Valerie Lemaine, MD

Dear JumanjiM,

Thank you for your question. According to the World Professional Association for Transgender Health (WPATH) Standards of care, which are available for free online (see link below), most physical changes from hormonal therapy will occur over the course of 2 years. The amount of change to expect is variable. The onset of breast growth typically begins within 3-6 months. The expected maximum effect on breast growth generally takes 2-3 years. Please note that the degree and rate of physical effects you will experience depends in part on the dose, route of administration, and medications used.




Although not an explicit WPATH criterion, it is recommended that MtF patients undergo feminizing


hormone therapy (minimum 12 months) prior to breast augmentation surgery for a minimum of 12 months. The purpose is to maximize breast growth in order to obtain better surgical (aesthetic) results. 

In light of this information, you should consult with a board-certified plastic surgeon who performs MtF breast augmentation. It seems as though you have waited long enough to achieve the maximal potential breast growth from HRT. 

The WPATH criteria for breast augmentation (implants/lipofilling) in MtF patients are the following:
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country;
4. If significant medical or mental health concerns are present, they must be reasonably well
controlled.



I hope this helps!

Valerie Lemaine, MD, MPH

Board-cerfitied plastic surgeon

Thank you for your excellent question. First, congratulations on being 10 years cancer free! As for breast reconstruction, there is no defined age limit. I recommend that you schedule a consultation with a board-certified plastic surgeon who is an expert in breast reconstruction. Your plastic surgeon will review breast reconstruction options that are customized to you, based on your specific situation, your personal preferences and your expectations. 

In health,

Valerie Lemaine, MD, MPH

Board-certified plastic surgeon

I understand your concern. At 1 month, it is too early to tell if you need a revision. It takes about 3 months to see the final results of liposuction. Gravity is most likely drawing the residual swelling down to your pelvic area, and it can cause the firmness you are describing. This should resolve on its own with time. The numbness should recover too but it could take several months.

You should definitely follow up with your plastic surgeon to discuss your concerns.

I hope this helps!

Best,

Valerie Lemaine, M.D., M.P.H.