Background: Transgender plastic surgery is a large compilation of feminizing face and body procedures. Of all of these procedures breast augmentation has the greatest impact on making a feminization change. It also do so in a rapid and assured manner, creating an instantaneous body shape change as all breast augmentation surgeries do.
On average transgender breast augmentation consistently creates good breast mound shapes. This has to do with the genetic male chest which is not exposed to the tissue stresses of pregnancy and weight gain/loss. Even in the male chest that may have some slight sagging the volume expansion effects of a breast implant quickly overcome any loose tissue.
To avoid scarring many transgender breast augmentation are done through an axillary incision. But with larger breast implants or when the use of a textured anatomic shaped implant style is desired, the axillary incision is more problematic. It is far better to switch to an inframammary incision to successully get these types of breast implants into good partial submuscular position.
Case Study: This 21 year-old transgender female desired breast implants. She had been on hormone therapy for several years but had developed little breast tissue or enlargement. She wanted a fairly large breast increase but also wanted a more natural shape and opted for anatomic silicone breast implants.
Under general anesthesia and through 4cm long inframammary incisions, 600cc shaped anatomic silicone breast implants were placed in a partial submuscular position.
With good overlying breast skin and nipple position, the results of her breast augmentation were satisfying. The tautness of the breast skin and the size of the implants made for rounder breasts than what one would think from using anatomic shaped implants.
Highlights:
1) Breast augmentation is one of the most important of all body contouring procedures for male to female transgender patients.
2) There is nothing unique about the genetic male chest that would not make it amenable to successful breast implant placement.
3) Because of the good quality of the genetic male chest skin, transgender breast augmentation is highly successful with the creation of good breast mound shape.
Dr. Barry Eppley
Indianapolis, Indiana