Hello and thank you for your question. Board-certified plastic surgeons will likely disagree about how long to wait before having a breast augmentation surgery after having begun hormone replacement therapy. You should allow enough time for the hormones to help your breasts develop, and this amount of time will vary form individual to individual. On average, however, 18 to 24 months should allow enough time for breast tissue to develop in most patients. Schedule several in-person consultations with board-certified plastic surgeons in your area and select a surgeon with significant experience treating transgender females and get their recommendation. Good luck! Michael Eisemann M.D. Plastic Surgeon Houston, Texas