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There isn’t a lot of research out there as to how to feminize male breasts. Some providers do add in progestins at least at the beginning when patients are taking hormones by mouth. Others fear the effects of progestins on mood and risk of blood clots and avoid them altogether. Progestins have never been scientifically proven to better feminize the breasts.The most common way breasts are feminized with hormones therefore is oral estrogen with a testosterone blocker, if the patient still has their testicles.Most Drs don’t prescribe creams alone.Breast growth is variable and most folks will see most of the growth in the first 2 years. Some patients will notice their breast may have a “tuberous appearance” where the fold is high.If a patient wants surgery to feminize the breasts it’s usually better to wait a couple of years to see first what the hormones do. In addition to a breast augmentation many of my male to female patients seek a lift or some sort of feminizing mastoplasty procedure to make the breast look more feminine.