Here's What Makes Top Surgery Different From a Mastectomy

My binder was never tight enough for me. I struggled to put it on every morning, like a snake trying to wriggle back into a shed skin. It was surgical-grade, ultra-thick elasticized cotton that smashed my breasts into flesh patties against my ribcage, but it didn't make the problem go away. I tugged and fussed, checking myself from the side in the mirror. No matter what I did, my breasts were still there. When I peeled the sweaty garment off hours later, they'd be waiting for me — and I couldn't stand them. I was aware of gender dysphoria, but the constant, nagging irritation of my breasts was unbearable.

Late at night, I would comb through images of women who'd undergone double mastectomies, their scarred chests adorned with tattoos, flowers, and empowering words. I felt guilty for wanting what they had — or, rather, what they didn't have. Life without a binder sounded like a dream come true. But because I wasn't a cancer patient, a mastectomy wasn't in my future. Top surgery, however, was an option: a dramatic reshaping of the chest that would help me to create an aesthetic more aligned with my desired gender expression or identity.

In the Venn diagram of chest reshaping procedures, the overlap between the two surgeries is significant. For me, top surgery meant life in a body that felt right, at last. No binder needed.