• NO Nipple Grafts
• NO Vertical Scars
• Excellent Nipple-Areola Size, Positioning, Sensation & Pigmentation

• Appropriate Nipple Projection
• Only 2 Incisions vs. 3


Dr. Hope Sherie has developed the new, cutting edge buttonhole technique for FTM chest reconstruction.

For many transmen chest reconstruction is the most visible and definitive step in physical transition.

Until recently, the surgical options for chest reconstruction have included the “key-hole” or peri-areolar technique which is limited to removal of a small amount of breast tissue and does not reposition the nipple or remove excess skin, the “inverted-T” technique which retains the nipple appearance and sensation at the expense of additional vertical scars and limited nipple repositioning, and the double incision technique with free nipple grafts which gives the best aesthetic result for most patients at the expense of nipple projection, sensation, and temporary, and occasionally permanent, nipple-areolar depigmentation.

I am very happy to announce the availability of a new technique which allows the nipple-areolar complex (NAC) to be resized and moved to an appropriate masculine location while retaining nipple sensation, and projection (which is decreased as appropriate) without the additional vertical scars of the inverted-T technique. In most cases, pigmentation has also been retained. The breast tissue and extra skin are removed through standard double incisions, which may be shaped in a curved, straight, or oblique way. However, instead of removing the NAC as a free graft, the resized NAC remains attached to a thin dermal pedicle within which the nerves and blood vessels are preserved. Real ButtonAfter careful measurement of the desired nipple location, a circular incision is made in the chest wall skin and the NAC is then brought out through this opening like a button through a button-hole and sutured into place. Not only are pigmentation, sensation, and projection retained, a more natural appearance is achieved than with nipple grafts.

Since 2015, we have performed the “buttonhole” technique on hundreds of patients with a variety of body and breast sizes with excellent cosmetic results, nipple viability and sensation retention. I am delighted to offer this technique to individuals who desire the surgery. Please feel free to contact our office. We will be happy to provide more information or assist you in scheduling a consultation.

Do I qualify?

The requirements for Buttonhole qualification are:
1) Patient is non-smoker
2) Patient is not diabetic
3) Pedicle length (distance from nipple to skin incision) can be no longer than 12cm


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