Do You Need to Be on Estrogen Before Getting Implants when Transitioning from Male to Female? (photo)

Doctor Answers 3

Transgender breast augmentation and hormone therapy.

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Hormone therapy is not necessary for M-F transgender breast augmentation, but if you are unsure about HRT (hormone replacement therapy), or if you have just started it, you need to understand that female hormones (and testosterone-inhibiting medications) will cause changes in your breasts, muscles, and fatty tissues, all of which impact results of breast augmentation.

When a trans woman is taking hormones, most plastic surgeons experienced in surgery for transgender patients will recommend waiting at least 18 months for maximum changes in the breasts to be seen. This time period also corresponds with WPATH guidelines, which may need to be adhered to if insurance reimbursement is being sought. In my experience, most insurance plans do not cover breast augmentation, even in trans women, but the physiologic effects and time recommendations are still appropriate to follow.

Many of my M-F transgender patients have decided for one reason or another that they will not be taking female hormones, and breast augmentation is perfectly fine to consider whenever they decide to proceed.

But if you are considering HRT, or have just started it, you would be wise to allow your breasts to achieve whatever growth hormones may stimulate for a full 18 months or more, and not ask your plastic surgeon to try to "hit a moving target" and still give you the results you desire and deserve! Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Breast augmentation in transgender patients

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There is no requirement for estrogen prior to a breast augmentation in a male to female patient.  However estrogen treatment will develop more feminine characteristics, including formation of breast volume and shape.  This will help to make the final result of the cosmetic surgery more feminine.

(You can also go on estrogen after the surgery but because the breast tissue formation is unpredictable, you may need a touch up to better align your implants after your new breast tissues has formed)


Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 519 reviews

Do You Need to Be on Estrogen Before Getting Implants when Transitioning from Male to Female?

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It makes sense, since the procedure will have a better outcome in a patient who has developed some breast tissue from estrogen use. It also assures the surgeon that this is not an impulsive decision.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.