Male to Female Breast Augmentation

Who is this treatment suitable for?

Transgender patients transitioning from male to female. Trans women may find that hormones are not enough to help create sufficient breast tissue and will take the step of breast enlargement surgery. Many patients find transforming their physical appearance in this way gives them a boost in confidence.

What does the treatment involve?

You will first need a consultation with a Consultant who is experienced in trans female breast augmentation. They will be able to advise you on the best size, shape and type of implant to help you achieve the look you want. The surgeon will take into account your natural breast tissue and body shape as well as your chest diameter, height and nipple position. Implants or expanders can be placed under the breast tissue alone or under the chest muscle (pectoralis major) in their upper half. This is usually governed by how much soft tissue or “padding” you have to adequately cover an implant. It will also depend on surgeon and patient preference.

The degree of natural elasticity (stretchiness) of your chest wall skin and the desired size of augmentation will determine whether you are suitable for a one stage or two stage procedure.

For a one stage procedure, the patient’s chest skin is stretchy enough to accept the chosen implant size and still give an acceptable cosmetic outcome. In those patients in whom this is not possible, it is necessary to insert a tissue expander. After the surgery, this is gradually inflated week by week, a bit like a balloon though usually using fluid rather than air, until the chest skin is stretched up to the desired volume and shape. After a period of time to allow the tissues to settle (approximately 3 months minimum), either the expansion port is removed only (leaving the expander in place) or the whole expander is removed and replaced with a purely silicone implant.  All of these decisions will be made between you and your Consultant.

The surgery is carried out under general anaesthetic and takes approximately 1-2 hours. The incision is most commonly placed in the inframammary fold or lower crease of the breast. You may or may not have drains depending on your surgeon’s preference. Most patients require an overnight stay in hospital and are discharged the following day, though sometimes day case surgery is possible. 

How should I prepare for the surgery?

Your Consultant will assess your fitness with regard to undergoing surgery.

You can prepare for surgery by:

• maintaining a good level of fitness (regular walking or other exercise)
• avoiding smoking nicotine products a minimum of 4 weeks prior to surgery.

If you are taking any medications that thin the blood (such as aspirin) you may be asked to stop this prior to surgery. In addition, if you regularly take any health supplements or herbal medications, it is important to disclose this to your Consultant, since some supplements can interact with medications or increase the risk of bleeding.

How long is the recovery process?

Following surgery, your Consultant may wish you to wear a supportive post-operative bra day and night for several weeks. Information on where to purchase post-operative garments will be provided by the surgeon and pre-assessment clinic. You will not be able to drive straight after surgery and will need a friend or relative to drive you home. Pain relieving tablets will be provided.

Patients often experience discomfort in the chest for several days following surgery, though it usually settles quickly. It is safe to drive once you feel comfortable and fully in control of a car – usually around 2 weeks following surgery. Patient’s return to work will vary depending on occupation, but would usually be after 2-4 weeks. Once you have had your post-operative check and the wounds have fully healed, sports can be resumed following advice from your surgeon.

Specific risks and complications

The majority of patients will recover from surgery without complication, but all surgery carries potential risk including chest infection, heart complications, stroke and DVT. Should you experience any complications, your surgeon will ensure you receive any necessary treatment.

During your consultation your Consultant will discuss with you any risks that are specific to your surgery.