Excellent question. In my practice, we understand that transgender patients are on a journey to aligning their physical body with their gender identity, and that the journey can be a long and sometimes difficult one. Our goal is to help you feel comfortable, happy, and confident in your own skin. Top surgery is the most commonly performed gender reassignment surgery for transgender individuals. Although the decision is very personal, many transgender people say this procedure was a vital step toward alleviating their gender dysphoria and the key to being more comfortable with their appearances. But ultimately the decision will be yours. During your initial consultation, we determine based on your individual goals and desired body shape how to tailor your top surgery specifically to you. Breast enhancement can be achieved with a breast augmentation with breast implants, or with a fat transfer. If you are a good candidate for breast implants, I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve. If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. If you are a good candidate for a fat transfer, the fat can be removed from any unwanted areas including hips, flanks, and abdomen. I perform the fat grafting in multiple planes including under the muscle to give the best, most natural enhancement to my patients. Fat grafting is a great solution for someone who wants to bring their breast size up a cup or so and use natural tissue vs. an implant. However, it can also be combined with an implant or used as a secondary procedure to fill in areas that are flat or thin. It should not affect nipple sensation, mammograms, cancer risk or breast feeding. The great thing about a fat transfer to the breasts is that once it is injected, it becomes part of your body, meaning if you gain or lose weight, the transferred fat can do the same.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 Board Certified Plastic Surgeon #RealSelf100Surgeon #RealSelfCORESurgeon