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The best way to determine size is to use a volume sizing system with your board certified plastic surgeon that specializes in transgender surgery. Once you know which volume gives you the look you like, then an implant can be chosen based on your dimensions and the look you are trying to achieve. That size would probably be a good choice for you.
In general it is best to be part of a formal transgender program and already be on female hormones with your breasts plateauing in size prior to implant placement. The fact that you have been on HRT for 3 years satisfies this guideline. I never recommend silicone shots as they can be dangerous and result in severe complications.Re: number of cc's per cup size: It is not that simple. It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon with experience in transgender surgery. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 750 cc implant to make her go from a “A” cup to a “D” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below.
Men who are living alternative lifestyles occasionally want to have breast augmentation. Medically there is no contraindication to it. There are psychological implications. The good news is that the operation is easily reversible if the patient decides the choice was poor.
I typically approach the transgender woman in a slightly different way than a cis- woman. First of all, are you on hormone therapy, and if so, for how long, are you continually seeing the breasts enlarge or have they plateaued? What dose of estrogen are you taking and what method...
While I am not an endocrinologist, I do lecture to many transgender individuals around the country regarding breast augmentation. I even had an endocrinologist specializing in transgender endocrinology practice in my office twice monthly for years. I would refer to his recommendation...
