M to F Transgender- Anatomical Shape over the Muscle?

This is how I would like to have my implants done when I have them done next month. I am sure there are negative aspects to my decision but I would like to know of anyone who has performed a BA on a trans patient this way and had good results?

Doctor Answers 5

Transgender Breast Augmentation

Thanks you for your question.  I have done many breast augmentation on transgendered women.  I perform a lot of augmentation with silicone implants above the muscle but I always use round silicone implants with great results.  The problem with anatomical implants is that they can rotate.  also, because anatomical implants are textured to try to prevent rotation of the implants, the scar tissue can adhere to the implant and you can see more rippling or folding of the implant.

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Breast implants for transgender

The most natural implant with least complications will still be submuscular, round ,  silicone, not too big at first.

Transaxillary will limit scars or  saline transumbilcal   with increase in size to gel as a second procedure

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 26 reviews

Anatomic shaped implants

While there are a number of special factors that need to be taken into account when considering breast augmentation in a M to F transgender patient, I do not believe that my basic "rules" for augmentation change.   I typically recommend sub-muscular placement of round implants.  Sub-muscular placement increases soft tissue coverage and camouflage of the implant while (probably) decreasing the risk of capsular contracture.  I have operated on a number of M to F transgender patients and find that the outcome is similar to that seen in small breasted (small A cup) female breast augmentation patients.   I have found that it often takes longer for the final shape and contour to emerge.

I did use a number of anatomically shaped implants in the past, but did not find any advantage to their use.  In fact, if the implant rotated in the pocket the outcome was compromised.   You should carefully consider the available information and your reasons for wanting subglandular-anatomical implants before proceeding.  Talk to your surgeon and get another opinion if appropriate.  Good luck.

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 20 reviews

Transgender Breast Augmentation?

Thank you for the question.

No, I generally advise all my breast  augmentation patients to have their procedures done in the partially submuscular position and use round breast implants.  In my opinion, there are a lot of advantages of placing implants in the submuscular position  and disadvantages in using anatomical shaped implants.

Although no technique,  placement of implant,  or type of implant is perfect I think the potential need for revisionary surgery is greater when implants are placed on top of the muscle and when anatomic implants are used. You will find other plastic surgeons who differ in their views.

I hope this helps.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.