Keyhole top surgery is a gender affirming chest procedure designed for trans masculine and gender diverse patients with very small amounts of chest tissue and excellent skin elasticity. This minimally invasive technique removes breast tissue through a small incision near the areola, resulting in a flat, masculine chest with minimal visible scarring.
Because skin is not removed, keyhole top surgery is best suited for carefully selected patients. Each surgical plan is customized to the patient’s anatomy and goals, with a focus on smooth contours, symmetry, and natural results.
Keyhole top surgery at SimplyTrans is performed under the care of Dr. David Sayah. Patients seeking keyhole top surgery in Beverly Hills or Los Angeles choose SimplyTrans for physician led evaluation, precise technique, and refined outcomes that support comfort and confidence.
Keyhole top surgery is a chest masculinization technique designed for individuals with small chest volume and excellent skin elasticity. Because this procedure does not remove excess skin, it is best suited for patients whose skin can naturally tighten after the underlying breast tissue is removed.
Ideal Candidates:
This technique is typically recommended for individuals who have:
- Very small breast volume
- Minimal to no chest sagging
- High skin elasticity
Because no skin is excised, keyhole surgery is generally not appropriate for larger chests or significant ptosis (sagging).
Surgical Technique:
The procedure is performed through a small incision placed along the edge of the areola or through the lower portion of the nipple-areola complex. Breast tissue is then carefully removed through this tiny opening. In most cases, the nipple remains attached, meaning free nipple grafts are not needed, which can help preserve sensation and blood supply.
Scarring:
One of the main advantages of keyhole top surgery is its minimal scarring. The incision is very small and usually blends into the border of the areola, making scars subtle and often difficult to notice once healed.
Recovery:
Recovery is often faster than double incision top surgery. Most patients wear a compression binder for approximately 6 weeks and can usually return to light daily activity within about 2 weeks, depending on healing and surgeon recommendations.
Limitations:
Because no excess skin is removed, this technique is not ideal for larger or sagging chests. A common way surgeons assess candidacy is the “pencil test”—if a pencil placed beneath the chest fold stays in place, there may be too much tissue or skin laxity for keyhole surgery to provide an optimal result.
Potential Risks:
A possible drawback of keyhole surgery is that a small amount of residual tissue may remain behind the nipple, which can occasionally require a minor revision or touch-up procedure for improved contour.
Recovery Timeline
Week 1:
- Focus on pain control and rest
- Limit arm movement and avoid strenuous activity
Weeks 2–3:
- Light daily activities are usually allowed
- Continue to avoid heavy lifting and intense upper-body movement
Weeks 4–6:
- Gradual return to more normal activities as approved by your surgeon
- Heavy lifting and strenuous exercise may still be restricted until cleared
3–6 Months:
Chest contour continues to refine as healing progresses
Final results become more visible as swelling and bruising fully resolve
Why Choose Dr. Sayah for Keyhole Top Surgery in Los Angeles
Selecting a board-certified plastic surgeon with extensive Keyhole Top Surgery procedures. Dr. Sayah’s qualifications include:
- Board certification by the American Board of Plastic Surgery
- Fellowship of the American College of Surgeons (FACS)
- Over 26 years of plastic surgery experience
- Medical degree from UCLA David Geffen School of Medicine, graduated top of class
- General surgery training at NYU Medical Center
- Plastic surgery residency at UCLA Medical Center
- Advanced fellowship training in endoscopic plastic surgery
- Hospital privileges at Cedars-Sinai Medical Center, Saint John’s, and UCLA
- Published research in fat grafting, surgical techniques, and body contouring
- Extensive experience with complex body sculpting procedures
- Artistic background as oil painter and sculptor
- International reputation serving patients from around the world
- Multilingual capabilities (English, French, Spanish, Farsi, Italian)
- Clinical faculty positions at Cedars-Sinai Medical Center and USC
- Member of the American Society of Plastic Surgeons
Dr. Sayah’s comprehensive training in reconstructive and aesthetic surgery, combined with his artistic sensibility, enables him to create beautiful, natural-looking buttock enhancement that complements your unique body proportions. His commitment to patient safety, adherence to established safety protocols, and meticulous surgical technique ensure you receive exceptional care and optimal outcomes.
Meet Dr. David Sayah
Dr David Sayah is a board certified plastic surgeon in Beverly Hills known for his natural approach to aesthetic surgery. With more than 26 years of experience, he combines surgical precision with artistic insight to deliver balanced and refined results. His philosophy centers on enhancing individual beauty rather than changing it.
A graduate of the UCLA School of Medicine and a Fellow of the American College of Surgeons, Dr Sayah trained at leading medical centers including NYU and UCLA. His work in wound healing and scar formation research helps patients heal beautifully with minimal scarring. Fluent in five languages, he welcomes patients from Beverly Hills, Los Angeles, and across the world who seek exceptional, natural results.
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436 North Bedford Drive Suite 202
Beverly Hills, CA 90210
Phone: (310) 385-7710
