Making the Transition
Having an outer appearance that doesn’t match your inner self can cause significant distress and dysphoria. Transitioning to a more comfortable gender can be assisted by cosmetic surgery. Whether it is MTF breast augmentation or FTM chest reconstruction, gender affirming surgery can assist in your transition. We realize that electing to have cosmetic surgery is a very personal decision and is dependent on your feelings, philosophies, and your overall health. Our goal is to make you feel more comfortable with your body by aligning your physical characteristics with how you feel internally, and how you want to present yourself to others.
It’s natural to be a little anxious and have a lot of questions before undergoing any type of procedure. Dr. Won offers all patients a free consultation and can answer all of your questions and inform you about all options that are available to you. Additionally, she will go over what to expect from both the surgical and the recovery process, and provide you with a price quote. We also have an insurance coordinator on staff who can help you determine if your procedure may be covered by your insurance plan.
Male to Female Breast Augmentation
For patients transitioning from male to female, Dr. Won performs the following types of breast surgeries:
- Breast augmentation with silicone implants
- Breast augmentation with saline implants
- Fat transfer breast enhancement without implants
MTF patients are generally recommended to undergo hormone therapy for at least 12 months prior to breast augmentation in order to maximize breast growth and obtain optimal aesthetic results. This is not a requirement however.
There are different options to choose from, based on the look and feel of what you want to achieve as you transition from male to female.
Silicone versus Saline Implants
Silicone implants are more expensive and require a larger incision and a more involved surgery. For our transgender patients, they are the most popular choice since they work best for someone who has no breast tissue to start with. They also have a very natural look and feel to them.
Saline implants are also an option and are less expensive than silicone. During your consultation, Dr. Won can guide you through the pros and cons and help you determine which implant type is best suited for you.
Both types of implants are FDA approved and have good safety records. The life of either type is the same, which ranges from ten to fifteen years.
The blood supply to the nipple is not affected during surgery so no sensation is lost. During surgery, an incision will be made for proper placement and the nipple is pulled through and sutured into place.
Breast Implant Replacement
The average lifespan for a breast implant is ten to fifteen years, however other factors may also affect breast appearance and warrant replacement. Aging, weight fluctuations, gravity, or hormonal factors may also come into play. We recommend that you see Dr. Won annually so that she can monitor your breast health and integrity of your implants.
Fat Transfer Breast Augmentation
This type of breast augmentation utilizes liposuction to take fat from other parts of your body such as your thighs or stomach, and inject it in to your breasts. This is an option for those who prefer to have a smaller breast size or do not want implants placed in their bodies. This procedure is growing in popularity since it is a less-invasive procedure than using breast implants.
The transfer of fat is two separate procedures, completed on the same day. First, Dr. Won will perform liposuction on the area that the fat will be extracted from. It is usually taken from the belly, thighs, or buttocks. During the liposuction process, the extra fat is carefully removed and then sculpted in order to reveal the feminine curves.
Once this procedure is completed, the fat cells that have been extracted are put through a purification and cleansing process in preparation for the breast augmentation. The prepared fat cells are then injected into the breasts to create a feminine appearance.
The healing process for fat transfer breast augmentation is relatively quick and easy. Some swelling and bruising is expected at both the site that the fat cells were removed, and also in the breast area, however healing should occur quickly. Most patients who undergo this procedure are able to return to work in about a week.
Recovery from Breast Augmentation Surgery
Recovery time is going to be based on the extent of the procedure performed and the patient’s overall health. The great thing is that you will be able to see immediate results!
Generally, you will wear an elastic-type bandage or support bra in order to keep swelling to a minimum and provide support to your breasts as you heal. Sometimes, a thin tube may be placed under the skin in order to provide drainage for any excess fluid or blood that may accumulate, but this is usually removed within the first week. You should be able to return to work in approximately two weeks, depending on how active your job duties are. Bruising and redness will usually decrease in the first few weeks, however it may take a few months for all of the swelling to completely subside.
Dr. Won will provide you with detailed instructions regarding your recovery on how to care for your new breasts, any medications you may need to take, and any concerns to watch out for at your surgical site.
Swelling is to be expected after any type of surgery but this should go down in a matter of weeks and you will quickly realize the benefits of the type of surgery that you have.
Female to Male Chest Reconstruction
Female to male chest reconstruction surgery is an option for those who want to have a more masculine appearance by removing their breasts. When considering any type of cosmetic surgery, it’s important that you have detailed information on Dr. Won’s surgical techniques, what to expect while recovering, and what results to expect from the surgery.
There will be some scarring which is always a consequence of surgical procedures. Recovery will be different for each patient, and over time, scars will fade. However, most transgender patients are willing to live with their scars in exchange for their unwanted breasts. Size, color, and texture of your scars depends on many factors including genetics, your skin’s ability to heal, post-surgical care, and the type of lifestyle that you lead.
There are different techniques that can be used to remove your breast tissue and reconstruct your chest wall so that it has a more masculine appearance. The type of technique and incisions used will depend on the size and shape of your breasts, your skin elasticity, and the amount of sagging that you may currently have.
Liposuction can be used for very small chests or in combination with other surgical techniques. The Keyhole/Peri-areolar incision may work best for those who have small to moderate sized breasts. The Double Incision is used for larger chests or those who have a lot of sagging.
The more common surgery is double incision mastectomy with free nipple grafts. The breast tissue is removed at the level of the breast capsule with an elliptical incision. The result is a curved incision that follows the outline of the pectoralis muscle of the chest. The nipple-areolar complex is removed as a full thickness skin graft, then resized and repositioned for a more masculine appearance. The less common surgery is called “keyhole” surgery for those patients with very little breast tissue and minimal excess skin, and nipple-areolar complex that is already in an ideal size and position. Most of the breast tissue is removed via liposuction, additional breast tissue can be removed through a small periareolar incision. The nipple-areolar complex is not altered.
Depending on which type of procedure you have, your nipples will be affected to some degree. Usually, the nipple and areola are removed and then grafted back on to the chest in the correct position, however in some cases the nipple may just need to be repositioned. The areola can be made smaller, and the nipple can be reduced so that it doesn’t protrude as much like it does on a woman’s breast. Dr. Won will go over what will be required from you during recovery to ensure the best possible outcome for your graft success. Nipples are one of the more sensitive areas on the body, and some sensation may be lost however, once the graft takes and you begin to heal, you will experience more sensation.
Female to male chest surgery is complex, and in some cases, you may need a second surgery to obtain optimal results, however the majority of people only need one. Dr. Won will advise you of risks and possible outcomes that may warrant a second surgery.
Recovery from FTM chest surgery requires at least 4 weeks to recover. After that time, you can begin to ease into activities that are not vigorous for at least an additional 2 weeks. It’s also important to avoid strenuous activity during this time frame to avoid stretching the scars which may affect their healing. Recovery will also include the use of temporary drains to avoid fluid or blood buildup at the surgical site. You will also be required to wear a compression bandage for the first week to help you heal properly.
Are you a Candidate for Gender Affirming Surgery?
Not everyone is a candidate for cosmetic surgery. If you are in the process of losing weight, it is best to wait until you have reached your ideal weight before undergoing any kind of cosmetic procedure. The reason for this is because weight fluctuations can affect the long-lasting benefits that are gained from having cosmetic surgery. Additionally, if you are currently a smoker, you will need to stop completely prior to undergoing any type of procedures since smoking can affect both the healing process and the results gained from a procedure. Also, it is important that you have a positive attitude and a realistic outlook about what surgery can do for you. An unhealthy lifestyle and poor overall health and fitness can wreak havoc on your appearance.
We do require patients to have at least one letter from their mental health provider and confirming persistent, well-documented gender dysphoria. This is based on the standards promoted by WPATH (World Professional Association for Transgender Health). You can read more about this here.
Your Trangender Surgery Procedures will be performed in Dr. Won‘s surgery center located in Shoreline