Transgender Breast Augmentation

Hi. I am a 21 year old transgender woman who has been on estrogen and testosterone blockers for 10 months. I have very little breast tissue (32AA?) and am having a breast augmentation in 1 week. My surgeon selected 475CC Moderate Plus implants and I'm beginning to get scared that they are too big for me. I want to have big breasts but I don't want to have health problems because of it. I am 5'9" and 125-130 lbs. I have a small frame. Does this sound too big?

Doctor Answers 4

Transgender Breast Augmentation

Thank you for your question!  Typically, breast augmentation on transgender women utilizes larger implants.  This is due to the breadth of one's chest and the width of your breasts.  That being said, this is a generalization and there are times that trans women have narrower breasts and the implant size is subsequently smaller.   Due to your height it may be that this is the right implant size for you, at least with the selected profile.  If you think you want to go smaller, a lower profile implant may be just the trick.  The lower the profile of the implant the greater the diameter and less projection.  I would run this by your surgeon and ask him or her about the profile and your concern going too big.   I hope this helps!!

Bay Area Plastic Surgeon
4.9 out of 5 stars 112 reviews

Transgender Breast Augmentation

Thank you for the question.
Despite good intentions, online consultants will not be able to provide you with meaningful specific advice. Ultimately, in person consultation with well experienced board-certified plastic surgeons will be necessary. Careful measurements, dimensional planning, and careful communication will be key.

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. Ask 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 “natural” or "C or D 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.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Transgender (Male to Female) Breast Augmentation Implant Size

  • Without an actual physical examination, or at least seeing photos of your chest, it isn't possible to say whether or not a 475cc implant is too large for your frame.
  • I have noticed in my own practice that transgender females often choose larger implants than genetic female patients.
  • This is related to patient desire, chest wall anatomy, and how much native breast tissue there is.
  • We have found that doing some implant sizing with our patients at their initial consultation, and then again at their pre-operative visit, is a very useful exercise that allows patients to choose the appropriate size implant. 
  • Definitely discuss your concerns with your plastic surgeon.

Joshua Cooper, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 44 reviews

Transgender breast augmentation

The size of the breast implant that is used will depend on several factors, including your chest wall measurements and the amount of breast tissue you have.  If you have any concerns you should clearly communicate them to your surgeon.  Sometimes, a consultation with another board certified plastic surgeon can be helpful.  Best wishes and be safe.  

Josef Hadeed, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

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.