The general concepts for MTF breast augmentation top surgery in transwomen are similar to those considered for a standard breast augmentation in cis-gender women. However, there are defined anatomical issues and limitations present much of the time that absolutely must be addressed and discussed prior to surgery. If this is not done, the results can be limited, poor or even bizarre and the patient will, at a minimum, be disappointed.
Such outcomes are ones that you likely want to avoid if you are seriously contemplating undergoing this gender affirming procedure unless you are absolutely prepared for such lesser results and have thoroughly considered the alternative.
Despite the relentless gas lighting by the media, politicians and others, genetic males and females are absolutely anatomically different from each other.
This is not an opinion.
It is an absolute, irrefutable scientific fact!
In comparison to the female chest, the male chest generally has:
- Thinner and tighter skin
- Nipples that are situated lower and more lateral
- Greater distance between the nipple-areolar complexes
- Smaller nipple-areola complexes
- Wider sternum and wider chest
- Thicker pectoralis major muscle
- Lack of a defined crease
- More barrel shaped chest
Each of these differences can have an impact on the results of a MTF breast augmentation. The unique constellation of these issues and their degree in each individual will strongly determine the best potential outcome of the contemplated procedure.
That is, a person’s specific anatomy is an overwhelmingly important factor in affecting the potential outcome from MTF top surgery.
This is absolutely something that I will discuss during your consultation.
A wider sternum dictates that the breasts will be further apart. Nipple-areola complexes that are situated very laterally will create a similar situation, though even worse. This often will result in abnormal, even bizarrely separated breasts.
Not an ideal or desirable situation.
There are some anatomic combinations that can present situations where pursuing top surgery breast augmentation would yield poor results at best. In such instances, it may be a prudent choice not to proceed with this gender affirming procedure.
The following patient of mine is an example of where a more ideal underlying anatomic situation can lead to favorable top surgery results. This 31 year old transwoman was seeking a gender affirming breast augmentation. She had been on estrogen and progesterone for slightly over one year and had experienced some breast growth. However, this was not enough and she wanted to be around a “C” to “D” cup size (photos A, C and E). She also wanted the implants to be placed in a submammary pocket – above the muscle.
A. Before MTF Top Surgery
B. 3 months after MTF Top Surgery
C. Before top surgery
D. After Top Surgery
E. Before Top Surgery
F. After Top Surgery
She underwent a breast augmentation with Allergan style SRF smooth surfaced full profile silicone breast implants size 295 cc. These were placed in a submammary pocket through an inframammary incision (photos B, D and F). Results are at 3 months.
This patient was very happy with her results which were as she had desired.
Your Consultation
If you are contemplating MTF top surgery and would like to schedule an informative, thorough consultation with me, you can do so by either calling the Arizona Center for Aesthetic Plastic Surgery at (480) 451-3000 or contacting us online here.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona
