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Gender-Affirming Breast Augmentation Techniques

We offer various techniques and options for breast augmentation top surgery, formerly referred to as MTF top surgery or MTF breast augmentation, in our office. Although your surgeon will provide you with more details regarding your procedure, this page can provide you with some background prior to your consultation, including your breast implant options, incision patterns, and autologous fat grafting. We also discuss the different composition, sizes, and shapes of our breast implants to give you an idea of your options. If you want to see photos of our breast augmentation results, you can visit our before and after page.

Some people feel that breast augmentation top surgery, and possibly other gender confirmation surgeries, are essential steps towards mind and body embodiment. While not all trans people feel the need to undergo a breast augmentation procedure, this page can help inform those who do with proper expectations to ensure an outcome you are happy with.

Choosing Your Breast Implants

Your surgeon is available to guide you through the various choices and details, including:

Saline vs. Silicone: Saline implants are filled with saline (saltwater), typically at the time of surgery. For a lower cost and a shorter incision line (about 1.5 inches), saline implants are a popular choice. Silicone implants come prefilled  with a cohesive silicone gel and have become the more popular choice because they offer a softer, and what some consider a more “natural” appearance, especially for those without a lot of breast tissue.

Implant Size: Though you may be tempted to think in terms of cup size, you should instead think in terms of your body’s natural proportion. Breast implant sizes are based on the amount of liquid or gel contained within the implant’s outer shell (200cc-500cc on average). During a free, virtual consultation, you will have the chance to try out a variety of implant sizers to help you better envision your chest after surgery.

Implant Shapes:  When it comes to shape, round breast implants are the most common choice because they are completely symmetrical, so rotation is not an issue. We prefer using round implants over teardrop shaped implants because there are less limitations when it comes to placement and location, and teardrop shaped implants require a longer incision. 

Incision Patterns

You have several options when it comes to incision location. Your implants can be placed through an incision made along the border of your areola (periareolar), just below the fold of your chest muscle (inframammary), or through your armpit (transaxillary).

Though your incision location will ultimately depend on your personal preference, our surgeons typically recommend the inframammary fold incision. This is because most patients choose silicone implants (which are inserted fully inflated and sealed) and have narrow areolas.

Autologous Fat Grafting

Autologous fat grafting (fat transfer) may play a role in breast augmentation in the future. Fat grafting involves moving fat from one part of the body to another. In the case of breast augmentation, it can involve moving fat from the stomach, for example, into the breasts. However, this technique is not as successful when a large amount of volume is needed and the skin is particularly tight. Breast augmentation with saline or silicone breast implants is currently greatly preferred. 

If you have additional questions about the information on this page, our surgeons will be able to answer them during your personal consultation.