Dr. Jaime Schwartz: 5 Things You Probably Don’t Know About Male To Female Transgender Top Surgery

As a breast augmentation expert, I’ve helped many Male to Female (MTF) transgender patients seeking to improve their appearances with a top surgery. Below are some of the differences that you might not be aware of, between a traditional female breast augmentation and a transgender breast augmentation.

1. Most MTF transgender patients already have breasts when they come to me for a breast augmentation.

Before undergoing breast surgery with implants, we require the transgender patient to stay on a regimen of hormones for at least 18 months. We’ve found that they may become more feminine in appearance from the hormones alone, and they’ll start to gain fat in the right areas, lose body and facial hair, and see some breast growth. By the time they come to my office for their breast surgery, they already have breast tissue. They’re usually around an A or B cup, and are looking to enhance their already feminine appearance and fully transform their bodies.


2. Transgender top surgery is very similar to a traditional female breast augmentation.

The male to female transgender patient, like other women seeking a breast augmentation, want to enlarge their breasts for increased confidence and a more feminine silhouette with cleavage.

During the consultation, I work with them to choose the implant that best suits their body in a very natural way. We take into consideration the breast size they want, the size of their chest wall, and any asymmetries we’ll be correcting during the procedure.

They’ll have the choice of implants—textured or smooth, shaped or round, silicone or saline. Silicone implants are the most popular choice, currently. When choosing the size, I use take precise measurements (base diameter and breast height), and have them try on anatomic sizers to determine the most natural looking size breasts for their frame.

Then, I’ll use Vectra 3D imaging for confirmation of this size, where they can virtually “try on” their implants, to see exactly what their bodies will look like after the breast augmentation surgery.

Watch me demonstrate Vectra 3D Imaging:

3. MTF patients are required to live as the gender they identify with for 1-2 years prior to having top surgery.

Surgery can often be a life-changing event for any person. Transgender patients put a lot of thought into their cosmetic procedures, just as much as any other potential patient would. Because a breast augmentation can dramatically impact their appearances as well as their lives, we find that patients that have been living for some time as the gender they are most comfortable with before the surgery, will lead them to be a lot happier with the results of their surgery.


For instance, this transgender patient of mine, Jenna, was thrilled with her results:

4. The incisions and post op scars may be different for a transgender patient.

Because male nipples tend to be much smaller than female, it is difficult to do an areola incision when performing a breast augmentation on a transgender patient. I usually use an intra-mammary fold incision (IMF), which means the scar will be in the crease of the breast. When sized properly, after the procedure, the bottom of the breast will fall and cover the minimal scar nicely.

Additionally, I offer a fat transfer after the augmentation to further enhance the natural breast feeling and appearance.

5. Transgender top surgery is less painful, easier to recover from, and less invasive than ever right now.

We’ve made some exciting advances in minimizing discomfort during our patients’ recovery. I offer my transgender patients what I call a “well-being enhancement” where we’ll inject Botox into their pectoral muscles two weeks before the surgery, to decrease pain and muscle spasms. I also inject EXPAREL, a long-acting numbing medication at the time of the surgery that decreases pain and lasts for 3-4 days. This changes their recovery process dramatically. Also, nowadays, I do most of my transgender breast surgeries in “twilight” where the patient is not asleep, but sedated, during the process. This has led to faster recoveries and more “peace of mind” for those concerned about anesthesia and surgery.

What makes me different:

I have an extensive background in breast reconstruction surgery and am widely known for fixing some of the most complex breast surgery problems in the industry. I was selected by the ASPS as one of 10 plastic surgeons to develop U.S. National clinical practice guidelines for breast surgeries using tissue expanders, implants, and autologous tissue, and participated as a principle investigator for an FDA clinical trial for correcting poorly healed breast scars.

Right now, I am participating in a clinical trial called the GLOW Study for Mentor® MemoryShape™ and MemoryGel™ breast implants, where breast augmentation patients, if they qualify for the trial, will get some money back for having the procedure. We’re the only site in California that is participating in this special clinical trial. Please contact us for enrollment details and to schedule a consultation.

SchwartzPractitioner at the Roxbury Institute and founder of The Beverly Hills Breast Institute, Dr. Jaime Schwartz the highest quality and most comprehensive breast surgery care to men, women and transgender patients, alike.

View Dr. Jaime Schwartz profile and contact information here.