Having Male-to-Female Breast Augmentation

Male-to-female breast augmentation is a type of gender-affirming surgery. It's also called transfeminine top surgery.

Gender words are used here to talk about anatomy and health risk. Please use this information in a way that works best for you and your health care provider as you talk about your care.

Why is this procedure done?

Male-to-female breast augmentation is done to give a person a more female-looking chest. An experienced plastic surgeon increases breast size, often with implants. They may also make other changes to the chest to make it more female in appearance.

What happens before the procedure?

Your health care provider will ask about your health. They will also give you a physical exam. They will note the size and shape of your breasts. Some photos may be taken. Your provider will use this information to help plan the surgery. You and your provider will also decide the desired amount of breast enlargement, placement of the incisions, and the type of implant that’s best for you.

You may also need some tests, such as blood work or imaging tests. Tell your provider about all the medicines you take. That includes prescriptions, over-the-counter medicines, herbs, and supplements. It's important to let your provider and your plastic surgeon know about your expectations.

You'll be asked to sign an informed consent form agreeing to the surgery. Signing the form means that you understand the surgery and its planned results. Signing also means that you understand the risks and the possible complications of the procedure. Ask any questions you have before you sign the form.

What happens during the procedure?

Male-to-female breast augmentation may be done in a hospital or surgery center. In general, the surgery includes the following steps:

• You will lie down on your back on the operating table.

• You will be given medicine through an IV. This medicine will help you relax and sleep during the procedure. You won’t feel any pain during surgery. In some cases, you will need general anesthesia.

• The surgeon will make incisions (cuts) in your chest.

• The surgeon will put in the implants. The nipples and areolas may also be moved, if needed.

• The surgeon will close the cut or cuts.

What happens after the procedure?

After the surgery, you’ll be taken to a recovery room. Health care providers will closely watch your heart rate, blood pressure, and temperature. You will be given pain medicine and fluids.

After you're back at home, follow any instructions you are given. Your provider will tell you when you can return to your normal routine. During your recovery:

• Don't smoke. Smoking decreases blood flow, which slows healing.

• Take any prescribed medicines as directed.

• Wear the special bra or bandage you were given as directed by your provider.

• Care for your incisions and the bandage (dressing) over them as instructed.

• Follow all guidelines for showering. Don't swim, bathe, use a hot tub, or do other activities that might cover the incisions with water until your provider says it’s okay.

• When you shower, gently wash your incision sites. Then pat the incisions dry. Don’t put lotions, oils, or creams on the incisions until after they are fully healed.

• Don’t raise your arms above breast level for 10 days. And don’t lift, push, or pull anything heavier than 10 pounds for at least 7 days.

• Don’t drive until you are no longer taking prescription pain medicine and your provider says it’s okay. When riding in a car, position the seatbelt so it doesn’t go over your breasts.

• Be aware that breast swelling may last for 3 to 6 weeks. Talk with your provider about ways to manage the swelling.

Keep all follow-up visits with your provider to make sure you are healing well. Talk with your provider if you have any questions or concerns.

Risks of the procedure

Male-to-female breast augmentation has the following risks:

• Bleeding

• Infection

• Surgical wounds that don’t heal well

• Blood clots

• Loss of feeling in the breasts or nipples

• Scar tissue that squeezes the implant (capsular contracture)

• Leaking or displaced implant

• Changes in breast shape or size

• Need for another surgery

Call 911

Call 911 right away if you have:

• Trouble breathing

• Chest pain

When to contact your doctor

Contact your health care provider if you have any of the following:

• Severe swelling in one or both breasts

• A fever of 100.4°F (38°C) or higher, or as directed by your provider

• Bleeding or drainage through the special bra or bandage

• Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

• Pain that is not eased by medicine or that gets worse

• More soreness, swelling, or bruising in one breast than the other

• Breast that is very warm to the touch

• New symptoms or symptoms that get worse

Next steps

If you are thinking about male-to-female breast augmentation, here are some questions to ask your health care provider:

• Is the procedure covered by my insurance? Do you have an advocate to help coordinate with my insurance company?

• Where will the surgery be done, and will I need to stay in the hospital?

• Will I have dressings, bandages, or drains after my surgery? If so, when will they be removed?

• What are my activity restrictions after surgery? When can I resume my normal activities like work?

• When can I drive after surgery?

• When can I shower or bathe?

• How will I be kept comfortable after surgery?

• How long will healing take?