Transgender woman breast implants. Any suggestions? (photos)

Thank you for the question and pictures.

  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. *** IAsk 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 “porn star” or "DD 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.  You will find a separate page, on the same website, dedicated to "larger" breast augmentation surgery concerns.   Best wishes.

Thank you for your question and photographs.

It is near impossible to replicate somebody elses anatomy but you can bring a goal picture with you to your consultation so the doctor has an idea of your cosmetic goals. I would recommend that you schedule a consultation with a board certified plastic surgeon so they can perform a physical examination and take measurements so they can recommend the best implant type/sizes for your body and cosmetic goals. There are 3D simulators that can show you what you would look like with different types of implants and different sizes, this can be helpful when trying to decide what size would achieve your cosmetic goals. At my office, I use high profile Sientra implants to create a round full result that looks natural, giving you the result that you want. Additionally, i use Crisalix which is a virtual reality device that will allow you to view different sizes of implants and pick which best suits your desires.  As the only board certified plastic surgeon in Pittsburgh offering this virtual reality imaging system, we have a 100% satisfaction rate.  Crisalix is truly a unique experience for our patients as they can view themselves using virtual reality goggles and can instantly visualize their own breasts changing in size and shape with all of the various brands, sizes and shapes of breast implants.  Thus, our patients leave the consultation feeling confident with the size of the implant they chose. Best of luck!
Best of luck in your endeavors!
Sincerely,

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

Dear tnvolboy,

The issue with placing such large implants is that a lot of the time patients have a tight "skin envelope" meaning their skin would not accommodate high volume implants. There are other options such as tissue expansion which slowly stretches the skin so that larger implants can be placed. This would have to be discussed with a board certified surgeon. Typically you would have surgery to have the expanders placed, and then once a week you will return to the surgeon's office to have saline injected to gradual expand the skin envelope. Once the expanders get to the desired volume, you would have a second surgery to have the them removed and the implants placed. That being said, it is still not guaranteed that you would get the same shape as the picture you have posted. I would go for a consult and see what the surgeon recommends. Good luck!