Non-Binary Top Surgery in Bellevue — Chest Reconstruction Designed for Every Identity
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?
Types of Non-Binary Top Surgery
Double Incision with Nipple Graft
Periareolar (Keyhole or Crescent)
Best suited for patients with smaller chest volume and high skin elasticity. Tissue is removed through incisions around the areola, preserving natural nipple position and typically retaining greater sensation.
Results in a more subtle reduction rather than a fully flat chest.
Double Incision with Nipple Preservation (No Free Graft)
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. Dr. Day’s assistant Sophia was extremely helpful with reminders on what paperwork to get in for my therapist, primary, insurance, etc. Within a month I had my surgery. I am so beyond grateful and my chest looks amazing."
Benefits of Non-Binary Top Surgery
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 experience across hundreds of gender-affirming procedures, combined with his meticulous approach to soft tissue contouring, means he can execute subtle, highly individualized chest contouring that other surgeons may not offer.
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. In the end, I’m very happy with my results."
Am I a Good Candidate for Non-Binary Top Surgery?
- 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 ready? Schedule a consultation with Dr. Day to discuss your goals and determine the right timing. Call (425) 818-8991 [INSTANCE 2 OF 3] or request your appointment online.
Not Sure If You're a Candidate?
Ready to Take the First Step? Schedule Your Top Surgery Consultation
The Process And Recovery
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 Post-Op
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.
Week 1
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 2–4
Chest contour becomes more visible as swelling subsides. Gradually return to exertional activity — start at 50% of your pre-operative baseline and increase by approximately 5% per day. No heavy chest exercises, heavy lifting, or overhead activity until cleared by Dr. Day.
Weeks 4–6
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
Does Insurance Cover Non-Binary Top Surgery?
Key Insurance Points
- Washington State's insurance market includes several plans that cover gender-affirming surgery, including top surgery, when supported by appropriate documentation
- A letter from a licensed mental health professional (LCSW, psychologist, or psychiatrist) is typically required — our team can guide you on the exact criteria
- WPATH (World Professional Association for Transgender Health) letters are the accepted standard; Dr. Day's team has experience navigating this process
- If insurance does not apply, CareCredit (6-month promotional financing) and Alphaeon Credit are available to make your procedure accessible
Insurance Coverage
- Confirm with our patient care coordinator: Which specific insurance carriers are currently being accepted for non-binary top surgery (Apple Health, Premera, Regence, UHC, etc.)?
- Confirm: Are there updated insurance pre-authorization timelines to share with patients?
- Confirm: Is a WPATH letter required in all cases or only for specific insurers?
Non-Binary Top Surgery Results
When You'll 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 Results Last
Top surgery results are designed to be long-lasting. The tissue removed does not grow back. Significant weight fluctuations may affect chest shape over time, and maintaining a stable, healthy weight is the best way to preserve your results long-term.
Scarring
For double incision procedures, horizontal chest scars are placed at the lower chest crease to maximize concealment. Scars are initially pink and raised, gradually flattening and fading over 12 to 18 months. Dr. Day’s meticulous closure technique is designed to minimize scar visibility. Scar care instructions will be provided post-operatively.
"Skilled surgeon, inclusive office, reasonable wait-list, highly recommended! I have undergone multiple procedures with Dr. Day and would again."
— Leah W., Gender-Affirming Surgery Patient • Google Review
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.
Insurance Coverage
Non-binary top surgery may qualify for insurance coverage. Our office works with major commercial insurers and Washington Apple Health to assist with pre-authorization. Our patient care coordinator will guide you through the documentation and submission process. Please call (425) 818-8991 [INSTANCE 3 OF 3] to discuss your specific coverage before your consultation.
💰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 Investment
- 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)
- Post-operative recovery and follow-up care
- Clara Recovery Supplements
Flexible Financing
For patients paying out-of-pocket or for costs not covered by insurance, Pacific Sound Plastic Surgery accepts CareCredit (6-month promotional financing) and Alphaeon Credit — both designed to help you move forward on your timeline. Ask our patient care coordinator about financing during your consultation.
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.
✓ 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.
✓ 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.
✓ 30+ Peer-Reviewed Publications & National Presence
Dr. Day’s 30+ peer-reviewed surgical publications and national invited presentations reflect a level of academic rigor and clinical currency that translates directly to patient outcomes.
✓ Ivy League Trained
Dr. Day completed his surgical training at an Ivy League institution, building a rigorous academic foundation before specializing in plastic surgery.
✓ 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.
"Dr. Day was able to fit me in so soon for a consultation, and not a month later a surgery date! He made my experience incredibly easy and created a safe space to express what I was looking for in my procedure. Definitely would be recommending him to a ton of my friends seeking gender affirming care."
— Ryanne C., Gender-Affirming Surgery Patient • Google Review
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.
Does insurance cover non-binary top surgery?
Coverage varies by insurance plan. Many major commercial carriers and Washington Apple Health (Medicaid) cover top surgery when documented as medically necessary for gender dysphoria. Dr. Day’s office will assist with pre-authorization and documentation requirements. Call (425) 818-8991 to discuss your specific insurer.
What documentation is required for insurance pre-authorization?
Most insurers require a letter from a licensed mental health professional (psychologist, LCSW, or psychiatrist) documenting a diagnosis of gender dysphoria and supporting surgery as medically necessary. WPATH guidelines are the accepted standard. Our team is familiar with the process and will guide you through each step.
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 at the lower chest crease — a location that is concealed 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.