Transgender (M-F) Breast Augmentation
Transgender breast augmentation differs from breast augmentation in genetic females in important and unique ways. Male-to-Female transgender patients often undergo hormone therapy as well as testosterone-reducing medications as part of their transition process. Female hormones can stimulate some degree of breast development, while softening the skin and diminishing muscle bulk. Usually, hormone-induced breast enlargement in transgender patients has reached its maximum after 18 months of hormone therapy; less than a cup, or cup and a half bra size enlargement is usually seen.
This breast size may be inadequate and still-disproportionate, especially in tall patients with wider chest dimensions, thicker pectoralis muscles, and tighter breast/chest skin; breast augmentation to enlarge the breasts is possible, but requires knowledge and experience with the anatomic details and characteristics in transgender females who request breast enlargement with implants.
Many transwomen have sufficient softness of their skin and muscle to perform single-stage augmentation with saline or silicone gel implants of the desired size and dimensions to create beautiful, proportionate breasts with attractive cleavage. However, after over two and one half decades of experience with transgender patients, we have found that it is inappropriate to say this is true for every transwoman requesting breast enlargement, especially to a size proportionate for a larger, taller frame.
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Some M-F transgender patients may not achieve the desired natural results (in terms of size, proportion, and softness) with single-stage implant placement. This may be due to thicker pectoralis muscles and more taut skin that will not allow large enough implants. In these cases, replacing the initial too-small implants with larger ones at a second operation in 6-12 months (once tissues have stretched, softened, and scar tissue matured) can achieve the desired size. Adjustments in pocket size, shape, or position can also be carried out at this second (optional) procedure.
Another subset of transgender breast augmentations patients will benefit from a planned two-stage procedure, rather than hoping for adequate size and natural appearance with too-small, too-tight, wide-cleavage implants in one operation, followed by multiple (expensive) re-operations to try to correct problems associated with a failed or inadequate single-stage operation. These transgender patients will benefit from placement of crescent-shaped submuscular tissue expanders in the chest/breast area at one operation, followed by healing for 2-3 weeks. Then, outpatient expansion of the tissues is carried out over several weeks to months as sterile saline is injected into the expander via a remote or integral filler port, gradually stretching the overlying tissues much like abdominal tissues stretch with pregnancy. When adequate tissue capacity and softening has occurred (usually several months to as long as a year), a scheduled second operation is then performed to remove the expanders, make any pocket adjustments needed for optimal position, and place the final appropriate-sized implants. Of course, touch-up or revisionary surgery is always possible with any surgical operation, but this planned 2-step approach has been shown to actually reduce the need for multiple unplanned operations in appropriately-selected patients.
Cost for Transgender Breast Augmentation
Total cost for single-stage transgender (M-F) breast augmentation with cohesive silicone gel implants is approximately $8500; two-stage placement of tissue expanders (1st operation) is approximately $8750, with second stage removal of expanders and placement of permanent silicone gel prostheses (2nd operation) approximately $6500. While the two-stage process is more costly and time-consuming than a single stage, we have found that in the appropriate patients who are better served by tissue expansion to create proper-sized pockets for proportional and beautifully-shaped breasts, total costs and time to achieve the desired result is actually less than 3 or 4 individual $7300-8500 operations, not to mention the time off work or social activities! Exact cost quotes are always given at the time of complimentary consultation with our American Board of Plastic surgery-certified plastic surgeons. Financing options are available.
Because of the high demand for free consultations with our plastic surgeons, our staff will ask for a credit card number in order to schedule a consultation; there is no charge whatsoever for appointments that are kept–you will be charged $100 only if you fail to keep a scheduled appointment, or fail to cancel at least 48 hours in advance of your appointment time–for Monday appointments, you must cancel no later than noon on the previous Thursday; for Tuesday appointments, you must cancel by noon on the previous Friday.