Breast feminization surgery, also known as top surgery, for transgender women can give you the breast shape, size, and overall appearance you’ve always wanted.
Dr. Andrew P. Trussler performs breast augmentation to help transgender women transition physically to their self-affirmed gender.
Good Candidates For MTF Breast Augmentation In Austin, TX
To be good candidates for these procedures, patients need to be in good health physically and mentally, without significant medical issues such as diabetes, hypertension, or cancer. They need to be within 10 percent of their ideal weight and preferably be non-smokers, or at least willing to quit for 2-4 weeks prior to and after surgery. Patients need to be 18 years old and currently on hormone therapy.
During your consultation with Dr. Trussler, he stresses that his MTF breast augmentation patients need to have realistic expectations for these surgeries. This procedure will change the patient’s body to better fit with their expressed gender, but it won’t create perfection.
Are there any major differences between traditional breast augmentation and transgender breast augmentation?
Preparation is the biggest difference. Candidates for a transitional breast augmentation are required to complete at least three months of counseling and receive a letter of recommendation from a mental health professional before they can begin the transitioning process. There are no requirements for a woman seeking breast augmentation.
Many transitioning women choose to take female hormones to help feminize their appearance. In some patients, these hormones lead to the development of some minor breast tissue, which is beneficial for Dr. Trussler in the augmentation process. If the patient doesn’t have enough breast tissue, a tissue expander will be needed. This is also unlike a woman having breast augmentation, although this is often necessary after a woman has a mastectomy and then desires breast reconstruction.
For transitioning women, implants are placed on top of the pectoral muscle of the chest. With traditional augmentation, the patient can opt to have her implants placed atop the chest muscle or they can be placed behind the pectoral muscle.
It typically also takes longer for the implants to settle in transgender augmentation. This is because the skin of the transitioning female has less elasticity. This makes the implants initially appear too high, hard, and round. As the skin settles, the implants descend, and a natural contour is achieved. For traditional augmentation, this process happens much more quickly.
Do I Need To Be On Hormone Therapy Before Breast feminization surgery?
Patients do need to be on hormone therapy toward feminization. This will create the appropriate amount of breast tissue necessary to adequately cover your implants. It’s best if the patient has been on hormone therapy for some time. If hormone therapy has not produced the necessary amount of breast tissue to cover the implants, Dr. Trussler can utilize a tissue expander to stretch the skin layers in the chest until they have an adequate amount of surface area. This usually is only necessary if the patient desires larger breast cup sizes.
How do I choose the size of my new breasts?
Dr. Trussler has various tools to help patients visualize how different implant sizes and characteristics will look on their individual body. This applies to traditional augmentation patients and transitioning female patients. With these tools, you can see what different projection characteristics and size variations look like on your body.
What Decisions Will I Need To Make About My MTF Breast Augmentation?
There are various options available with MTF breast augmentation, and you’ll work with Dr. Trussler during your consultation to make your choices from the following categories:
- Implant Type — You’ll choose between silicone, saline, and gummy bear (highly cohesive) implant types.
- Implant Size — Breast implants are sized based on the amount of material filling the silicone outer shell. This is measured in cubic centimeters, CCs. For instance, your implants could be 350 CCs.
- Implant Projection — Different implants have different profiles: low profile, moderate, moderate plus, high, and ultra-high profile. The profile of a breast implant refers to how much an implant projects forward from the chest wall when the person is standing.
- Incision Location — You will decide the incision location for Dr. Trussler to insert your implants. They can be placed with incisions made around the areola complexes, along the breast crease at the bottom of the breast, or through the armpits. Obviously, the trans-axillary incisions made through the armpit create no visible scarring on the breasts.
- Implant Placement — You’ll decide if you want your implants placed below the breast tissue but above the pectoral muscles or below the pectoral muscles.
Is there anything I need to do to prepare for transgender augmentation?
As discussed above, there are certain criteria that need to be met prior to qualifying for transgender augmentation. Plus, you’ll need to be on a course of female hormones prior to this procedure.
As for preparation for the actual surgery, you’ll need to follow the same instructions as you would for any surgery. Dr. Trussler will provide instructions during your consultation, but you’ll need to stop taking any blood thinning medication, aspirin, anti-inflammatories, and most herbal supplements for one week prior to your surgery. If you smoke, you’ll need to stop for at least two weeks prior to your surgery and two weeks post-surgery, as smoking constricts blood vessels, and this impedes healing.
Recovery after this surgery is not difficult, so you won’t need to plan an extensive recovery area. But you will be limited in lifting things and any impact exercise, so you will want to plan for that. Also, you’ll probably need 4 to 5 days off work.
How we perform transgender Breast Augmentation surgery
Dr. Trussler performs transgender breast augmentation with the patient under general anesthesia. The procedure takes about 2 hours.
Breast implants are placed to increase the breast size, just as with female breast augmentation. Dr. Trussler makes the incision, creates a pocket to hold the implant, and then places the implant. Saline implants are placed empty and then filled in place. This allows for smaller incisions. Silicone or gummy bear implants are placed already filled. Once the implant is in place, Dr. Trussler checks for symmetry, and then the incision is closed.
“Dr Trussler is amazing. He’s candid, knowledgeable, and super eager to help you look and feel your best.”
What Results Can I Expect From Breast Augmentation With Dr. Trussler?
MTF breast augmentation can enhance the breasts and provide these attributes:
- Increased size
- Increased shape
- Enhanced projection and cleavage
- Improved nipple shape
- Improved breast symmetry
- Enhanced overall breast appearance
Will I have noticeable scarring after my transgender breast augmentation?
Any time an incision is made in human skin the healing process creates a scar. Depending on how large the implants you’ve chosen, the scarring will vary somewhat. For instance, saline implants are placed unfilled through a small incision resulting in a small scar. Larger silicone implants will need an incision along the bottom of the breast at what will become the breast crease. There will be a scar in this location, but it will be at the bottom of the newly formed breast, and it will fade quickly. If smaller implants are used, Dr. Trussler may be able to make the incision around the areola, and the incision there is virtually invisible.
Regardless of the location and size of your incision scarring, these scars fade dramatically in less than a year. Scar care will be started around 3 weeks prior to surgery and if needed laser will be started at or around 3 months.
Transgender Breast Augmentation Recovery
These surgeries do not create overly difficult recovery, although the increased musculature involved with MTF augmentation can create more soreness and discomfort for a few days. After your surgery, your breasts will be bandaged, and you’ll be in a surgical bra. This will transition to a support bra and then to a strong sports bra. You’ll need to wear these for 24 hours a day for about a month, as this limits the stress on your incisions. It also helps to limit swelling.
Most patients can return to work in 5-7 days, but heavy lifting needs to be avoided for 6 weeks to limit stress on your pectoral muscles and entire chest area. Strenuous exercise also needs to wait for about 6 weeks. You will have scarring along your incisions, but this will fade over the next 2-3 months. We will also provide you with scar care to use once your sutures are removed.
The Risks Of MTF Breast Augmentation
This is surgery, and it entails all of the risks involved with such: excessive bleeding, poor incision healing, reaction to anesthesia, infection, and the like. These are rare with this procedure.
Specific to WTF breast augmentation, these are the risks:
- Capsular contracture, where scar tissue forms around and distorts the implant shape
- Fluid accumulation beneath the skin
- Bleeding around the implant
- Breast pain
- The asymmetry between the breasts
- Implant displacement
- Implant rupture
Is my transgender breast augmentation permanent?
These are intended to be permanent procedures. Of course, like any manufactured item, breast implants have a lifespan. Implant duration is improving, but patients need to plan on one and probably more breast revision surgeries to replace aging implants. Currently, implant manufacturers guarantee their implants for a minimum of 10 years, offering to fully pay for any replacement procedures prior to that time.
Implant duration can vary widely between patients. But if you are a younger patient having transgender augmentation, expect future procedures to exchange or replace your implants.