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Male to Female Top Surgery: What to Expect

Making the decision to undergo top surgery during your male to female transition can be both liberating AND anxiety-inducing.  If you’re looking to take the next step in your gender transitioning journey, we hope this article offers some clarity on what to expect during this sensitive time.

Male to female top surgery is the process of increasing the breast size to create a more aesthetically female appearance regarding shape, size, and contour in transgender women.  Top surgery involves the surgical placement of either saline or silicone -based breast implants and/or the transfer of fat from one area of the body to the breast area through liposuction.  Depending on the patient’s personal body aesthetics, both procedures may be required to yield desired results.  The desire to undergo male to female top surgery is the physical procedure to help transgender women transition to their self-affirmed gender identity and is usually performed on an outpatient basis.  Like breast augmentation surgery for cisgender women, the entire surgery can take up to 4 hours to complete depending on the patient’s specific needs.  For instance, because transgender women typically have broader chests than their cisgender female counterparts, surgery trajectory and time involved may vary patient to patient.

What to Expect During Your Male to Female Top Surgery

After your initial consultation and health assessment with Dr. Jamie Schwartz, you will then be scheduled for your life-changing surgery.  During the procedure, Dr. Schwartz will make small incisions around the areola near the armpit or at the inframammary fold (crease just beneath the breast) where the silicone or saline breast implants will be inserted and placed beneath the breast tissue.  However, if the feminizing hormones you were administered prior to your top surgery failed to properly increase your current breast size, you may require an initial procedure to have “breast expanders” strategically placed in front of your pectoral muscles.  A saline solution is then injected into the expanders to safely and slowly stretch the chest skin and surrounding tissue to make adequate room for the incoming implants.  After the chest area has sufficiently reached the proper amount of expansion for implant placement, a procedure will be scheduled to remove the expanders and proceed with customary breast augmentation.  

As with breast enhancement surgery for cisgender females, you should expect to rely on a trusted family member or friend to accompany you to your surgery since you will be unable to operate a vehicle once the procedure is finished.  You will be prescribed pain medication to help alleviate subsequent pain and discomfort, but expect copious amounts of swelling, soreness, and unsightly bruising for weeks to follow.  The nursing staff will instruct you on how to change your bandages, including the most effective way to shower without getting them saturated.  In fact, expect to completely forego showering or bathing for at least 24 hours following your surgery.  You will also be required to wear a supportive compression bra (sans underwire) around the clock for at least 3-6 weeks, as well as limiting any upper body exercising for the first month or so to decrease risk of displacing your new implants.  Scars at the incision site will greatly diminish in time but may not disappear completely.  Applying vitamin E oil or pure cocoa butter can help the skin heal faster, while improving its tone, texture, and elasticity.


At Beverly Hills Breast Institute, we understand the decision to undergo male to female top surgery can be a daunting one on so many levels.  Rest assured, we are here to help guide you through the entire process to make the experience as painless and comfortable as possible – both physically and emotionally.  To schedule a consultation with Dr. Jamie, please contact our office to speak to any one of our highly skilled team members.


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