Non-Binary Top Surgery in Bellevue
Chest Reconstruction Designed for Every Identity
Non-binary top surgery at Pacific Sound Plastic Surgery is a deeply individualized procedure designed to align your chest with your gender identity — whether that means a flatter chest, reduced volume, or something entirely tailored to your vision. Dr. Kristopher Day, a double board-certified plastic surgeon with more than a decade of surgical experience, brings precision, respect, and extensive expertise to every top surgery consultation. At our boutique Bellevue practice, your identity is seen and your surgical goals are honored.
Double Board-Certified (ABPS + ABS)
Ivy League Trained
Highly Rated Bellevue Plastic Surgeon
Proudly Serving Bellevue, Seattle, Kirkland, Redmond, Mercer Island, Issaquah, Renton
What Is Non-Binary Top Surgery?
Non-binary top surgery is a category of chest surgery designed for individuals who identify outside the traditional gender binary. Unlike binary top surgery, which typically aims for either a fully masculine flat chest or a feminine chest contour, non-binary top surgery is defined entirely by each patient’s unique goals. Some patients seek a moderately flatter chest while preserving nipple placement and sensation. Others want significant tissue reduction without a traditionally masculine outcome. There is no single “correct” result — only the result that is right for you.
At Pacific Sound Plastic Surgery, Dr. Day approaches every non-binary top surgery consultation without assumptions. He takes time to understand your specific vision before recommending a surgical approach.
Types of Non-Binary Top Surgery
Double Incision with Nipple Graft
The most common approach for patients with larger chest tissue. This is a complete (simple) mastectomy in which essentially all breast tissue and excess skin are removed, with the nipple-areolar complex repositioned (with or without free nipple grafting — see below). Incisions are placed along the natural anatomic boundary between the chest and the abdomen, so they appear anatomically correct and fade significantly over time.
Periareolar (Keyhole or Crescent)
Best suited for patients with smaller chest volume and good skin elasticity. As with double incision, this is a complete (simple) mastectomy — essentially all breast glandular tissue is removed. The difference is in the leftover skin and subcutaneous tissue (the “breast envelope”): periareolar leaves more of it in place, which is appropriate when the chest is smaller and the skin will retract well on its own. Incisions are placed around the areola, the nipple-areolar complex stays attached to its native blood supply and nerves, and most patients retain meaningful nipple sensation.
Double Incision Without Free Nipple Grafting
A variant of the double-incision approach for patients who do not want nipple reconstruction. The breast tissue and excess skin are removed and the chest is closed without preserving or grafting the nipple-areolar complex. This eliminates the graft healing process and avoids any element of nipple reconstruction in the final result.
Breast Reduction (Chest Reduction)
For patients who want a smaller, less prominent chest contour but want to retain some chest tissue rather than a flat result. The breast is reduced and reshaped — preserving the natural nipple-areolar complex and its sensation — to create a chest that better aligns with the patient’s identity without committing to a fully masculine flat-chest outcome. This is often the most fitting option for patients who specifically do not want a binary surgical result.
Customizing Your Procedure
Dr. Day’s precision and extensive experience with gender-affirming chest surgery translate directly to meticulous attention to contour, symmetry, and scar placement. He works collaboratively with each patient to map out the exact degree of chest reduction, nipple size, areola position, and any additional contouring (liposuction to the flanks or underarms is often discussed) that will produce the most affirming result.
"I got top surgery with no free nipple grafts, a surgery I had wanted for years… Within a month I had my surgery. I am so beyond grateful and my chest looks amazing. My recovery went super smooth and my results look better than I could have anticipated. Dr. Day was recommended to me by a friend and now I will be recommending him to everyone I know."
— Mars C. · Top Surgery Patient · Google Review
Benefits of Non-Binary Top Surgery
Patients in Bellevue, Seattle, Kirkland, Redmond, and surrounding communities seek non-binary top surgery for reasons that go beyond aesthetics — for many, it represents a fundamental step toward alignment between body and identity.
Physical & Aesthetic Benefits
- A chest contour that reflects your identity, whether flatter, reduced, or custom-sculpted
- Reduced dysphoria associated with binding or hiding chest volume
- Freedom from daily binding — which can cause musculoskeletal discomfort over time
- Greater ease with physical activity, exercise, and clothing
- Long-lasting results with stable weight
Why Dr. Day's Approach Is Different
Dr. Day does not impose a binary framework on his top surgery patients. His surgical planning begins with listening — understanding your goals in detail before recommending any technique.
His extensive experience with gender-affirming procedures, combined with his meticulous approach to soft tissue contouring, means he can execute subtle, highly individualized chest contouring tailored to each patient’s goals.
Emotional & Identity Benefits
- Relief from gender dysphoria for patients whose identity conflicts with their assigned chest
- Increased comfort in social, professional, and intimate settings
- Ability to present authentically without relying on garments or layering
- High reported patient satisfaction and quality-of-life improvement
- A result designed entirely around your self-definition, not a binary template
"I went to Dr. Day for gender affirming top surgery and I ended up getting a double incision bilateral mastectomy with no free nipple grafts which is a surgery I had wanted to have for years. Dr. Day was kind, straightforward, and honest when discussing surgical options and set realistic expectations for what a potential final result would look like based on my body shape and the amount of tissue that was being removed. He was transparent about the reasoning behind him suggesting I get liposuction on each side (which I ended up doing) and why it would produce the best result. In the end, I'm very happy with my results."
— Erin B. · Top Surgery Patient · Google Review
Am I a Good Candidate for Non-Binary Top Surgery?
Non-binary top surgery candidacy is assessed collaboratively. Dr. Day considers both surgical factors and personal readiness to ensure the best possible outcome.
- Ideal Candidates
- Adults (18+) with persistent chest dysphoria or gender non-conforming identity
- Patients who have explored their goals and have a clear vision of their desired chest
- Non-smokers, or patients who have quit smoking at least 4 weeks prior to surgery
- Patients in generally good health without unmanaged cardiac, pulmonary, or metabolic conditions
- Those who have a letter of support from a qualified mental health provider (per WPATH standards)
- Patients with realistic expectations for scarring, healing timeline, and final results
- When to Wait
- Patients actively managing an uncontrolled medical condition (diabetes, cardiac issues, etc.)
- Those who are currently smoking or using nicotine products
- Patients who have not yet established clarity on their specific surgical goals or desired outcome
- Individuals who have not yet obtained mental health support documentation where required by insurance
- Those who are significantly above a healthy BMI range — weight stabilization improves surgical outcomes
- Patients in the middle of other major medical treatments that may affect healing or anesthesia tolerance
Not Sure If You're a Candidate?
Schedule a consultation with Dr. Day to discuss your goals and options.
Your Non-Binary Top Surgery Journey
Your Consultation with Dr. Day
The consultation is where your surgical plan begins. Dr. Day takes an unhurried, judgment-free approach — asking about your identity, your goals, your timeline, and any prior binding history that may affect tissue characteristics. He will examine your chest, discuss technique options, and provide his surgical recommendation.
You will leave with a clear picture of what your procedure will involve, what results are achievable, and what your recovery will look like.
Preparing for Surgery
- Obtain required documentation (mental health letter, WPATH-compliant if using insurance)
- Complete pre-op labs and medical clearance (coordinated through our office)
- You will receive specific pre-operative instructions including any medications or supplements to stop before surgery (this may include blood thinners, hormones, GLP-1 medications, NSAIDs, certain vitamins, and alcohol)
- Stop all nicotine use at least 4 weeks before surgery
- Arrange for a responsible adult to drive you home and assist for the first 1–2 days
- Set up a comfortable recovery area at home (recliner or wedge pillow, loose clothing)
The Day of Your Procedure
Non-binary top surgery is performed under general anesthesia at our accredited surgical facility. Procedure time varies by technique — typically 2 to 3 hours for double incision approaches and 1 to 2 hours for periareolar techniques. You will go home the same day.
Recovery Timeline
Day 1 (Day After Surgery):
What to Expect
Low-grade activity is encouraged — walking the day after surgery promotes circulation and recovery. Surgical drains may be placed; Dr. Day’s team will walk you through drain management. Expect swelling, tightness, and mild to moderate discomfort well-controlled with medication. Avoid any activity that causes grimacing, grunting, straining, or sweating.Low-grade activity is encouraged — short walks are recommended. Avoid any activity that causes grimacing, straining, or sweating. Discomfort is managed with prescribed medication. Surgical bra worn at all times.
Week 1
What to Expect
Continue frequent low-intensity activity (walks, short outings). Desk work and sedentary remote work may resume for most patients. Follow-up appointment at our Bellevue office. Drains typically removed within 5–10 days if placed. Avoid any activity that causes grimacing, grunting, straining, or sweating. A compression vest is worn 23 hours per day (the “23-and-3 Rule”) — remove only to shower and launder.
Weeks 4-6
What to Expect
Full, unrestricted activity resumes. Scar maturation continues — scars will fade and flatten significantly over 12–18 months. Final chest contour is well-established by 3–6 months post-surgery.
Follow-Up Care
Dr. Day includes all post-operative visits in your surgical plan. Our team is available by phone throughout your recovery — including for drain management questions, scar care guidance, and any unexpected concerns.
"I went to Dr.Day for a double mastectomy with no nipple graft. The process was very straightforward, they were communicative + professional, and I am very happy with my results. I had no complications medically or aesthetically, and was kept informed throughout. It was also my first time getting an operation, the staff were kind and assuring. I would recommend Dr.Day for anyone seeking similar surgeries!"
— Ashen W., Top Surgery Patient • Google Review
Non-Binary Top Surgery Results
When Will I See Results?
Immediately following surgery, you will notice a dramatic change in chest profile — though swelling will affect the final appearance for several weeks. The first glimpse at your result, even with post-surgical compression, is often described by patients as profoundly affirming. As swelling resolves over 4 to 8 weeks, contour definition improves. The final chest shape, including scar maturation, is typically complete by 3 to 6 months post-surgery.
How Long Do Results Last?
Top surgery results are designed to be durable and long-lasting. Significant weight fluctuations can affect chest shape over time, and maintaining a stable, healthy weight is the best way to preserve your results.
Scarring
For double incision procedures, horizontal scars are placed along the natural anatomic boundary between the chest and the abdomen, so they appear anatomically correct and fade significantly over time. Scars are initially pink and raised, gradually flattening and lightening over 12 to 18 months. Dr. Day’s meticulous closure technique is designed to produce the best possible scar quality. Scar care instructions will be provided post-operatively.
Non-Binary Top Surgery Cost in Bellevue
The cost of non-binary top surgery depends on the specific technique selected, the extent of tissue removal, the need for contouring procedures such as liposuction, anesthesia, and facility fees. During your consultation, Dr. Day’s team will discuss your options and provide a detailed cost estimate specific to your surgical plan.
What Affects Your Investment
- Surgical technique (double incision, periareolar, or no-nipple-graft approach)
- Extent of tissue removal and chest contouring needed
- Whether liposuction to the flanks or lateral chest is included
- Anesthesia type and total procedure time
- Post-surgical garments and drain management supplies
What’s Included in Your Non-Binary Top Surgery Investment
Your surgical fee covers all of the following at Pacific Sound Plastic Surgery:
- Surgeon's fee
- Facility / operating room fee
- Anesthesia (administered by a board-certified anesthesiologist or certified registered nurse anesthetist)
- Enhanced Recovery After Surgery medication (Exparel)
- Cosmetic surgery insurance coverage (Cosmetasure)
- High-end compression garment (Isavella)
- High-end scar ointment (Biocorneum)
- Swelling and bruising ointment (Arnica)
- Clara Recovery Supplements
- Chlorhexidine Anti-Septic Scrub Cloths
- Post-operative recovery and follow-up care
Financing Options
Pacific Sound Plastic Surgery accepts CareCredit (6-month financing) and Alphaeon Credit, two of the most widely used healthcare financing programs. Both allow patients to begin their journey without paying the full cost upfront.
Pricing is discussed in full detail during your consultation so there are no surprises. Call (425) 818-8991 to get started.
Why Choose Dr. Kristopher Day for Non-Binary Top Surgery in Bellevue?
Choosing a surgeon for gender-affirming surgery is a deeply personal decision. Beyond technical skill, patients need a surgeon who listens, who communicates honestly, and who performs at the highest level of surgical precision. Dr. Day offers all three.
✓ One of the Highest-Rated Plastic Surgeons in Bellevue
Dr. Day’s reputation for patient care, communication, and surgical results is reflected in some of the highest patient satisfaction scores among Bellevue plastic surgeons — documented across hundreds of real, verified patient experiences.
✓ Inclusive, Boutique Practice
Pacific Sound Plastic Surgery is a small, intentional practice. Dr. Day sees every patient personally — there is no revolving door of providers. Gender-affirming patients report feeling seen, heard, and respected throughout the entire process.
✓ Double Board-Certified Plastic Surgeon
Dr. Day holds dual certification from the American Board of Plastic Surgery and the American Board of Surgery — the gold standard in surgical credentialing.
✓ 30+ Peer-Reviewed Publications & National Presence
✓ 30+ Peer-Reviewed Publications & National Presence
✓ Ivy League Trained
Dr. Day completed his surgical training at an Ivy League institution, building a rigorous academic foundation before specializing in plastic surgery.
✓ Surgical Facilities
Swedish Medical Center · Carillon Point Surgery Center · Virginia Mason Franciscan Health · Sound Plastic Surgical Center
Conveniently Located for Eastside Families
Pacific Sound Plastic Surgery is centrally located in downtown Bellevue, making Dr. Day’s expertise accessible to patients throughout the Eastside — without the stress of navigating Seattle traffic. Our patients enjoy a private, boutique surgical experience with complimentary parking, just minutes from the communities they call home.
Seattle
~15 minutes
World-class plastic surgery results without the downtown Seattle parking hassle. A quick drive across SR-520 or I-90 to our private Bellevue office.
Kirkland
~10 minutes
Just minutes from downtown Kirkland and the Juanita waterfront via I-405 or surface streets.
Redmond
~10 minutes
Convenient for the Redmond tech community via SR-520 or surface streets.
Mercer Island
~10 minutes
A quick drive across I-90. Our discreet, private environment is ideal for discerning Mercer Island residents.
Issaquah
~10 minutes
Convenient for Issaquah Highlands and Gilman Village area families via I-90.
Renton
~5 minutes
Easy access from Renton and the Landing via I-405 North. Boutique care and personalized attention just minutes away.
Frequently Asked Questions
What makes non-binary top surgery different from binary top surgery?
Non-binary top surgery is distinguished by the absence of a predetermined outcome. Where binary top surgery typically targets a fully masculine flat chest or a feminine contour, non-binary top surgery is defined entirely by what the patient wants — which could be a moderately flatter chest, a reduction without full flatness, customized nipple presentation, or any configuration that best reflects their identity. Dr. Day approaches each non-binary patient as an individual with no assumed endpoint.
What surgical techniques are available for non-binary top surgery?
The most common techniques include double incision (with or without free nipple grafts), periareolar (keyhole), and variations tailored to the individual. The right technique depends on your chest size, skin elasticity, the degree of flatness desired, and your preferences around nipple placement and sensation. Dr. Day will recommend a technique based on your anatomy and goals at your consultation.
Can I choose not to have nipple grafts?
Yes. Some patients prefer a double incision procedure with no free nipple grafts. This eliminates the graft healing process and removes any element of nipple reconstruction from the outcome. Dr. Day has performed this approach and will discuss the aesthetic implications so you can make an informed decision aligned with your goals.
What documentation is required for insurance pre-authorization?
A WPATH Support Letter is required for all patients pursuing gender-affirming surgery with insurance coverage. This letter can come from either a licensed mental health professional (psychologist, LCSW, or psychiatrist) or a primary care physician, and should document gender dysphoria and support the medical necessity of surgery. Securing the letter is the patient’s responsibility — we communicate the requirement and timeline, but the letter itself is provided by your own care team. Insurance pre-authorization typically takes a minimum of 4–6 weeks once your surgical consultation has been completed.
How long is the recovery after non-binary top surgery?
Walking is encouraged starting the day after surgery. Most patients return to desk work and light sedentary activity during Week 1. Surgical drains (when used) are typically removed within the first week. A compression vest is worn 23 hours per day for at least 3 weeks (the “23-and-3 Rule”), with extended wear encouraged for up to 3 months. Exertional activity resumes at Weeks 2–4 on a graduated basis — starting at 50% of pre-operative levels and increasing gradually. Full unrestricted activity, including upper body exercise, resumes by Weeks 4–6. Final chest contour is generally visible by 3 months, with scar maturation continuing for up to 18 months.
Will I lose nipple sensation?
Sensation outcomes depend on the technique. Periareolar (keyhole) approaches generally preserve more sensation because the nipple remains attached. Double incision with free nipple grafts results in some degree of permanent sensation loss at the nipple site, though partial sensation sometimes returns over time. Dr. Day will discuss sensation expectations specifically for the technique he recommends for you.
How visible are the scars?
For double incision procedures, horizontal scars are placed along the natural anatomic boundary between the chest and the abdomen, so they appear anatomically correct and sit at a location that is covered by most clothing, including swimwear. Scars evolve significantly over 12 to 18 months, fading from pink to a lighter skin-tone color and flattening considerably. Periareolar incisions are placed around the areola and tend to be less visible overall. Dr. Day provides detailed scar care instructions post-operatively.
Can I combine non-binary top surgery with other procedures?
Yes. Liposuction to the lateral chest or flanks is commonly performed at the same time to refine the overall chest and underarm contour. Other combination procedures are discussed case by case during your consultation. Dr. Day will evaluate whether combining procedures is appropriate for your anatomy and recovery tolerance.
How do I get started?
The first step is a consultation. You can schedule by calling (425) 818-8991 or using the online scheduling link. Dr. Day’s team at Pacific Sound Plastic Surgery will confirm your consultation appointment, provide a pre-visit questionnaire, and outline what to bring — including any existing insurance documentation or referral letters.