Best Profile Implants for Flat-Chested Transgender MTF?

Thank you for your question and for providing the photo. There is no single profile implant that universally works best in transgender patients. The implant selected should be chosen based on a 3 dimensional approach, and take into account the skin, muscle and other specific considerations of top transformation procedures. It is best to first select the proper width of the implant so that it matches your chest width.This will avoid a large space between the breasts and give the most natural shape. The projection can then be determined based on your desired look and the laxity of your chest skin. This often varies between a moderate profile or a moderate plus profile implant. In my experience in transgender surgery, the high profile implants are rarely useful as their lack of width combined with the tightness of the overlying skin makes them look quite unnatural. Your photos would be an example of someone who would likely not have a natural result if high profile implants are used.The best next step for you would be to consult with a plastic surgeon well versed in this type of surgery. Read reviews of his/her work with transgender patients. During the consultation, they can discuss the implant options with you, and help you to decide how best to proceed.Best of luck with your top surgery.Jeff Rockmore

You would benefit by considering form stable shaped textured implants.  I would place them under the muscle through an incision at the bottom of your breast.  While these are not the only option, they would provide a very natural breast shape.  They also have a lower complication rate than round smooth implants as you referenced above. 

Regarding size, while I don't have the chart in front of me, typically the surgeon will measure your breast width and then arrive at a breast implant size that will fit your shape.  Transgender patients can often handle larger sized implants mainly due to the broadness of the chest and shoulders.  You don't seem to have this issue can then choose amongst the different profiles based on how large you want to be post operatively.  Hope this helps.