Gender Affirming Breast Augmentation Techniques

Some people feel that breast augmentation, and possibly other gender confirmation surgeries, are essential steps towards mind and body embodiment . While not all trans people feel the need to undergo a breast augmentation procedure, this page can help inform those who do with proper expectations to ensure an outcome you are happy with.

CChoosing Your Breast Implants

Your surgeon is available to guide you through the various choices and details, including:

Saline vs. Silicone: Saline implants are filled with saline (saltwater), typically at the time of surgery. For a lower cost and a shorter incision line (about 1.5 inches), saline implants are a popular choice. Silicone implants come prefilled with a cohesive silicone gel and have become the more popular choice because they offer a softer, and what some consider a more “natural” appearance, especially for those without a lot of breast tissue.

Implant Size:  Though you may be tempted to think in terms of cup size, you should instead think in terms of your body’s natural proportion. Breast implant sizes are based on the amount of liquid or gel contained within the implant’s outer shell (200cc-500cc on average). During your consultation, you’ll have the chance to try out a variety of implant sizers to help you better envision your chest after surgery.

Implant Shapes:  When it comes to shape, round breast implants are the most common choice because they are completely symmetrical, so rotation is not an issue. We prefer using round implants over teardrop shaped implants because there are less limitations when it comes to placement and location, and teardrop shaped implants require a longer incision. If you have questions about implant shapes, please ask your surgeon during your consultation.

Incision Patterns

You have several options when it comes to incision location.. Your implants can be placed through an incision made along the border of your areola (periareolar), just below the fold of your chest muscle (inframammary), or through your armpit (transaxillary).

Though your incision location will ultimately depend on your personal preference, our surgeons typically recommend the inframammary fold incision. This is because most patients choose silicone implants (which are inserted fully inflated and sealed) and have narrow areolas.

Autologous Fat Grafting

Autologous fat grafting (fat transfer) may play a role in breast augmentation in the future. However, this technique is not as successful when a large amount of volume is needed and the skin is particularly tight. Breast augmentation with saline or silicone breast implants is currently greatly preferred. If you have additional questions about this technique, your surgeon will be able to answer them during your personal consultation.