As many as 25 million people now identify as transgender worldwide.
And in the U.S, at least 4,000 gender affirmation surgeries have been undertaken since the year 2000. Undoubtedly, a significant portion of those would have been MTF (male to female) transgender breast augmentations.
Yet despite how widespread the procedure has become, a considerable amount of misinformation still remains.
To help rectify our collective lack of knowledge, this article examines seven little-known facts about transgender breast implants.
1. MOST PATIENTS ALREADY HAVE BREASTS BEFORE THE SURGERY
It's standard practice for a surgeon to prescribe a male-to-female (MTF) transgender patient with hormone replacement therapy before surgery is even considered.
Typically, the patient will stick to a strict hormone regimen for at least 18 months. As time goes by, their appearance becomes more and more feminine.
Eventually, their body and facial hair will fall out, and they will begin to develop fat tissue in the breast area.
By the end of the 18 months, their breasts are usually either an A or B cup. Surgery is then undertaken to enlarge the breast area to create a more feminine upper-body aesthetic.
Timing is everything for plastic surgeon Doctor Jaimie Schwartz, for the best results, a patient should be in an optimal developmental state for MTF top surgery
2. Transgenders Breast Implant Surgery Is Not Unlike Breast Augmentation Surgery for Women
Believe or not, the process involved with transgender and female breast augmentation is essentially one in the same. As mentioned, the transgender patient has already grown breasts through the use of hormone replacement therapy. Therefore, both the transgender and the female patient simply wish to enhance the size of their breasts, usually with the objective of improving their self-esteem and developing a more feminine upper profile.
For both patients, the Doctor Jaimie Schwartz will discuss the kind of breasts they would like to acquire. Aspects such as cup size, breast width, natural fit, and how to fix any imperfections or asymmetries are all considered.
Both patients also get to choose the implant type, whether it be silicone or saline. Silicone remains the most popular choice for female and transgender patients. Other options include shaped or rounded, and textured or smooth implants.
After precise measurements have been taken, both patients are typically given the opportunity to use anatomic sizers to determine the most natural breast size for their frame.
Doctor Jaimie Schwartz uses Vectra 3D, which allows either patient to view a virtual image of how their breasts will look after surgery.
3. INCISION POINTS AND SCARRING CAN BE DIFFERENT FOR TRANSGENDER PATIENTS
Although there are many similarities between female and transgender breast augmentations, there is one fundamental difference to consider.
Generally speaking, female nipples are much larger than those of the male.
Consequently, this makes it notably more difficult to perform an areola incision during an MTF transgender breast augmentation.
To overcome the issue, Doctor Jaimie Schwartz may perform an intra-mammary fold incision instead, which results in the scar being located at the crease of the breast. The bottom of the breast later falls over to cover up the scar.
4. MTF TRANSGENDER PATIENTS SHOULD LIVE AS A FEMALE FOR TWO YEARS BEFORE THEY UNDERGO SURGERY
Depending on the surgeon, this is not a hard and fast rule but more of a suggestion.
A transgender top surgery can drastically change the way a person is perceived in society. There is no doubt transgender patients put plenty of thought into the matter.
Nevertheless, the consensus in the medical community is that if a transgender patient spends a considerable amount of time living in the role of their preferred gender, they will be much more likely to be happy with the outcome of the surgery.
During this "probation" period, the patient is typically prescribed hormone therapy to help them adapt to their new gender role.
5. NEW PROCEDURES AND TECHNOLOGIES ARE MAKING THE SURGERY LESS INVASIVE THAN EVER
Surgeons have come up with some clever tricks over the years to help their patients feel at ease. A few examples include:
- Injecting the pectoral muscles with Botox around two weeks before the surgery. This is effective in reducing pain and muscle spasms.
- Injecting EXPAREL immediately before the surgery. This long-lasting numbing medication reduces pain in the pectoral region for as long as four days.
- Performing surgeries just after sundown while the patient is conscious although heavily sedated. This technique alleviates anxiety for patients unwilling to go under a full anesthetic.
6. THE RECOVERY PERIOD IS SURPRISINGLY REASONABLE
It's not exactly a trivial procedure, but a male-to-female (MTF) transgender breast augmentation surgery may involve less recovery time than you think.
First of all, it is an outpatient procedure, meaning the patient will return home that evening, albeit wearing bandages and a surgical bra.
Bed rest is essential for the first few days. During that time, it is recommended someone stay with the patient to provide basic care. The bandages are redressed a day after the surgery.
The patient will not be able to drive for one week after the surgery.
Within 5-7 days, the patient may be able to return to work at a desk job if given approval by the surgeon.
Any form of light exercise, heavy lifting or movement of the arms above the head should be avoided for at least two weeks.
Strenuous exercise can often be resumed after six to eight weeks.
Finally, after 10 to 12 weeks the new breasts should have settled into their final shape and size.
7. THERE ARE SOME RESTRICTIONS IN PLACE
Not everyone is automatically eligible for the surgery as some restrictions apply. These include:
- The patient must be 18 years or older.
- The patient must not be a current smoker.
- The patient must have undertaken at least 18 months of female hormone therapy.
- The patient must have lived in a female gender role for at least two years.
- The patient must supply a letter of recommendation from a psychologist or a qualified mental health practitioner.
- The patient must be physically fit and have reasonable expectations regarding the outcome of the surgery.
THE SURGERY EXPLAINED
By now you're considerably better educated on transgender breast implant surgery than the general population. And that can only be a good thing.
If you or anyone you hold dear is considering the operation, don't hesitate to get in touch with the highly regarded plastic surgeon Dr. Jaime S. Schwartz.
