Breast Augmentation for Transwomen

Top surgery is a surgical procedure that is performed on transgender women to create a more feminine chest. The procedure involves the removal of breast tissue, the reshaping of the chest, or the placement of breast implants.

Reasons

There are many reasons why a transgender woman might choose to have breast augmentation. Some of the most common reasons include:

  • To improve their physical appearance and feel more comfortable in their own skin.
  • To alleviate gender dysphoria, which is a feeling of distress or discomfort caused by the mismatch between a person's gender identity and their physical body.
  • To improve their quality of life and allow them to live more authentically.

Risks

As with any surgery, there are some risks associated with breast augmentation among trans women. These risks can include:
  • Bleeding
  • Infection or Swelling
  • Poor Scarring
  • Changes in sensation in the nipples
  • Implant displacement
  • Capsular contracture

Importance of Surgeon and Implant

It is important to choose a qualified surgeon who has experience performing breast augmentation on transgender women. Trans women have specific needs for their operation.  An experienced surgeon will be able to safely guide you throughout the whole process, from consultation to recovery.

The type of implant that is used is also important. Finding the suitable breast implants not only helps you achieve the look that you want, it also assures your safety against post-op complications. Your surgeon can help you in the processing of choosing the right size and implant shape for your goals.

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Consultation

The first step in the breast augmentation process is to schedule a consultation with a certified surgeon. During the consultation, the surgeon will discuss the patient's goals for the surgery and answer any questions and concerns that the patient may have. The surgeon will also perform a thorough physical exam to assess the patient's suitability for surgery. 

It is also at this stage that you will plan aspects of your operation such as the type of anesthesia, incisions, and implant size, shape, and placement.

Preparation

Once the patient has decided to have breast augmentation, they will need to prepare for the procedure. General preparations may include:

  • Quitting smoking
  • Fasting the night before surgery, upon doctor’s instructions
  • Maintaining a healthy weight
  • Avoid taking aspirin or anti-inflammatory drugs
  • Stopping or adjusting certain medications, upon doctor’s advice
  • Slowing down on hormone therapy, upon doctor’s instructions

Trans women undergoing breast augmentation also require specific medical evaluations, including:

  • Review of personal and family medical history
  • Overall physical exam
  • Lab tests measuring testosterone levels
  • Age- and sex-appropriate screenings
  • Testing for HIV and other sexually transmitted infections

Surgery Process

Breast Augmentation among trans women takes the same components of surgery with cisgender women.

The patient will be given general anesthesia, which will put them to sleep during the surgery. The surgeon will then make incisions in the chest and place the breast implant. After the placement, the incision will be stitched close.

If feminizing hormones have not created sufficient breast volume, the procedure may include use of tissue expanders. An initial procedure will be done by placing the expander in the chest. This will slowly stretch the chest skin in the span of a few weeks. Once there’s enough stretch, you will proceed to breast augmentation with the breast implant.

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Recovery

After surgery, the patient may be advised to stay in the hospital for a few days.  Gauze or bandages will protect your surgical scars, and an elastic bandage or sports bra will provide support throughout recovery. Your surgeon will also be giving you instructions regarding incision maintenance, medication, and follow up check ups.

It is normal to experience swelling and soreness early on, but it will subside. If you experience shortness of breath, chest pains, unusual heartbeats, or other side effects, consult your surgeon immediately. 

Take note that scars do not disappear completely. However, after a healthy recovery, you can enjoy the look and feel of your breast. Surgery results can help trans women alleviate gender dysphoria that they might have experienced before. 

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