Transgender Breast Surgery
Men and women that are in the process of transitioning from their biological sex to their actual gender often find that correcting their sexual characteristics helps them feel more comfortable in their bodies. Many patients feel that the breasts and chest play a key role in helping them feel more feminine or masculine. This journey to claiming your real and true identity is emotional and often turbulent. Dr. Messa and all the staff at Weston Cosmetic Surgery Center provide attention and support for each of our clients and their physical and emotional needs.
Whether you are a female transitioning to a male (FTM) or a male transitioning to a female (MTF), we are here to address all your breast needs to help you claim the body you’ve always desired.
Both FTM and MTF patients must meet certain criteria before they can undergo surgery. These measures are set in place to ensure that you are physically, mentally, and emotionally ready for your transition. Therapy and psychological evaluations must be undergone with a medical professional that specializes in gender transitions. The minimum criteria that must be met prior to your consultation is:
- You are over 18 years of age
- You have completed at least three months of counseling
- You are physically and emotionally healthy
- A letter of referral from your psychiatrist or psychologist
Patients may also be on a hormone replacement therapy program. For MTF, female hormones are taken, which may increase breast tissue and can be beneficial prior to breast surgery. FTM patients may increase their male hormone intake, which can reduce their amount of breast tissue.
FTM Breast Removal
Transitioning males may feel that their feminine breasts prevent them from having a masculine or firm physique. Breast removal surgery, known as transgender mastectomy, helps them achieve the chest contour that creates the more masculine aesthetic they desire.
The keyhole incision is ideal for patients with minimal existing breast tissue, usually a B cup or smaller. An incision is created around the entire outer edge of the areola, and the nipple-areolar complex remains attached to the underlying tissues.
Double Incision/Bilateral Mastectomy
The double incision is most suitable for patients that have a full B cup or larger and those with sagging, pendulous breasts. An incision is created horizontally in the crease below each breast that extends to the lateral outside of the chest. The nipple-areolar complex is usually removed, resized, and grafted into a new location on the chest.
Tissue Removal Process
The transgender mastectomy procedure involves the removal of fat tissue and glandular breast tissue, including the milk ducts. Liposuction of the breasts can be used to eliminate excess fat. Excess skin and tissue is trimmed away, and the remaining tissue is pulled towards the center of the of the chest. Large areolas can be resized to create a more masculine aesthetic. The nipple-areolar complex is repositioned in a natural location. Your incisions are then closed.
The nipples may be removed and then reattached during surgery, or they can remain attached to the breast tissue via a pedicle flap. For patients with large nipples, they can be resized before being attached to the areola. In some cases, the nipple cannot be preserved. These patients can undergo nipple tattooing to restore the appearance of their nipples and/or areolas.
Potential Scarring Risks
All surgical procedures run the risk of resulting in visible scarring. Patients that use a keyhole incision will have minimal scarring around the areola and are more likely to retain nipple sensation. Patients that require a double incision will find that they can develop scarring under the lower border of the pectoral muscle. However, scarring is likely to fade over time, and chest hair growth through hormone therapy can mask the appearance of scarring. Patients that undergo a double incision are more likely to experience a loss of nipple sensation.
Breast removal can often result in a chest that is flat and lacks masculine definition. Pectoral implants can be placed following your recovery to help you achieve a more male aesthetic. Pectoral implants are created from silicone and come in a variety of shapes and sizes to suit your individual needs.
MTF Breast Augmentation
Transitioning females often feel that their lack of adequate breasts prevents them from having the subtle, feminine curves they desire.
Breast augmentation is the surgical process of inserting breast implants to create full, shapely breasts.
Hormone Therapy Prior to Augmentation
Most patients that meet the necessary criteria to undergo MTF breast augmentation will have been on a long-term hormone therapy program that increases their body’s estrogen and other female hormones. Long-term hormone therapy can help many transitioning women develop mild breast tissue, usually an A cup worth of tissue. This is beneficial to most patients, especially those with thinner or leaner builds because it provides breast tissue to help cover the implants.
While hormone therapy can help provide patients with the excess tissue needed for their breast augmentation, many find that they don’t have an adequate supply of tissue to help them achieve a natural aesthetic. These patients will need to undergo a two-step breast augmentation process. The first step is the placement of tissue expanders, which are similar to empty implants that are inserted into the potential breast pocket. The implant is then filled over a period of weeks to slowly stretch the overlying tissue. Once this process is complete, the expander is removed and your breast implants are inserted into the newly crafted pocket.
Breast Implant Options
The type, texture, and size of your breast implants will play a large role in how your breasts will look and feel following your surgery. It is important that you choose a breast implant that best meets your needs and goals. While some patients prefer high, noticeably augmented breasts, those who prefer a more natural aesthetic will need to ensure that their breast implants are proportional to their body’s frame. The amount of breast tissue present at the time of augmentation will also impact your sizing options.
Please read our blog for more detailed information on breast implant options. You and your surgeon will decide together on the best implant for your surgery.
Your breast implants will be inserted through an incision along the lower crease of each breast. This allows for any possible scarring to be hidden by the lower pole of the breasts. It also allows your surgeon to create a more defined breast fold for a more natural aesthetic.
Recovery, no matter the procedure, varies between patients. Generally, you will experience bruising and swelling across the chest. Pain medication can be used in the initial days following your surgery to alleviate any discomfort. Depending on your job, most patients can return to work within two weeks of their procedure. However, many patients require more time to emotionally prepare for their re-entry into the workplace. You should be able to resume all your regular activities by six weeks.
Continue Your Journey
At Weston Cosmetic Surgery Center, our entire staff is dedicated to providing you with the safest, most supported, and most relaxing journey possible. This doesn’t end directly after your surgery. In the months following your procedure, you will have routine visits with your surgeon to ensure your new chest or breasts are healing properly and that you are satisfied with the results of your procedure. It is our privilege to help you become the person you were meant to be.
To schedule your consultation to discuss your candidacy for breast surgery and to go over all your options, schedule your consultation today. Please contact our office at 954.659.7760 or fill our online contact form for additional information.