Tall trans woman breast augmentation. Any advice on choice of size and other details? (Photo)

Experience in this type of surgery is of utmost importance. Based on your complexion and height, I would recommend 400 to 450 cc. This will surely provide a large B or Small to medium C-cup. Smooth implants should be considered only for under the muscle placement, as capsular contracture is more frequent when placed over the muscle. I agree also with the round shape for the implants. During consultation, you should try on the different sizers available in order to choose the correct size with the opinion of your surgeon. Furthermore, based on your anatomy, a smaller than 400 cc implant will most probably not be too noticeable and a larger may not fit the skin pocket. 

I appreciate your question.I prefer to use anatomic implants to complement what you have already grown.You may also to reposition the nipples a bit more medially as they will be lateral.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz

In my experience, no matter which profile is used, this is unlikely to give you the results you desire. Even though proportionally narrow chested, because of your height this still represents a wider implant that requires quite a lot of projection. Your surgeon should choose the proper implant for your goals.

Based on your pictures there are two bits of advice that I can give you. First, your nipples are widely spread apart and an implant should be centered behind the nipple. If a large implant is used, and it is centered, it will extend onto the side of the chest and under your arm. If a smaller implant is used, there will be a wide cleavage between the implants. Your best choice for implant may be a shaped implant with a narrow base diameter. Although the cleavage will still be wide, a push-in bra can help their appearance in clothing.Secondly, because you are thin, your tissues may slowly stretch over time and cause the implant to sag. If you choose a textured silicone implant, stability of the implant and its surrounding scar tissue may provide added support for a longer lasting result.I hope that this helps you.

Thank you for the question.Despite good intentions, online consultants will not be able to provide you with meaningful specific advice. Ultimately, in person consultation with well experienced board-certified plastic surgeons will be necessary. Careful measurements, dimensional planning, and careful communication will be key.Generally speaking, the best online advice I can give to transgender patients who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:



1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.






2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate.







3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery.



I hope this (and the attached link, dedicated to transgender patient breast augmentation) helps.