Transgender Breast Surgery

Transgender breast surgery is often a critical component in the gender affirmation process. Board-certified Sacramento plastic surgeon Dr. Debra J. Johnson explains transgender breast surgery for those transitioning from male to female and from female to male.

Breast Augmentation Surgery

Breast augmentation surgery is a vital rite of passage for many transgender women. The surgery itself is similar to that performed for cisgender women wishing to increase the size or shape of the breasts. It is one of the most common plastic surgery procedures. Keep in mind that transgender women often have broader shoulders and chests, so bigger implants tend to appear more proportional.

Implants, made of saline or silicone, are implanted under or over the chest wall muscle. The options for placement are discussed beforehand, as there are advantages and disadvantages to each, and much depends on individual anatomy. Most transgender women prefer silicone implants, as they feel more natural for those with little breast tissue. However, all implants carry a risk of failure. If a saline implant fails, it requires a relatively quick and easy swap-out. If a silicone implant fails, the surround scar tissue capsule must be removed as well, which makes it a bigger operation with more down-time.

After gender affirming implant placement, expect to take at least one week off from work while recuperating. The implants should settle completely a few months post-surgery.

Subcutaneous Mastectomy

Transgender men may consider undergoing subcutaneous mastectomy. It is commonly referred to as top surgery or masculinizing chest surgery. While the procedure removes the excess breast tissue, the extent of the scarring depends on the current breast anatomy.

Those men with small breasts may be able to undergo liposuction to reduce the volume, and then a small incision to remove the fibrous breast tissue. Larger-breasted men may need to have excess skin removed as well as the breast tissue. The nipple/areola may need to be repositioned. If this is the case, then the nipple/areola is removed, reduced in diameter, and replaced on the skin as a free graft.

Because subcutaneous mastectomy will not remove all breast tissue, your surgeon will instruct you on monitoring your breasts with self-exam and perhaps mammography for screening.

Learn More about Transgender Breast Surgery

For more information on transgender breast surgery, contact board-certified Sacramento plastic surgeon Dr. Debra J. Johnson and schedule a personal consultation. It is vital to choose a board-certified plastic surgeon experienced in this field.