, walking |
| Full activity | Weeks 6–8 | Lifting, gym, swimming |
Scars fade over twelve to eighteen months. Good aftercare, silicone gel and sun protection make a real difference to how double incision top surgery scars mature.
6. Double Incision Top Surgery Cost: UK, England and Turkey Compared
Top surgery prices vary widely. In England, private double incision top surgery typically starts around £7,000 and can exceed £12,000 once the hospital, anaesthetist and follow-up are added. NHS pathways are free but waits are long. That gap is why many patients look at top surgery abroad.
Top surgery Turkey and Istanbul
In Istanbul, all-inclusive double incision top surgery packages usually cost significantly less than a private UK quote, even after flights. A good package covers the surgeon, hospital, anaesthesia, tests, vest, medication, hotel and transfers. See top surgery abroad cost for a full breakdown.
Cheapest is not always cheapest
If you are hunting for the cheapest place to get top surgery, compare what each quote includes. A cheap double incision top surgery without aftercare can cost more once revisions or extra nights appear.
7. Best Place to Get Double Incision Top Surgery
The best place to get top surgery is where an experienced gender-affirming surgeon, an accredited hospital and clear aftercare meet. For double incision top surgery, ask how many cases the surgeon performs a year and to see before and after photos of chests similar to yours. Our guide to the best top surgery surgeons lists the right questions.
Top surgery Europe options include Germany, Poland and Turkey. Many UK patients choose top surgery Istanbul for its short waits and English-speaking coordination; read top surgery Istanbul by Neda. Neda is a trans health care advisor, not a surgeon, and connects you with the surgical team while staying with you from first message to follow-up. Learn more on our about us page.
Planning your double incision top surgery
To start planning your double incision top surgery, send photos and a short history through our contact us page for a free assessment.
8. Further Reading from Our Blog
- FTM top surgery techniques: how to choose safely
- Breast removal surgery for trans and non-binary patients
- Private top surgery UK guide
- Top surgery without nipples
Browse every guide on our blog.
9. FAQ
How long does double incision top surgery take?
Double incision top surgery usually takes two to four hours, with one night in hospital.
Is double incision top surgery the same as a double mastectomy?
They are similar, but double incision top surgery is designed to shape a masculine chest, while a standard mastectomy only removes tissue.
Will I keep nipple sensation after double incision top surgery?
Sensation is often reduced after double incision top surgery because nipples are grafted. Some feeling returns over months.
Is top surgery in Turkey safe?
Yes, when double incision top surgery is performed by an experienced surgeon in an accredited hospital with a clear aftercare plan.
How soon can I fly home?
Most patients fly home seven to ten days after double incision top surgery, once the surgeon has checked the grafts.
Trans Health Care Advisor
Neda Deniz Health Tourism Agency Ltd. has been helping the members of trans & non-binary community from all around the world to find qualified, affordable, trans-friendly plastic surgeons using the latest techniques to perform FTM Top surgery, FTM Top Surgery and voice masculinization surgery.




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Blog Posts
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Keyhole Top Surgery: Candidates, Scars, Sensation, Recovery and Cost
Cheapest Place to Get Top Surgery: Country-by-Country Cost Ranking for 2026
Best Place to Get Top Surgery: How to Compare the UK, Europe and Turkey in 2026
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Kristian BaldisseraTrustindex verifies that the original source of the review is Google.
Ho eseguito un'operazione di mastectomia poche settimane fa, cominciando con la prenotazione attraverso Noah, che mi ha aiutato step per step ad avviare il percorso e rispondendo a tutte le domande che avevo riguardo l'operazione. Posso dire che sono tornato a casa molto soddisfatto e felice. L'ospedale è molto pulito e accogliente e il personale super disponibile e gentile, prima, durante e dopo l'operazione. Ho anche incontrato altre fantastiche persone che hanno vissuto la stessa operazione e con cui ho affrontato insieme il post recovery in ospedale. Sarò per sempre grato di aver potuto vivere questa esperienza con così tanta serietà, per poi arrivare ad un risultato soddisfacente e euforico.Posted on Google![]()
Andrea BarbaTrustindex verifies that the original source of the review is Google.
È difficile esprimere a parole tutta la mia gratitudine per Neda, il dott Serkan per lo splendido lavoro, la gentilezza e la disponibilità del consulente Noah, medici e infermieri...che insieme hanno realizzato un mio più grande sogno ❤️🩹Posted on Google![]()
EleTticusTrustindex verifies that the original source of the review is Google.
Ho avuto un’esperienza estremamente positiva con Neda, il personale medico e Noah come consulente per la top surgery. Fin dal primo momento, sono stato accolto con gentilezza e professionalità. Il dottore si è dimostrato altamente competente, sempre disponibile a rispondere a ogni mia domanda e a rassicurarmi lungo tutto il percorso. Le infermiere sono state incredibilmente gentili e premurose, facendomi sentire a mio agio e seguito in ogni fase del post-operatorio. Un ringraziamento speciale va a Noah, che è stato un supporto fondamentale: ha sempre risposto con pazienza e chiarezza a ogni mio dubbio, aiutandomi a vivere questo percorso con maggiore serenità. Consiglio vivamente questa esperienza a chiunque stia valutando la top surgery e cerchi un team di professionisti attenti e rispettosi.Posted on Google![]()
Bex GeorgeTrustindex verifies that the original source of the review is Google.
I just had the pleasure of heading to Turkey and having my mastectomy with Neda. It was incredibly professional throughout the whole experience. From pick ups, drop offs, appointments, information and I couldn’t be happier with my results and the wonderful service provided. Every single member of the team I met from surgeon to driver were so hospitable and welcoming. I highly recommend, thank you guys! 🤜🏻🤛🏻Posted on Google![]()
Davide PaolicelliTrustindex verifies that the original source of the review is Google.
Ciao a tutti, ho avuto in intervento 2 giorni fa qui ad Istanbul dal Dr. SD È la seconda volta che vengo nella clinica di Neda, l’anno scorso ho accompagnato un mio amico e ora siamo tornati qui per me! Il costo dell’intervento comprende anche 1 notte in ospedale, hotel per me e il mio accompagnatore, esami pre-operatori e taxi privato. L’autista gentilissimo ci è venuto a prendere direttamente dall’aeroporto e ci ha portato in hotel, idem fino all’ospedale e viceversa. La presenza del consulente Noah Olyver, che ci ha aiutato con la prenotazione e i voli, e della traduttrice Miss S è stata fondamentale. Sono arrivato qui il 13 gennaio (il giorno dopo aver fatto 18 anni, perché ovviamente anche qui è obbligatoria la maggiore età), la mattina del 14 mi sono stati fatti tutti gli esami pre-operatori (prelievo del sangue, elettrocardiogramma, ecografia al petto, controllo pressione) e dopo qualche ora sono entrato in sala operatoria. Sono sempre stato tranquillo e sono stati tutti accoglienti e gentili, mi sono sentito sempre al sicuro con Neda e le infermiere. L’hotel è in una zona comoda e centrale. Sono celiaco e il simpaticissimo dottore si è occupato personalmente di ordinare del cibo sicuro per me. Devo dire che ho alcuni problemi di salute e allergie, ma ho avvisato al momento della prenotazione e nessuno di questi è stato un problema. Il dolore è pochissimo e la felicità è al massimo!! Finalmente sono libero, non pensavo che questo giorno sarebbe arrivato così velocemente, guardarmi allo specchio è stato bellissimo per la prima volta ❤️ è un bellissimo regalo di compleannoPosted on Google![]()
Sarah EmmersonTrustindex verifies that the original source of the review is Google.
On the 10th Feb, I went and got my top surgery in istanbul, my gf and her dad accompanied me on the the journey. The first moment I booked, to arriving, surgery and departing was very well organised, Neda sorted everything, I did not have to worry about anything. You have drivers to pick you up and drop you off from airports, hotels and hospital. Everything was very smooth, and there was always communication between Neda and also the drivers, any questions, they were there to help. On my surgery day, I was picked up by a driver and taken to the hospital where we met Mrs S our translator, who was amazing and extremely helpful, she explained everything that was happening on the day and was there to help and for any language barrier issues, but honestly, I didnt struggle with the language barrier in the hospital, I just used google translate on my phone if it was needed. It was all very organised, super clean, comfortable, you get your own room, my gf stayed the night with me. Pre tests and Surgery was smooth, everything felt easy, naturally nervous but felt very looked after and i felt safe and it wasn't stressful for me at all. After pre test I met the surgeon Dr Serkan, who is absolutely lovely and such a happy guy, you always hear him laughing, he lined me up and listened to how I would like my chest to look, and the job hes done is awesome, super happy with my results, highly recommend. I love it! The nurses are absolutely amazing, they are so caring and considerate. I had one nurse called Nursema who looked after me while I stayed the night, honestly the best caring soul Ive met, she was amazing at taking care of me. I truly was looked after so well in hospital, I dont think I would have got the same care in the Uk. Discharge day, and drain removal day... I was so scared of the drains being taken out, but Dr Serkan took them out, i felt no pain and tbh i didnt even feel it come out. I had to ask 'is it out yet?' Lol. So thats all good, no pain with drains :) Highly recommend to anyone wanting/thinking about getting top surgery, everything was stress free and easy. Im almost 1 week post op now and healing is going super well, the doctor and Neda stays in touch with you all through recovery also, the communication between everyone is amazing. Thankyou :)Posted on Google![]()
Fabio PlacentinoTrustindex verifies that the original source of the review is Google.
Mi sono operato di mastectomia il 16 Gennaio 2025. Avevo deciso di operarmi tre mesi prima, ma ho deciso io di aspettare tre mesi altrimenti ci sarebbero state date disponibili già prima. Appena ho contatto il consulente Italiano per la mastectomia, Noah Olyver, mi ha aiutato subito in tutto quello che sarebbe servito per l'intervento, dal mettermi in contatto con Neda, proprietario dell'agenzia, al fare i biglietti aerei. Ha risposto tempestivamente a tutte le mie domande nei tre mesi precedenti l'intervento, ha placato le mie ansie. Con un prezzo molto conveniente non solo ho avuto l'intervento ma anche albergo per me e il mio accompagnatore (la mia ragazza), una notte di degenza in ospedale sempre con accanto la mia ragazza, dove hanno provveduto anche per la sua colazione, pranzo e cena, fascia post operazione, assicurazione sul viaggio e servizio taxi. Appena arrivato a Istanbul c'era ad aspettarmi l'autista, Selami, con un furgoncino abbastanza lussuoso, che mi ha portato in albergo e nei giorni seguenti mi ha scortato dall'albergo all'ospedale e viceversa fino al ritorno in areoporto. L'ospedale è un posto molto accogliente, ciascun paziente ha una stanza singola, cosa che ho molto gradito per la privacy. La signorina S, la traduttrice, mi ha aiutato a comunicare col personale sanitario. Il personale dell'ospedale è competente ma soprattutto estremamente gentile e sempre pronto a donarti sicurezza con un sorriso. Neda mi ha accolto con molto calore ed è simpatico e spontaneo. Il chirurgo, il dottor Serkan Dinar, è molto gentile, professionale e ha delle mani d'oro perché ha fatto un lavoro stupendo. Inoltre Neda, il chirurgo e Noah, mi seguono anche nel post operatorio, non importa se sono in vacanza o non è il loro giorno lavorativo, rispondono sempre a tutte le mie perplessità. Per quanto riguarda l'intervento in sé non è doloroso come credevo, più che altro il dolore è stato per i muscoli indolenziti e sulle parti dove si formano lividi e gonfiore ma ora sto già molto meglio. Ho provato un po' di dolore solo nel togliere i drenaggi ma confrontandomi con altri ragazzi ho capito che è una cosa soggettiva. Quando c'è la rivelazione del petto il dottore spiega tutto quello che c'è da fare nel post operatorio, medicazione e azioni da evitare e ti permette di registrare tutto così da seguire bene le indicazioni a casa. Nel complesso ho avuto un' ottima esperienza con l'agenzia di Neda, e nonostante sia lontana da casa penso che se dovessi fare un altro intervento sarebbe la mia prima scelta!Posted on Google![]()
Aurelio FlorisTrustindex verifies that the original source of the review is Google.
I got peri/keyhole top surgery with Dr. Serkan on 10/01/25. My experience has been absolutely lovely: the hospital is clean and warm and all the nurses are incredibly nice and professional. Staying at the hotel allowed me to meet plenty of other people that were having the same surgery, which made the experience a lot more fun and enriching. Neda and Noah are both incredibly nice and available for any questions. I felt safe and cared for every day: from when I arrived at the airport to the minute I was dropped off to fly back home. My results are everything I've ever dreamed of, and I'm not even completely healed yet. I would have had to wait 4 years to get surgery in my country, and now that weight is off my shoulders and I have my dream result. Thanks a lot to Neda, Dr. Serkan, & his wife and their team <3Posted on Google![]()
Oisín RobertsTrustindex verifies that the original source of the review is Google.
I had a great experience having surgery here. The translator, Miss S, was very present and very friendly. I always felt as though I knew what was about to happen next, how and where. The driver, Selami Çaylak, was also very friendly. I felt incredibly welcome and secure being shuttled between the hotel, hospital and airport. The tests and the surgery took place across two different, but very nearby, hospitals. The care in both was great. During my surgery and the stay in the hospital where that happened, the nurses was extremely gentle and caring. They were all very communicative, explaining what they were doing and when they were changing shift, introducing the nurses that would be taking over. This was very reassuring, particularly during that part of my recovery because I was definitely at my most confused then because of the medicine. The food at the hospital was delicious, simple, nutritious, Turkish food. They were very attentive to provide a lot of food for my partner who was there with me without being asked to. They also provided pillows, blankets and a comfortable sofa for her to sleep on while I stayed there. In the hotel, where I spent the remainder of my stay, the food was also amazing. It was easy to order to your room via a QR code provided that linked to a whatsapp chat where you messaged. The food came from a cafe opposite where we met an older man who worked there, he was so friendly with us and taught us Turkish words for what we were saying. Breakfast was free, included with our stay, and we paid for everything else but it was very cheap. I haven’t fully recovered yet, I am only one week post-op, but I feel very confident because Dr Serkin has provided me with all of my medicine, tapes and cream for my recovery. He also explained clearly the timeline and asked us to record him talking about it incase we forgot, this was so helpful. From what I have seen so far of my results, they look amazing. I am overjoyed. Dr Serkin is a very kind, good humoured and friendly man who obviously enjoys his job. I felt very safe in his care. Since coming home, Neda has been very communicative via Whatsapp answering any queries or questions I have relating to my recovery. Overall, I had a really great experience and at no point felt doubt in the service that Neda has put together. I would sincerely recommend anyone considering this service to book with Neda.Posted on Google![]()
Jonathan RavasiTrustindex verifies that the original source of the review is Google.
Vorrei ringraziare Noah e tutto lo staff della clinica per il supporto straordinario che mi hanno dato nel raggiungere un traguardo importante. Sin dal primo momento, Noah è stato professionale, attento e sempre disponibile a rispondere a tutte le mie domande, prima, durante e anche dopo l’intervento mettendomi a mio agio e guidandomi in ogni fase del percorso. Inoltre, vorrei sottolineare quanto tutto lo staff della clinica sia stato comprensivo, premuroso e pronto a intervenire in caso di necessità, dimostrando un'alta professionalità e una grande attenzione verso ogni dettaglio. Grazie a loro, ho potuto affrontare questa esperienza con serenità e fiducia, raggiungendo un risultato che non avrei mai pensato fosse possibile. Grazie ancora a tutti per l’impegno, la disponibilità e l'umanità che mi hanno mostrato in ogni momento.
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