Male to Female (MTF) Top Surgery - What To Expect

Once you decide to transition, it is natural to wonder about the various procedures and surgeries that one can undergo to mitigate the gender dysphoria they have been experiencing for most of their lives.

There is a substantial amount of information pertaining to HRT and bottom surgery, while breast augmentation is largely underexplored or explained very briefly.

In particular, the process of transitioning from a male body to that of a female via breast augmentation during transitioning is something that is not often discussed. So, let us look at the procedure more elaborately in this article. 



While HRT and breast augmentation are different procedures, going on estrogen during Hormone Replacement Therapy does lead to the growth of breasts, even if the changes are not always phenomenal.

This change can actually be attributed to the use of both testosterone blockers and estrogen.

The procedure is not very different from restarting your puberty. The change is minimal because your body has already been producing testosterone for years.


MTF Breast Augmentation Surgery

Many transgender women undergo breast augmentation surgery after they have been on HRT for a while.

Depending on your goals and preferences, the surgery could augment your breasts by a specific amount. In some countries like Sweden, this is offered for free of cost for transgender women as the country believes it is crucial for their self-confidence and to mitigate gender dysphoria.

However, as goals and preferences vary, many people do not undergo this procedure since they are happy with the breast tissues created by HRT. 


As a transgender person, when you undergo breast augmentation surgery, you will suddenly notice an increase in the size of your breasts, which could requires some adjustment, including new clothes and undergarments that can accommodate this increase in size, depending on how drastic the change is.

If your breasts were quite small before the procedure, it is likely that your skin could stretch significantly, although that is not always painful. But, understandably, they may not look natural for many, as 90% of the breasts are made up of silicone.

Compared to those assigned female gender at birth who get the same procedure, breast augmentation may look less natural on transgender women, as a relatively larger portion of their breasts is made up of silicone thereafter. 

So, for the first few years after the surgery, be prepared for breasts that may look slightly unnatural. After a year or so, the swelling will decrease, and they will gradually take on a more natural appearance.   


One more fact that is not often addressed on the internet is that, when a transgender woman undergoes breast augmentation surgery, the nipples will have to be moved so they are more center aligned.

This is because in men, the development of the chest area will move the nipples towards another direction.

As a result, you will most likely need to move your nipple area during surgery. This also sometimes holds true for cisgendered women, where breast augmentation surgery requires their nipples to be moved slightly to the center.

Obviously, the area where the nipples are placed is a very sensitive area, and following the surgery you would want to retain that. While you won’t completely lose that sensation, the fact is that you will most likely only regain 95% of it. 


For many people, this is a great trade-off- breast augmentation for a slight loss of sensation in the nipple area. However, what you choose to do depends on your goals and needs.

Finally, it is worth noting that it is, after all, a surgery. As a result, it is associated with pain during recovery and could take a lot of time to heal.

However, many transgender women have reported that they have felt more connected to their identity and womanhood after they underwent breast augmentation surgery.

So, it is definitely worth considering. Regardless of what you decide, undergoing a surgery or not doing so will not change your identity in any manner- you are a woman and you don’t need to undergo a surgery to prove that, if that isn’t your cup of tea.

If you do choose to go ahead with a surgery, good luck!!  


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