Do I need to see a therapist before MTF breast augmentation for small breasts?

Question

I am a male that would like to get very small breast implants. I am a crossdresser that spends 50% of my time as male, I will never fully transition, nor will I ever take hormones. I am not over weight but have developed A cup breasts with gynocoamstia. I know what I want, do I need to see a therapist before under going this procedure? Insurance will not be involved.

Randal Haworth, MD, FACS · Answer

While some medical professionals may suggest seeing a therapist before undergoing any elective procedure, it may not always be necessary. However, it is important to be sure that you have a clear understanding of the risks and benefits of the procedure, as well as any possible complications, and that your decision to undergo the procedure is an informed one.

Ultimately, the decision to see a therapist before undergoing the procedure is up to you, and it is important to find a healthcare provider/plastic surgeon that you feel comfortable with and who can provide the necessary information and guidance throughout the process.

I hope this helps,
best of luck !

Jed H. Horowitz, MD, FACS · Answer

dear modest
if you are emotionally stable and able to legally make decisions then a therapist is recommended but not an absolute
below is some information to help with your choices
The Naked Surgeon: The Truth about Breast Augmentation for Transgender Women

Breast augmentation for "male-to-female (MTF)" patients is "feminizing" top surgery and a gender-affirming procedure for transfeminine patients that can help create natural-looking breasts and improve self-esteem. The goal is to feminize a patient's appearance and improve their mental health, sexual confidence, and overall quality of life.

Breast augmentation is a significant step in the journey of many transgender women towards aligning their bodies with their gender identity. This is often termed top feminizing surgery or MTF (male to female breast augmentation). It's a deeply personal decision that can have a profound impact on self-confidence and overall well-being. The goal is to make the patient’s appearance more feminine by creating natural appearing and feeling breasts. This gender affirming operation will often improve our patient's self-esteem in the process of transitioning to a female appearance and life. It is also a process that comes with many questions and considerations as does any breast surgery.   In this document, I will attempt to provide answers to some of the most frequently asked questions about breast augmentation for transgender women.

1. What is breast augmentation?

Breast augmentation, also known as augmentation mammoplasty, is a surgical procedure to increase the size and enhance the shape of the breasts. This is typically achieved through the benefit of silicone breast implants or by transferring fat from another part of the body to the breasts (natural breast augmentation).

2. Why do transgender women undergo breast augmentation?

Transgender women may choose breast augmentation as part of their transition to align their physical appearance with their gender identity. For many, having breasts that are more in line with their gender identity can alleviate dysphoria and is gender affirming for them.

3. Am I a good candidate for breast augmentation?

The decision to undergo breast augmentation is highly personal and should be made in consultation with a qualified healthcare provider. Generally, good candidates for breast augmentation are in good overall health, have realistic expectations about the outcome of the procedure, and are emotionally prepared for the physical and emotional changes that come with it.

4. What are the different types of breast implants available?

There are several types of breast implants available, including saline implants, structural saline implants, and silicone implants. Each type has its own advantages and considerations, and the choice of implant type will depend on factors such as personal preference, body type, and desired outcome. The implants come in a variety of profiles to help create the best contours for each patient's different body type.

5. How is the breast augmentation procedure performed?

The breast augmentation procedure typically involves making incisions under the breasts, in the armpit, or through the belly button. I then   create a pocket, or space for the implant, and then insert the implant either behind the breast tissue or beneath the chest pectoralis muscle. The specific details of the procedure will depend on factors such as the type of implant used, the desired size and shape of the breasts, and the surgeon's technique.

6.What type of anaesthesia is used?

Most generally, I prefer my patients to be asleep for this procedure, which is quite short, usually less than one hour.  I will place local anesthesia around the breast at the beginning and end of the case to allow for comfortable healing.

7. What is the recovery like after surgery?

Recovery time after breast augmentation can vary from person to person, but most individuals can expect to take a few days off from work or other activities to recover. During this time, it's important to follow all the post-operative instructions carefully, which may include wearing lightly compressive sports bra and avoid strenuous activity. Most discomfort can be controlled with ibuprofen or extra strength Tylenol.

8. What are the potential risks and complications of breast augmentation?

Like any surgical procedure, breast augmentation carries some risks and potential complications. These may include infection, bleeding, changes in nipple sensation, implant rupture or leakage, and capsular contracture (the formation of scar tissue around the implant). Capsular contracture occurs in about 5% of my patients. Complications such as bleeding and infection are very rare. The most common reason for additional surgery is the patient's decision to change the size of the implant.

9. How much does breast augmentation cost?

The cost of breast augmentation will depend in part on the facility where I do the surgery and the type of implants used.  The range is usually $15-18,000 dollars complete including all follow-up care indefinitely.  We do not take insurance plans in our office.

10. How do I find a qualified surgeon for breast augmentation?

Finding a qualified board-certified plastic surgeon for breast augmentation is essential for achieving safe and satisfactory results. When selecting a surgeon, be sure to research their credentials, experience, and reputation, and ask for before-and-after photos of previous patients. Additionally, it's important to schedule a consultation with the surgeon to discuss your goals, concerns, and expectations for the procedure. We are happy to provide initial virtual consultations for patients who are not close to our office.

Conclusion

Breast augmentation can be a transformative step in the journey of transgender women towards aligning their bodies with their gender identity. By addressing common questions and concerns about the procedure, I hope to provide valuable information to help individuals make informed decisions about breast augmentation and achieve their best possible outcome.

Do I need to see a therapist before MTF breast augmentation for small breasts?

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