The annoyance of a handsome butch
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The annoyance of a handsome butch

Breast Reduction
The annoyance of a handsome butch

Not every woman dreams of a pair of enormous breasts. For women who wish to have the body of males, such female sex characteristics on the breasts make them feel depressed. To cover up their breasts, they are willing to suffer from the compression, sweltering, and discomfort of wearing the "breast binders," and to remove this mental block, most of them would eventually choose the breast reduction surgery.

The so-called breast reduction surgery simply means removing the patient's breast tissue. It not only removes the mammary gland and fat, but also needs to retain the nipples. The areolas of females are larger than that of males in general and therefore must be moderately reduced all while maintaining the sensibility of nipples. In addition, after the breasts are removed, the nipples and areolas must be repositioned to the same positions as the male nipples. Therefore, the complexity and technical difficulty of this surgery are even higher.

It is worth mentioning that after the people with larger breasts remove their breast tissue, they also need to have their excess skin removed, and there will be a scar under the breasts. As for patients with A or B cup sizes, the positions of their nipples and areolas are similar to that of males. Liposuction techniques can be used to aspirate the adipose tissue from the breast, and then the surgeon can remove most of the mammary gland without removing skin by opening an incision at the lower edge of the areola before finally suturing. In this way, not only the wound is smaller, but the postoperative scar is also hidden at the outer edge of the areola and is extremely invisible.
For patients with C cup size, surgery is required to remove a large area of excess fat and skin, and there will be an I-shaped scar on the chest.

As for patients with D cup size or even larger breast, surgery is required to remove the excess fat and skin, and the nipples will be re-implanted after suturing. There will be a T-shaped scar on the chest.

Breast Reduction



Case study 1

When Ray was an elementary school student, she found that compared to the girls' pink bubble world, she preferred playing ball games or video games. She also actively participated in sports days held by her school as well as the sport-related school clubs. Having always been dressing in a neutral style and been a sport-loving teen, she was often mistaken for a small boy by others. She did not know much about her sexuality orientation during her childhood, but when she grew up she started to understand what was going on. Ray has always maintained a healthy attitude toward it. As a swimming instructor and a lifeguard, she often envied that her male colleagues could wear casually, while she had to cover her breast binder with extra clothes on. It was not only hot but also made her appearance less attractive. She also felt awkward and uncomfortable during the teaching process. Breast reduction surgery is a gift she gave to herself for her 30-year-old birthday. "Be independent at thirty", she hoped that she could start a new chapter for her life and things can be more different. After the surgery, she hoped that she could also strengthen her body physically by working out and march toward her the goal of becoming someone like "JYB, the most beautiful girl in Thailand". You might want to flatten your breasts instead of enlarging them, and you might be different, but so what!


The incision is inside the areola, and the adipose tissue in the breast is removed by the liposuction.

The above is purely a case description, and the actual situation will vary from person to person.

Case study 2
Chris is a tattooist. Because of the environment that she grew up with, she always expresses courageously about what she wants. She thinks that life is short, so she should do things that make herself happy. It includes her sexual orientation. She does not think that God played her, rather she thinks that she was simply born in a wrong body, but she is physically and mentally healthy. With lots of self-confident, she actually thinks that she is more attractive than other real men.

In addition to her usual tattoo work, Chris also likes outdoor extreme sports. However, her breast binder often made her feel tight and inflexible, so she could not perform her best. She often imagined that one day she could surf shirtless and handsomely on the ocean.

Chris originally had a pair of large breasts, so Dr. Kao gave her a lot of psychological reconstruction when Chris consulted him, wanting Chris to perform surgery only after she really made up her mind, as the scar could become an issue after the surgery. Even if she got rid of the annoying feminine features, the scars may have deterred her. After seeing the effects of many cases, Chris did not change her straightforward personality and still wanted to do the surgery. She even said confidently that Dr. Kao could use his surgical specialty to change her appearance, and she could also use her tattooing profession to cover the scars caused by the breast reduction surgery.

Remove the excess breast tissue and skin to achieve the objective of breast reduction. The nipples will be re-implanted after suturing. There will be a T-shaped scar on her chest.

The above is purely a case description, and the actual situation will vary from person to person.






Q 1.Is everyone suitable for breast reduction surgery?

For breast reduction surgery, apart from the scar-related issues, it is also very important to consider about future because this is an irreversible operation. Females will face the problems that their breasts won't grow again and breastfeed is impossible in the future. Therefore, the surgeon must fully understand whether the customers are determined and whether their family members support them before the surgery by communicating with the customers in detail


Q 2.Does the breast reduction surgery eliminate the possibility of breast cancer?

The mammary gland removed by surgery is only in the front breast area, and the neighboring lymph nodes are not completely removed. The removed breast tissue can be tested to confirm whether there are affections. If the signs of breast cancer are found early, the physician can immediately proceed with complete treatment.


Q 3.Is psychological counseling required prior to breast reduction surgery?

Although there is no psychiatric appraisal requirement for breast reduction surgery in Taiwan, it is still recommended that patients who are hesitant about this surgery make discussion with the physician after a complete assessment is done by a psychiatrist.


Q 4.Does the patient need to wear body shaper after surgery?

It is necessary for the patient to wear body shaper in the first 3 months after the surgery to help postoperative recovery and effects. In the first month, the patient needs to wear the body shaper 24 hours a day, and from the second month on the time can be reduced to 12 hours a day.



  1. Do not ride a motorcycle or drive home after surgery (for patients who received eye or sleep anesthesia).
  2. Avoid strenuous exercise and do not lift heavy objects within two days after operation to avoid blood vessel rupture and swelling.    
  3. Do not remove the bandages or fixing device yourself.    
  4. Apply ice compression on the first 2 days (48 hours) after the surgery, and from the third day on, apply warm compression until the swelling is gone (please pay attention to the temperature of warm compression to avoid burns).    
  5. Take medication on time for 4 times a day (after meals and before sleep). If the pain is severe, take painkillers once every 3 hours.    
  6. Wound care: Use saline solution and cotton swabs to clean the wounds, wipe dry, and then apply the ointment every morning and evening.    
  7. Don't let the wound contact with water within 2 days after the surgery. From the third day on, use clean water to clean the wound. Do not use cleaner within 7 days after surgery to avoid irritation.
  8. Do not smoke, drink alcohol, tea or coffee, or have pepper and other irritating food within a week after the surgery to avoid affecting the postoperative wound from healing. 
  9. No seafood during the first week after the surgery to avoid allergies (except for fresh fishes).


Dr. Yi-Sheng Kao Director | Plastic Surgery Aesthetic Clinic

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