Breast Augmentation for trans women & femmes

by | Jul 8, 2024 | Gender Affirming Surgery

Breast Augmentation for trans women & femmes

Breast Augmentation for Trans Women… 

and those who identify as non-binary femme 

 

While not discussed as often as top surgery for trans masculine people, breast augmentation for those seeking a feminine aesthetic can be an integral aspect of transition for someone assigned male at birth. If you are considering breast augmentation, here are a few things to consider.

 

 

Do your research 

In order to get the most out of your consultation with any prospective surgeon there are a number of factors to consider, including:

  • Your body type
  • Your hopes for the surgery 
  • The desired shape 
  • What size you are hoping for
  • Where you want your implants to be placed

When doing your research it is important to look up results for people with a similar shape to you, in order to get a better idea of what you can expect.

 

The options

While breast implants come in a variety of shapes, the most common are round and teardrop. The individual aesthetic goal you have in mind, along with the characteristics of your breast, skin and chest, will determine which implant shape works best for you. Teardrop implants have a more contoured, or natural, shape than round implants. Both come in a variety of sizes. 

Size wise, implants are selected based on weight, rather than bra size. Cup size only measures the size of breasts compared to someone’s rib cage. This basically means that the same implant can result in a different cup size from person to person. Part of a surgeon’s work at the consultation stage is to determine the best implant weight for your body shape, based on your goals and your physical characteristics. This will enable them to estimate the associated cup size.

Finally, you’ll need to consider where, in your chest, the implants will be placed. There are two options available, over the muscle tissue (subglandular) or under the muscle tissue (dual plane). Where they should be positioned depends on a range of factors including any natural breast development achieved through any HRT regimen you may be on, or you may be considering. 

The consultation 

Choosing a surgeon that is right for you is particularly important, as each specialist will have a preferred technique that may work best for specific body types. If they have been on HRT, most trans feminine patients will enter the process of breast augmentation with some breast tissue, meaning a subglandular or sub facial (over the muscle) placement might be more effective. On the other hand, dual plane (under the muscle) placements are often recommended for patients looking for larger implants. 

WPATH guidelines recommend that chest surgery on trans feminine patients is carried out by a surgeon with specialist expertise. This is because, when compared with cis patients, transgender and non-binary patients have specific characteristics and needs that must be taken into account. 

 

HRT and existing breast development

While being on feminising hormone treatments for any specific amount of time is not always required for breast augmentation, pre-existing breast tissue can drastically affect the course of your consultation. Feminising hormone therapy helps to increase the size of nipples, expands breast tissue and changes the quality of your skin. All of these factors play a role in what your surgeon will recommend and will potentially influence their preferred technique and the advice they give at your consultation. 

 

Going on HRT after an augmentation is also a possibility, but does not provide the surgeon with the same information regarding how your chest is likely to develop.

 

Now what?

With an idea of what you might want and what is possible, here are some things to keep in mind before your consultation. 

 

  • There’s no need to become an expert, your consultation is your chance to get an expert’s opinion. 
  • Your task is to come into the consultation with an understanding of why this procedure is important to you and an open mind on how to get there.
  • Your skin’s thickness and elasticity are important factors in surgery recovery and will inform your surgeon’s advice during the consultation. 
  • External factors, such as smoking, may negatively impact the skin’s recovery time post surgery, cutting down or stopping smoking is highly recommended for the best outcomes. 

 

Check out this useful checklist from GenderKit for an overview of everything you will need to consider when undergoing gender affirming surgery.

 

Worth noting

The NHS doesn’t traditionally fund breast augmentations, but there are channels to make a special request if you believe an exception should be made in your case. You can read the NHS England policy on individual funding for more information.