FTM Transgender - What are the Effects of Hormones on Breasts?

Firstly, I'm a trans male (FTM) and unfortunately I have a D cup. Top surgery is too expensive right now, but I plan on starting hormones soon. I'm looking for a few facts on the affects of hormones (T) on breasts if any. Do they cause any shrinkage at all or any other kind of side effects to breasts?

Doctor Answers 11

Testosterone effects on breast tissue

I have seen many patients on testosterone who experience shrinkage of their breast size, almost as if a beach ball has lost some of its air. There is a lot of patient variability to the response to testosterone. At the same time there are other secondary effects of testosterone which will develop, so you should have an endocrinologist managing the use of this medicine.

Testosterone effects on breast tissue

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I have seen many patients on testosterone who experience shrinkage of their breast size, almost as if a beach ball has lost some of its air. There is a lot of patient variability to the response to testosterone. At the same time there are other secondary effects of testosterone which will develop, so you should have an endocrinologist managing the use of this medicine.

Hormones for FtM SRS

Male hormones will suppress estrogen.  This will lead to some decrease in breast volume but not to a decrease in breast skin.  You can expect your breasts to droop as the volume decreases.  To get from a D cup to a male chest contour you will need a formal surgical procedure at some point.

Testosterone may cause acne and hair development on your chest.  If you develope hair it will likely be permanent, even if you stop the hormones.

Hormones for FtM SRS

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Male hormones will suppress estrogen.  This will lead to some decrease in breast volume but not to a decrease in breast skin.  You can expect your breasts to droop as the volume decreases.  To get from a D cup to a male chest contour you will need a formal surgical procedure at some point.

Testosterone may cause acne and hair development on your chest.  If you develope hair it will likely be permanent, even if you stop the hormones.

Hormone Therapy Effects on Breasts

Hi BeingMe,

Thanks for the post. While hormone therapy may reduce the breast tissue to varying degrees, it will not address the skin excess. Given that you are a D cup, you will likely have too much skin even if you experience significant decrease in the amount of tissue from the hormones. Based on this, you will likely need top surgery (most likely double incision top surgery) to truly achieve the contour you desire.  Financially speaking, many practices offer financing plans to help patients.

Sincerely,

Dr. Dadvand

Hormone Therapy Effects on Breasts

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Hi BeingMe,

Thanks for the post. While hormone therapy may reduce the breast tissue to varying degrees, it will not address the skin excess. Given that you are a D cup, you will likely have too much skin even if you experience significant decrease in the amount of tissue from the hormones. Based on this, you will likely need top surgery (most likely double incision top surgery) to truly achieve the contour you desire.  Financially speaking, many practices offer financing plans to help patients.

Sincerely,

Dr. Dadvand

Effects of Hormones on FTM Top Breast Surgery & Insurance Coverage

Many companies will require one year of HRT (Hormone replacement therapy). The #benefits of HRT for every patient, however, do include heavier #chest #muscles and more chest #hair; which can cover some incisions while you are healing. #HRT may be a strong consideration for most patients. WPATH (World Professional Association for Transgender Health) provides the best current standards of care for physicians to assist in the care of #transgender, #transsexual and #nonconforming patients.
Hormone therapy for top surgery is not required unless you’re seeking coverage through #insurance. There are a number of states that now prohibit discrimination and legally require #insurance companies to provide transgender health coverage. If you live in a state where surgery coverage is not mandated by law, you still might be able to get your top surgery covered via student health insurance. To get #Top Surgery covered by insurance there are a number of requirements. Here are some of the obstacles you may face:

1. Meeting the insurance company's basic criteria: legal adult status, Gender Dysphoria diagnosis, support letters from qualified mental health practitioners, your primary care provider and your surgeon.

2. Having to pay out-of-pocket for surgery, then getting a reimbursement from the insurance company.

3. Having to be evaluated by a board of in-network doctors.
4. Finding in-network surgeons who have Top Surgery experience.

Keep in mind, that coverage varies between health insurance companies, states, and plans. Read your policy completely, not only the summary, and look for the #exclusions and limitations section. Finally, call your insurance company's member services department, or, contact a #benefits representative and ask the following:

• Is my selected surgeon a provider with my specific plan? (Make sure that you provide the representative with your surgeon's NPI number.)
• If my surgeon is NOT a provider, does my plan have out of network benefits?
• Does my plan cover gender confirmation Top Surgery?
• How much is my deductible?

Being each person varies, it’s important to be realistic about your goals and what is achievable. It's best to consult with your board-certified plastic surgeon about your concerns and to confirm if FTM Top is in your best interest.

Effects of Hormones on FTM Top Breast Surgery & Insurance Coverage

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Many companies will require one year of HRT (Hormone replacement therapy). The #benefits of HRT for every patient, however, do include heavier #chest #muscles and more chest #hair; which can cover some incisions while you are healing. #HRT may be a strong consideration for most patients. WPATH (World Professional Association for Transgender Health) provides the best current standards of care for physicians to assist in the care of #transgender, #transsexual and #nonconforming patients.
Hormone therapy for top surgery is not required unless you’re seeking coverage through #insurance. There are a number of states that now prohibit discrimination and legally require #insurance companies to provide transgender health coverage. If you live in a state where surgery coverage is not mandated by law, you still might be able to get your top surgery covered via student health insurance. To get #Top Surgery covered by insurance there are a number of requirements. Here are some of the obstacles you may face:

1. Meeting the insurance company's basic criteria: legal adult status, Gender Dysphoria diagnosis, support letters from qualified mental health practitioners, your primary care provider and your surgeon.

2. Having to pay out-of-pocket for surgery, then getting a reimbursement from the insurance company.

3. Having to be evaluated by a board of in-network doctors.
4. Finding in-network surgeons who have Top Surgery experience.

Keep in mind, that coverage varies between health insurance companies, states, and plans. Read your policy completely, not only the summary, and look for the #exclusions and limitations section. Finally, call your insurance company's member services department, or, contact a #benefits representative and ask the following:

• Is my selected surgeon a provider with my specific plan? (Make sure that you provide the representative with your surgeon's NPI number.)
• If my surgeon is NOT a provider, does my plan have out of network benefits?
• Does my plan cover gender confirmation Top Surgery?
• How much is my deductible?

Being each person varies, it’s important to be realistic about your goals and what is achievable. It's best to consult with your board-certified plastic surgeon about your concerns and to confirm if FTM Top is in your best interest.

I'm FTM trans- what will testosterone due to my breasts?

Testosterone will have many masculinizing effects. This includes shrinkage of glandular breast tissue. Unfortunately, it will not shrink the skin to any noticeable degree. This will leave your breast looking like deflated pancakes.  You will need surgery in order to address this. If you have health insurance, you should check with your plan to see if they will cover the procedure.  If not, just start slowly saving so that you can get the results you want.  While it may take a little longer than you want it to, it will happen. 

I'm FTM trans- what will testosterone due to my breasts?

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Testosterone will have many masculinizing effects. This includes shrinkage of glandular breast tissue. Unfortunately, it will not shrink the skin to any noticeable degree. This will leave your breast looking like deflated pancakes.  You will need surgery in order to address this. If you have health insurance, you should check with your plan to see if they will cover the procedure.  If not, just start slowly saving so that you can get the results you want.  While it may take a little longer than you want it to, it will happen. 

FTM hormones

Testosterone may have an effect on decreasing breast volume, however it will not decrease the amount of skin (which for D cup breasts is quite significant), so top surgery will most likely still be necessary in order to truly achieve a masculine chest contour.  We have had favorable experiences recently with insurance coverage for this procedure.In order to get a qualified, expert opinion on your surgical options and expectations visit a plastic surgeon certified by the American Board of Plastic Surgery. Best of luck, Keith M. Blechman, MD New York, NY

FTM hormones

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Testosterone may have an effect on decreasing breast volume, however it will not decrease the amount of skin (which for D cup breasts is quite significant), so top surgery will most likely still be necessary in order to truly achieve a masculine chest contour.  We have had favorable experiences recently with insurance coverage for this procedure.In order to get a qualified, expert opinion on your surgical options and expectations visit a plastic surgeon certified by the American Board of Plastic Surgery. Best of luck, Keith M. Blechman, MD New York, NY

Top Surgery

I appreciate your question.
The 2 major methods are double incision mastectomy with nipple grafting and keyhole.
It depends on the size of your breasts as to which method would be best for you and the ability to maintain nipple sensation
The decrease in estrogen will shrink your breasts but ultimately you may still need surgery 

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

Top Surgery

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I appreciate your question.
The 2 major methods are double incision mastectomy with nipple grafting and keyhole.
It depends on the size of your breasts as to which method would be best for you and the ability to maintain nipple sensation
The decrease in estrogen will shrink your breasts but ultimately you may still need surgery 

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

Hormones and Surgery

Hello. Although hormones do reduce the glandular component of the female breast and increase the presence of chest and body hair, reduction may not be as much as you desire. Mastectomy with the double breast crease incision and nipple graft would be the best option. I suggest consulting various physicians that are EXPERIENCED in this type of surgery to see who is within your budget, but will provide an excellent result. 

Hormones and Surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hello. Although hormones do reduce the glandular component of the female breast and increase the presence of chest and body hair, reduction may not be as much as you desire. Mastectomy with the double breast crease incision and nipple graft would be the best option. I suggest consulting various physicians that are EXPERIENCED in this type of surgery to see who is within your budget, but will provide an excellent result. 

Effects of Hormones on Breasts

You may notice a slight decrease in your breast size after commencing hormone therapy.  Based on your description of having a D cup, however, it is unlikely that your breasts will shrink considerably.  You will likely require surgery to address the breast tissue, excess skin, and nipple position.  A consultation with a board certified plastic surgeon can help you to understand what your options are.  

Effects of Hormones on Breasts

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You may notice a slight decrease in your breast size after commencing hormone therapy.  Based on your description of having a D cup, however, it is unlikely that your breasts will shrink considerably.  You will likely require surgery to address the breast tissue, excess skin, and nipple position.  A consultation with a board certified plastic surgeon can help you to understand what your options are.  

T and Double Incision Mastectomy

Top surgery is really the most definitive way to address your D cup breasts.  There are ways to finance the operation.  Hormone therapy may have some effect on your breasts, and if it is part of your plan otherwise, it will benefit you to start before surgery.  I would not expect the type of resolution that you are looking for without surgery however.

T and Double Incision Mastectomy

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Top surgery is really the most definitive way to address your D cup breasts.  There are ways to finance the operation.  Hormone therapy may have some effect on your breasts, and if it is part of your plan otherwise, it will benefit you to start before surgery.  I would not expect the type of resolution that you are looking for without surgery however.

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.