Transgender Breast Augmentation, Silicone Implants Under Muscle? Suggestions?

I'm looking to get Round Silicone implants under the muscle, high profile or moderate plus, I've gone to 1 consultation & the surgeon said i would look better in 260cc HP since i have a small frame i wanted to go bigger 300cc

Doctor Answers 9

Below the muscle

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In my opinion, you can go up to 300 cc without any difficulty. That should really not be a problem at all, especially if you go with a high profile implant.  Trying on implants is the best way to visualize how large you would like to be.  Ive done a number of transgender patients and would place them under the muscle. Would also recommend either through the armpit or through the nipple to leave the most inconspicuous scar. 

Best of luck.


260 is too narrow!

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Make sure your surgeon measures the breast base width as this is the number one determining factor in choosing an implant. The next most important factor is your soft tissue characteristics. Your skin looks tight so high profile may be the wrong choice. If a wider high profile implant is used the volume and projection may be too much. The 260HP is only 10.4cm wide and projects 4.3cm. This would be an option if your base width were only 11-11.4cm but I doubt you are that narrow. Centering a narrow implant under the nipple may result in wider cleavage and lack of adequate lateral fullness. A better result may be to go with a slightly wider implant that projects less so it fits nicely under your tight tissues. Like for instance a 265 midrange profile (11.4 x 3.7cm). Good luck

Kevin Rose, MD
Provo Plastic Surgeon

Implant size and projection is a function of the chest wall anatomy.

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The final volume and projection is in large part determined by the dimensions of the patient's chest. Specific advice cannot be given to you in this format but your plastic surgeon can explain the measuring process to you.

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Picking the right shape as well as size

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You look widely spaced, which is probably mostly due to the shape of your rib cage.  High profile will tend to exaggerate the spacing so I would suggest something with a wider base such as a moderate or moderate plus profile.  I think that if you had 260 under the muscle, you would feel like nothing was done!  The other question you need to answer is the approximate cup size you seek.  The sizes mentioned here would probably be a "B."

Myles Goldflies, MD
Seattle Plastic Surgeon

Implant Selection

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Thank you for your question. It is much better to accurately discuss implant volume and projection with an in office exam and detailed measurements.

In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements/characteristics. I use these measurements to help me during the sizing process to guide you to a safe result for your chest wall and just as important, one that meets your end desires.

The next step is to try on this range of implants in the office with your doctor. The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant. It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you during the sizing process.

In addition, review of photos and use of rice bags can be very helpful to the patient and surgeon in achieving a safe and happy result. Close intereaction and involvement from your surgeon during this process can help alleviate the anxiety and fears of choosing the right size.

I wish you a safe recovery and fantastic result.

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 95 reviews

It rersults much better subfascial plane dissection, is much less painful and much more less agressive

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it is better  result a subfascial plane location of  both implants  any seize  any shape it hurts  less and  looks wonderfull  ,it is general anesthesia  and recoverey  for 1 week it is ambulatory surgeery

Ramon Navarro, MD
Mexico Plastic Surgeon

Larger implants

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Thank you for asking about whether a 300 cc implant will fit you.

  1. A breast implant base width must fit your chest,
  2. So measurements are needed.
  3. Discuss your breast implant goal with your plastic surgeon and see if there is a high projection, narrow base breast implant that will work for you. Best wishes.

Best Breast Implant Size/ Profile for Me (Transgender Patient)?

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Thank you for the question and pictures.

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.

In your case, based on your photographs and stated goals, I think you are starting at a great starting point for breast augmentation surgery and should have a very nice outcome.   

Generally speaking, the best online advice I can give to ladies 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're 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) help.

Transgender breast augmentation

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For #transgenderbreastaugmentation you cannot pick an implant by saying you want a specific size and expecting a surgeon on line to give you an answer that is worth anything. The implant diameter is based on the chest measurements your surgeon makes at the time of your examination. The implant projection is based on the distance between your nipple and skin crease under the breast as well as the laxity in your skin envelope demonstrated by pulling the nipple forward. The position under or over the muscle is dependent on the thickness of the soft tissue just north or upward of the breast tissue.

The main issue you will need to consider are that your nipples point outward rather than forward and may do so even more if you just put in implants. Also, you have no cleavage and breast implants alone will not create cleavage. I suspect you fall into the category of patients that benefit most from a combination of breast implant augmentation and fat grafting contouring of the breast.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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.