Breast implants

Breast implants, or augmentation mammaplasty, is a procedure some trans women undergo in order to supplement development they had with hormones. Some women never feel they need them, while others wanted them very much.

The surgeon inserts the liquid- or gel-filled bag into into a pocket created under the skin. This can be done in several different ways, discussed later.

As with any medical procedure, there are advantages and disadvantages which must be considered when deciding if breast implants are right for you.

Some advantages:

  • they might help you pass better
  • they might help make your body more proportionate
  • they might make you look or feel more sexually desirable
  • they might make clothes fit better
  • they might help avoid embarrassment in public dressing areas

A few drawbacks:

  • breast implants are not considered lifetime devices. They can and do rupture in time.
  • you may have to undergo multiple surgeries over the course of your life.
  • some feel the risks of surgery and anesthesia are greater than the benefits
  • some are concerned about potential known and unknown risks from breast implants
  • some feel they are able to adjust to their hormonal development without augmentation
  • some believe that the look and feel of implants is not acceptable compared to natural breasts

Your Expectations

Your consideration of breast implants, for reconstruction or for augmentation should be based on realistic expectations of the outcome. To help you get an idea of what results may be possible, look at before and after pictures of patients who have had this surgery. Your doctor may have some to show you. There's a commercial site listed at the bottom of this page that has 120 examples. You may also want to talk with other women who have had this surgery at least a year before with the same surgeon. Keep in mind, however, that there is no guarantee that your results will match those of other women.

Your results will depend on many individual factors, such as your overall health; chest structure and body shape; healing capabilities (which may be hindered by smoking, alcohol and various medications); bleeding tendencies; prior breast surgery(ies); infection; skill and experience of the surgical team; the type of surgical procedure; and, the type and size of implant.

Scarring is a natural outcome of surgery, and your doctor will try to keep scars as subtle as possible. She or he can explain the location, size, and appearance of the scars you can expect to have. For most women, scars will fade over time to thin lines, although the darker your skin, the more prominent the scars are likely to be. Usually the body will develop a fibrous capsule which can be thick or thin around the implant which is a normal physiologic response to a foreign object in the body.

It is important to remember that implants age over time and may need to be replaced. Although your implant may last for many years, you should not expect it to last indefinitely.

General Description of the Surgery

Breast implant procedures can be performed on an outpatient (not hospitalized) basis or at a hospital. Breast implant surgery can be done under local anesthesia, or under general anesthesia.

Breast implant surgery can last from one to several hours depending on whether the implant is inserted behind or in front of the chest muscle, and whether surgery is performed on one or both breasts. Prior to surgery, the doctor should discuss with you the extent of surgery, the estimated time it will take, and the choice of drugs for pain and nausea.

Postoperative Recovery

The doctor should describe to you the usual postoperative recovery process, the possible complications that can arise, and the expected recovery period. Following the operation, as with any surgery, some pain, swelling, bruising, and tenderness can be expected, but they should disappear with time.

Medications for pain and nausea can be prescribed. Some women may experience fever, bleeding or other symptoms of infection; these should be reported immediately to the doctor. Patients should be instructed about wound healing and appropriate wound care.

If the surgery is done in a hospital, the length of the hospital stay will vary according to the type of surgery, the development of any postoperative complications, your general health, and the type of coverage your insurance provides.

Follow-Up

Ask your surgeon about follow-up care, including a schedule of follow-up examinations, advice about limitations to your activities, precautions you should take, and when you can return to your normal routine. (If you are enrolled in a clinical trial, your surgeon should give you a schedule for follow-up exams set by the study plan.)


A note on silicone injections

Some trans women have breast augmentation with liquid silicone injections. FDA has not approved the marketing of liquid silicone for injection for any cosmetic purpose, including enlarging the breasts. The adverse effects of liquid silicone injections have included movement of the silicone to other parts of the body, inflammation and discoloration of surrounding tissues, and the formation of granulomas (nodules of granulated, inflamed tissue). FDA prohibits manufacturers or doctors from marketing or promoting unapproved products such as liquid silicone. This means that a doctor cannot legally advertise or sell this material.

I do not recommend silicone injections. For more on the dangers of this procedure, please read:

Silicone injections


A note on experimentation and scams

Breast developers are one of the oldest scams going. I will not bother discussing the pumps and potions out there except to say this:

People who fool around with breast creams and magic herbal feminizing pills, unproven potions or contraptions, breast pumps, corsets, body wraps, and even experimental medical procedures are all too common in our community. The problem is that there are always scumbags willing to exploit transgender desperation, so our community is constantly preyed upon by these scammers. Worse yet, many of those ripping off transsexual women are transgender people themselves!

If you cannot afford to waste your limited transition money on unproven products and procedures, DON'T!

If it sounds too good to be true, it is.

Next: Risks and complications

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