Best Profile Implants for Flat-Chested Transgender MTF?

I am udergoing a Breast Augmentation in few weeks. I have talked to 3 doctors in a day but then they give me confusion in which profile implants i should have. A doctor told me to have a high and others told me to have a low profile implants. I am planning to have a 400cc mentor moderate (low) profile. Do u think i would have more natural looking and feeling breasts than having moderate plus or high profile for a flat-chested transexuals like me? i am 22, 5'8" and 140lbs .. thanks in advance!

Doctor Answers 14

Proper profile implants for M to F transgender patient?

The reason you are confused is because many plastic surgeons have minimal experience with M to F transgender patients, or have a tendency to use a certain profile implant with all their patients, female and transgender alike. This is wrong, IMHO.

At 5'8" tall, you would be considered a tall female, but your present chest and breast base anatomy is masculine (relatively wide, with taut skin and youthful robust musculature). Your surgeon and you should first determine the implant size needed to give you the breast volume you wish (that presumably is proportionate to the rest of your body), and once that is determined choose the implant profile that achieves that volume with the best match to your breast base diameter. Depending on size this would likely be moderate profile implants, or with somewhat larger implants, moderate plus profile implants.

This should be considered only when hormone therapy has enlarged your breasts as much as possible (12-18 months after initiation of hormone therapy; most patients will develop no more than about one cup size of breast tissue).

Because M to F transgender patients do have more pectoralis muscle bulk and taut skin than their physiologically-female flat-chested counterparts, anywhere from 1/3 to half of transgender patients will benefit from consideration of tissue expander placement to stretch the lower pole muscles and skin to yield a natural teardrop shape and adequate skin/muscle coverage for appropriately-sized implants. Simply placing implants in every transgender patient unfortunately can yield too-small, firm, convex-up, concave-down shaped breasts with wide cleavage. Totally unnatural look AND feel.

Obviously, it's not just about profile!

Assessment of muscle and skin tightness must be determined before recommending this two-stage surgical approach (or not), but doing this when appropriate will often minimize the need for multiple re-operations to try to obtain adequate size, position, shape, and softness of implants in the transgender chest.

As you can see, one approach and profile does NOT fit all!

There are a few plastic surgeons who perform significant numbers of transgender surgeries, and have office staff, nursing staff, and the associated capabilities that many plastic surgical practices do not have. Seek these practices and surgeons out, and obtain a few more consultations. It will be worth the time, effort, and (saved) expense of an improper choice. As anyone who does do significant numbers of transgender augmentations will tell you, this is NOT simply placing implants as we do in our non-trans female patient! For several examples of my transgender patients click on the web reference link below. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Breast Breast Implant for Augmentation in TransGender Male to Female

Regarding: "Best Profile Implants for Flat-Chested Transgender MTF?
I am udergoing a Breast Augmentation in few weeks. I have talked to 3 doctors in a day but then they give me confusion in which profile implants i should have. A doctor told me to have a high and others told me to have a low profile implants. I am planning to have a 400cc mentor moderate (low) profile. Do u think i would have more natural looking and feeling breasts than having moderate plus or high profile for a flat-chested transexuals like me? i am 22, 5'8" and 140lbs .. thanks in advance

Our colleagues in Thailand do more of this surgery than almost anyone else and the world and I would defer the details to them. I would like to give you a few points to think about.

The BEST looking / feeling breast augmentations are seen in woman (or tans gender MTF) who have enough breast tissue to cover the implants they choose. If you do not have female breasts, you should consider going on hormone therapy until you develop such breast tissue. The MORE breast tissue between the skin and the breast implant, the more the ripples of the implant would be covered and the more attractive the result.

For this reason, I would recommend a Mentor High Profile (similar to their MP plus) or moderate profile silicone gem implant placed via a Keller funnel (which allows the use of shorter silicone gel breast implant incisions). The silicone gel implants ripple less than saline implants and would feel more natural in your case.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Best Profile Implants for Flat-Chested Transgender MTF?

Thank you for the question and picture.
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 photograph, 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 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'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, dedicated to transgender patient breast augmentation) helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,503 reviews

Profile Implants for Flat-Chested Transgender MTF

It appears that you are tall and relatively slim. Your chest does not seem to be wide. Generally for this kind of surgery I usually recommend a round implant compared to teardrop. You will end up having more cleavage. The implant needs to be wide enough that it adequately covers your chest and gives you cleavage, so I am going to suggest any profile implant such that you get enough satisfactory projection. The volume 400cc seems to be adequate. Your surgeon needs to measure your chest dimensions and determine which profile you need. Generally for my patients, first after measurement of chest dimensions, then I decide the profile. Typically a high profile. So for you, if the dimensions from nipple to inframammary fold, form nipple to sternum and nipple to anterior axillary line, are the dimensions that need to be used.

Usha Rajagopal, MD
San Francisco Plastic Surgeon
4.6 out of 5 stars 41 reviews

Depends on your goals

The first thing to do is determine which volume it is that you like.  This is accomplished by trying on sizers.  Once you have determined which size is best for you, the implant choice should be made based on the base diameter of your chest, and the look that you are trying to achieve.  If you are narrow and want more upper pole projection, then a high profile implant would be best for you.  Even with high profile implants, if you fill them to the low end of the volume range they are more natural, while at the upper end of the range they are more projected.  Because you are thin, filling them in the higher end of the range may reduce your risk of rippling.

Gary Lawton, MD, FACS
San Antonio Plastic Surgeon
4.9 out of 5 stars 136 reviews

Best profile implants for MTF transformation

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

Jeffrey Rockmore, MD
Albany Plastic Surgeon
5.0 out of 5 stars 71 reviews

Style of implant

I would recommend the Mentor High Profile implant.  You have a small torso.  The high profile implants will give you nice projection. 

Ben J. Childers, MD, FACS
Riverside Plastic Surgeon
4.0 out of 5 stars 9 reviews

Profile of implant


You can easily determine which size and profile of implant fits you best by trying on some implants int the plastic surgeons office.  Just bring in a very tight T-shirt or sports bra and try on various implant sizes and profiles.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 166 reviews

Breast implant profile

Choosing the best breast implant for breast augmentation requires an in person consultation to evaluate the patient's physical characteristics such as skin laxity and width of natural breast. In general, moderate profile breast implants are better suited for wider breasts, whereas higher profile implants are preferable for narrow breasts with more tissue compliance.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Implant style

Based on your height, weight, and body habitus, the moderate profile implants would look the most natural. I would use a higher profile implant if you are narrow, and the moderate profile implants in your size range are too wide. It sounds like you are on the right track with what you have chosen.

Hayley Brown, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 90 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.