The transgender person who chooses to have breast augmentation (commonly referred to as “top surgery”) takes a major step in establishing a feminine identity. This is a procedure in which plastic surgeons like Dr. Javad Sajan shape the breasts to achieve a more feminine structure using breast implants.
Transgender Breast Augmentation in the USA
How is Breast Augmentation different from Implants?
The transgender person who chooses to have breast augmentation (commonly referred to as “top surgery”) takes a major step in establishing a feminine identity. This is a procedure in which plastic surgeons like Dr. Javad Sajan shape the breasts to achieve a more feminine structure using breast implants.
Transgender Breast Augmentation in the USA
MTF breast augmentation is more than just a procedure; it is a powerful step that helps transgender women feel seen, celebrated, and at home in their bodies¹. We support this journey with compassion, expertise, and customized care.
While hormone therapy may encourage some breast development in male-to-female patients, it often does not achieve the volume or shape many transgender women hope for². Dr. Javad Sajan offers gender-affirming breast augmentation that not only enhances the body’s appearance but also helps patients feel more at home in it, making FeminizationSurgeries a trusted leader in MTF breast augmentation across the United States.
MTF Breast Augmentation | Transgender Breast Augmentation in USA
Male-to-female transgender patients may see some natural breast growth if undergoing hormone therapy. This can include some changes in nipple appearance and the development of breast tissue. However, it is unlikely that an MTF patient will see breast growth to the extent they desire. Gender affirming breast augmentation can help transgender women see themselves in the body they imagined. Plastic surgeon, Dr. Javad Sajan performs the best MTF breast augmentation in Seattle USA.
Understanding
What is MTF Breast Augmentation?
Male-to-female breast augmentation, usually shortened to MTF breast augmentation, is a gender-affirming procedure that augments the breasts of transgender women³. This can help treat and alleviate gender dysphoria¹. It also allows trans women to wear their preferred clothing more easily.
Like with a traditional breast augmentation performed on a cisgender woman, Dr. Sajan uses breast implants to augment and shape the breasts. Modern silicone breast implants can result in natural-looking and natural-feeling breasts⁴.
Why Consider Transgender Breast Augmentation?
Hormone therapy often causes some breast development, but many trans women find the size, shape, or symmetry unsatisfactory². But it’s common to feel like the results don’t quite match how you see yourself. That’s where breast augmentation bridges the gap. It’s less about adding volume and more about waking up each morning and feeling at ease with what you see.
Many patients say the procedure helps ease gender dysphoria and gives them a sense of alignment¹. In fact, one study found that over 90 % of trans women who had breast augmentation were happy with the results and would do it again⁵.
Breast Implant Selection
Choosing breast implants for MTF breast augmentation involves a few unique considerations. Transgender women often have a wider chest, which may require broader or larger implants to achieve a balanced and proportionate appearance⁶. Many patients also prioritize a soft, natural feel, leading most to prefer silicone or gummy-bear implants over saline, which can sometimes feel firmer or show rippling⁴. Because the chest muscles are typically thicker, smooth implants are often favored, as they tend to settle into place more easily than textured ones⁶.
Implant selection is a highly personalized process. Dr. Sajan works closely with each patient, allowing them to try on various implant sizers or use 3D imaging to visualize potential results. Most breast implants last around 10 to 15 years⁸, and it’s important to monitor them over time. Routine check-ups, including physical exams or imaging like ultrasound or MRI every few years, help ensure the implants remain in good condition and continue to provide safe, satisfying results⁹.
MTF Implant Profiles, Shape & Size
Selecting the right breast implant as a transgender woman involves balancing three key factors: profile, shape, and size¹⁴. The implant profile refers to how far the implant projects from the chest wall and how wide its base is.
Profiles
- Low-profile implants: Broadest base, gentlest forward projection. This profile works well for wider chests and subtle fullness.
- Moderate profile: Balanced width-to-projection ratio; suits most transfeminine bodies for a softly rounded, natural look.
- High profile: Narrow based with maximum projection; ideal for slimmer rib cages or anyone looking for a dramatic cleavage without oversizing diameter.
Shapes
- Round implants: They provide even fullness across the breast and tend to give more volume in the upper pole, which is great for patients who want a noticeable cleavage appearance.
- Teardrop or anatomical implants: These implants have a more natural slope, mimicking the way breast tissue naturally develops. They’re fuller at the bottom and tapered at the top. It is ideal for those who want a more subtle and anatomically accurate contour.
- Shell texture: Smooth shells move naturally (common with round implants); textured shells help shape implants resist rotation but carry a rare BIA-ALCL association⁷.
Sizes
Implant volume is selected along a continuous scale. However, it is discussed in practical ranges to help patients visualize their options: about 150-250 cc for a subtle boost, 250-400 cc for a full-B to C-cup look, and 400-600 cc (or more) for a pronounced D-cup silhouette. Dr. Sajan will first match the implant’s width to your chest, then adjust volume in 25-50 cc steps so projection, skin stretch, and comfort stay balanced.
Benefits of MTF Breast Augmentation
Patients may experience several benefits from a gender-affirming breast augmentation in Seattle, USA. A few possible benefits include:
• A natural, feminine shape that feels in harmony with the rest of the body.
• Relief from gender dysphoria¹.
• A boost in confidence, whether out in public or at work.
• The ability to wear preferred clothing and bras.
• Soft, natural-feeling results⁴.
• Minimal scarring and a smooth recovery.
• A highly personalized experience.
For many trans women, breast augmentation is a way to take an affirming step toward living fully and comfortably in their bodies.
The Differences Between Traditional Breast Augmentation & Transgender Breast Augmentation
The core surgical steps of breast augmentation are almost the same for traditional breast augmentation and transgender breast augmentation, but a few transgender-specific factors require refined techniques and judgment⁶. Ignoring these things can compromise shape, cleavage, and long-term symmetry.
| Surgical Factor | Traditional Breast Augmentation | Transgender Breast Augmentation |
|---|---|---|
| Pectoral Muscle Thickness | Thinner muscle; sub-pectoral or sub-glandular placement is straightforward. | Muscle remains thicker even after estrogen therapy, restricting the implant⁶. |
| Chest Width / Sternum Spacing | Narrower rib cage; implants sit closer together naturally. | A wider chest means breasts tend to sit farther apart⁶. |
| Areola Size & Position | Areolas are larger and slightly farther apart. | Areolas are typically smaller and closer together⁶. |
| Cleavage Formation | Cleavage forms easily with standard implant sizes. | Extra chest width can leave a noticeable central gap⁶. |
| Post-Op Pain & Settling Time | Moderate discomfort; implants typically settle within a few weeks. | Thicker muscle can cause more initial pain and delayed implant drop⁶. |
Available Breast Augmentation Techniques
Multiple incision locations can accommodate the placement of breast implants. Patients may qualify for all of the incision types depending on their anatomy goals, implant choice, and medical history. Sometimes, Dr. Sajan may recommend one method over another based on the patient’s anatomy. Below are the four types of breast augmentation surgery:
Inframammary
The traditional breast-augmentation technique places the incisions within the inframammary fold, where the breast meets the upper abdomen.
Periareolar
The periareolar technique uses a half-moon incision around the areola, concealing the scar within the natural change in skin pigmentation.
Transaxillary
A popular choice for transgender women is transaxillary breast augmentation, where implants are inserted through a small incision in the armpit.
Transumbilical
The least used method is transumbilical breast augmentation. This approach is limited to saline implants only, as they must be filled after insertion.
Fat Grafting for MTF Breast Augmentation
In patients who have minimal native breast tissue or anyone hoping to enhance upper-pole fullness and create a more defined cleavage line, autologous fat grafting can be paired with silicone or saline implants for a softer, more naturally contoured result. As the grafted fat becomes part of your body’s own tissue and is not viewed as medically necessary, combined augmentation with transfer is classified as cosmetic; therefore, it is rarely covered by insurance plans.
Preparing for Surgery
Proper preparation reduces surgical risks and makes recovery smoother.
- Stop all nicotine, including vaping, at least two weeks beforehand¹².
• Shower with chlorhexidine (HIBICLENS®) the night before and again the morning of surgery¹³.
• Arrange reliable transportation and an adult support person for the first 24 hours.
• Stock your home with recovery essentials.
• Discontinue blood-thinning agents only under your surgeon’s guidance.
Transgender Breast Augmentation Results and Recovery
Every recovery is unique, but most trans-feminine patients follow the milestones below.
- First 48 hours: soreness, swelling, and limited range of motion. Prescription pain medicine and short, frequent walks help minimize discomfort and lower clot risk.
- 0-2 weeks: A medical-grade compression bra (or surgical binder) must stay on 24/7 for the full first two weeks, removing it only to shower.
- Weeks 1-3: Keep elbows below shoulder height and avoid lifting anything heavier than a half-gallon of milk.
- Weeks 3-6: Light office work usually feels comfortable by day 10-14.
- After 6 weeks: Once internal swelling stabilizes, you may start using a soft, non-underwire bra.
- 3-6 months: As pectoral muscles relax, the implants descend to their intended pocket and the upper pole softens.
12 months: Residual swelling resolves, scars mature from pink to pale, and breast shape, softness, and sensation reach their long-term baseline. Annual follow-ups and self-exams ensure implants remain healthy and symmetrical⁹.
Risks and Complications
Breast augmentation for trans-feminine patients has a strong safety record, yet like any operation, there are potential complications.
• Capsular contracture (excess scar tissue tightens and distorts the implant): 10–15 % incidence¹⁰.
• Implant rupture or leak: shell failure over time; average implant longevity 10–20 years⁸.
• Altered nipple or skin sensation: usually temporary.
• Implant malposition & asymmetry.
• Rippling or wrinkling.
• BIA-ALCL (rare lymphoma associated with textured implants)⁷.
• Hematoma or seroma: < 1 % incidence¹¹.
• Infection and poor scar quality.
• Need for revision surgery.
How Much Does MTF Breast Augmentation Cost?
The cost of MTF breast augmentation depends largely on how much your insurance provider is willing to cover. Coverage can vary based on your plan, medical documentation, and state-specific laws regarding gender-affirming care. Our team can also assist you in verifying your benefits and exploring financing options during your consultation.
What Insurance Options Are Available for MTF Breast Augmentation?
FeminizationSurgeries works with major insurance providers like Aetna, Cigna, Blue Cross Blue Shield, and Kaiser Permanente. Coverage depends on your specific plan and state, and the team assists with verifying benefits, submitting documentation, and handling appeals. If your insurance doesn’t cover the procedure, we offer discounted self-pay pricing and flexible financing to make care more accessible.
FAQ
How is breast construction performed?
Breast implants are placed either beneath the breast tissue or under the chest muscle. This is typically done through a small incision made in the breast crease (inframammary fold) for discreet scarring and optimal placement.
What dressings and supportive garments will I need to wear?
You will be required to wear a front-closure compression bra continuously (24/7) for the first two weeks following surgery. This helps reduce swelling, supports the healing tissues, and assists with implant positioning.
What should I expect as a normal part of the healing process?
Swelling, tightness, bruising, and temporary changes in nipple or breast sensation are all normal. Over time, the implants will gradually soften and settle into a more natural position.
How many visits will be needed after surgery?
Most patients return for 4 to 6 follow-up appointments during the first year to ensure proper healing, monitor progress, and address any concerns.
When can I return to my usual activities?
You may resume desk work within 3 to 5 days. Light exercise is generally safe after 2 weeks, but strenuous activity and upper-body workouts should be avoided for 6 to 8 weeks or until cleared by your surgeon.
What complications are associated with breast augmentation?
While breast augmentation is generally safe, risks may include infection, fluid accumulation (seroma), implant rupture or rippling, asymmetry, and capsular contracture (scar tissue tightening around the implant).¹⁰
What else do I need to know?
Breast implants are long-lasting but not lifetime devices. Regular imaging, such as ultrasound or MRI is recommended every few years to assess implant integrity and detect silent rupture, particularly with silicone implants.⁹
The Best MTF Transgender Breast Augmentation by Dr. Javad Sajan
Dr. Javad Sajan is a Seattle-based plastic surgeon who specializes in gender-affirming surgery for transgender, nonbinary, and gender-nonconforming individuals. He customizes each MTF breast augmentation to match the patient’s anatomy, goals, and identity, drawing on extensive experience to deliver natural, affirming results. To learn more and schedule a consultation, call 206-209-0988 or reach out online via chat or contact form. Dr. Sajan and the FeminizationSurgeries team are honored to support you on your gender-affirmation journey.
References:
¹ van de Grift TC, Kreukels BPC, et al. Association of gender-affirming surgery with mental health outcomes in transgender individuals. JAMA Surg. 2021;156(7):611-618.
² de Blok CJM, Klaver M, et al. Breast development in trans women after 1 year of feminizing hormone therapy. Endocr Pract. 2021;27(7):690-697.
³ World Professional Association for Transgender Health (WPATH). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. 2022.
⁴ Wixtrom RN, Canady JW. Cohesive silicone gel implants: 10-year safety data in augmentation and reconstruction. Plast Reconstr Surg Glob Open. 2020;8:e2882.
⁵ Yetman RJ, Iverson RE. Outcomes of breast augmentation in transgender women: patient-reported satisfaction. Aesthetic Surg J. 2019;39(9):NP546-NP555.
⁶ Lewis JR, Cardoso E, et al. Subfascial versus dual-plane pocket in gender-affirming breast augmentation. Aesthetic Surg J. 2020;40(11):NP683-NP694.
⁷ U.S. FDA & American Society of Plastic Surgeons. Breast Implant–Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Summary. Updated 2024.
⁸ American Board of Cosmetic Surgery. Breast implant longevity and monitoring guidelines. 2022.
⁹ U.S. Food and Drug Administration. Breast Implants—Patient Decision Checklist & MRI/Ultrasound Screening Recommendations. 2019.
¹⁰ Bachour Y, Peters Y, et al. Risk factors and rates of capsular contracture: a 10-year single-center analysis. Aesthetic Surg J. 2021;41(3):NP173-NP181.
¹¹ Fitzgerald O’Connor ET, Nguyen VT. Incidence and management of hematoma after primary breast augmentation. Plast Reconstr Surg. 2012;130(6):1184-1190.
¹² Sørensen LT. Effect of smoking on wound healing and infection in plastic surgery: a systematic review and meta-analysis. J Plast Reconstr Aesthet Surg. 2018;71(1):141-151.
¹³ Persichino J, Goh XL, et al. Pre-operative chlorhexidine bathing to reduce surgical-site infection. Infect Control Hosp Epidemiol. 2017;38(3):373-375.
¹⁴ American Society of Plastic Surgeons. Breast implant profile selection guide. 2016.
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