Breast augmentation or augmentation mammoplasty is done to construct and enlarge the breast size and shape. To obtain a feminine profile, trans-women consider breast augmentation as a priority surgery.
Since transgender women are born with broader shoulders and wider breastbone, large implants are normally inserted for proportion and a natural appearance.
For transgender patients who undergo hormone replacement therapy, the breasts will naturally develop. But, if you are unhappy with the results after the hormone replacement therapy and you want to further enlarge and enhance your breasts, surgery remains the only option.
This surgery is not exclusive to only transgender women. Many cis-gender and non-binary people have also benefited from this surgery.
What is male to female breast augmentation surgery?
Breast augmentation, or augmentation mammoplasty, is a surgical procedure that can enlarge and enhance the size of breasts in transgender women.
Long term hormone replacement therapy will naturally lead to larger breast size, but not all patients are happy with their breast size after the therapy. If you are still unhappy with the size of your breasts, breast augmentation can be an option.
Ideal Candidates For Breast Augmentation
- Transgender women who have already started taking estrogen therapy for one year
- Individuals 18 years and above
- Physically and emotionally healthy candidates
- Individuals with a body weight proportionate to the body frame
- Have undergone consultations and medical tests
- Generally requires at least 3 months of counselling
- A letter of recommendation is also required from a licensed health professional.
Before you go for breast surgery, you will need to consider whether you want saline or silicone implants. Saline implants consist of saline water (saltwater) and have an incision length of about 1.5 inches. On the other hand, silicone implants come with cohesive silicone gel, and they are softer and appear more natural than saline implants.
When deciding on the cup size, you might desire a larger size. The implants should be proportionate to your natural body frame. There are two choices of shape for the breast – round and anatomic (shaped like a teardrop). While you can choose the round implants for a symmetrical result, the anatomical implants will give you natural looking breasts.
Incisions can be made either along the border of your areola, through your armpit, or below the fold of your inframammary muscle.
Incisions are usually two to three inches long underneath the breasts for the implants. The implants are placed underneath the muscles to create a natural look after which the cut is sutured, and your chest will be covered with a surgical bandage. You will also be required to use a supportive bra.
Pre-Operative Care And Precautions
- A Pharmacy plan should be in place to obtain postoperative medications
- Two weeks before surgery, a healthy balanced diet and plenty of rest should be taken
- Strictly no smoking two weeks before and 6 weeks after surgery
- The night before surgery, shower with antibacterial soap Hibiclens scrub
- Get a blood test before surgery
- Stop recreational drugs
- Avoid taking aspirin and certain anti-inflammatory drugs. These may increase bleeding.
How is the surgery performed?
Breast augmentation can be performed at any stage of your sex reassignment surgery. It is performed under general anesthesia. Once the anesthesia has taken effect, an inframammary incision, about 3cm, is made. Behind each breast (either subglandular or submuscular) a pocket is made. This will then be followed by the placement of the implants inside the pockets for optimal appearance and symmetry.
The most common approach of positioning the implants is by making an incision along the crease under the breasts, called the infra-mammary fold. This will reduce the appearance of the scar. After comparing both breasts to ensure proper placement of implants, the incision will then be closed with stitches.
Dissolvable sutures will be used throughout the operation. The wound will be dressed with steri-strips with a waterproof dressing in place.
Complications And Risks
Breast augmentation surgery is considered a safe approach, but there are certain complications that may occur:
- Infection in the wound area is a common risk which can be corrected using antibiotics
- Bleeding and reaction to anesthesia happens after surgery
- The scars will be noticeable and permanent, especially under the breasts, though it may fade to a certain extent with time
- Regular smokers may expect poor healing
- In some cases, nipple sensation may decrease
- Ptosis (a condition of nipple/breast drop)
- Haematoma (blood collection)
- Capsular contracture
- Palpable implants
- In cases of leakage, the implants may deflate
Your surgeon will try to minimize the complications. But with every surgery, some discomfort, bruising and minor risks are to be expected. Surgeons with impressive records should be consulted
- Your surgical wounds will be covered in surgical glue which will fall off in a few days as your skin heals.
- Shower after one day. Wait for three weeks before you swim or soak in a tub.
- Swelling, bruising and soreness will be gone in 4 to 6 weeks
- Avoid heavy activities for the first two weeks after the surgery.
- Most patients can walk delicately after the surgery
- You will feel soreness for the first week, for which you are advised to take ample bed rest
- Driving is possible after a week
- Plan on being cautious for the first two months
- Sleeping on your back is recommended and keep your head elevated.
Results And What To Expect
Most results are life-long, but some implants may require replacement after 10 years. Implants are made to look as natural as possible. If cheap quality implants are used, the breasts may look hard and fake. Silicone breast implants generally look more natural and softer compared to saline. Silicone or saline both have their pros and cons which may be taken into proper consideration before making a final decision. The technique and expertise of the surgeon are crucial.
Costs Of Surgery
The cost of breast augmentation can widely vary. According to the America Society of Plastic Surgeons, the average cost of implants in the United States is 3,708 USD. In Thailand, the price is close to 3,400 USD.
How long does the surgery last?
A: Anywhere between 1-2 hours.
Is the change permanent?
A: In most cases, implants last a lifetime. However, some implants may need replacement.
At what stage of the sex reassignment process should I undergo breast augmentation?
A: It can be done at any stage.
Can I choose the size of implants?
A: Yes. However, you should keep in mind that the size should be in proportion to your body frame, or else the results will not look natural.
Will the sensation on my nipples change?
A: There are cases where patients experience a diminished sensation of the nipples, but it depends on your surgeon’s technique and approaches.