The process of undergoing breast augmentation top surgery, formerly known as MTF top surgery or MTF breast augmentation, can seem like a daunting task. However, by understanding the steps involved and what to expect, you can feel more prepared and confident throughout the process. This article provides a general timeline of the steps you can follow in your journey toward gender confirmation surgery. It covers important milestones such as scheduling a consultation, obtaining insurance approval, preoperative visits, and recovery, including instructions on care and follow-up visits.
Once you’ve decided to pursue surgery, the following is a general outline of the steps in the process:
Schedule a virtual or in-person consultation to learn about surgery, discuss your expectations and your body type, and bring up any concerns that you may have about potential complications, recovery, aesthetics, or any other issues that come to mind. If you have questions, make a list. If you have an ideal outcome in mind for your body type, bring photos as examples you can show to your surgeon.
After your consultation, we hope you will feel fully informed and empowered in moving forward with surgery. Your surgeon may give you some homework to do to determine what breast implant size would be most appropriate for you. All of your questions should have been answered without being rushed. You should have a good idea of what will happen from that point on and a general timeline for all the milestones that follow, including how long you’ll need to stay in town after surgery.
If you are hoping to have insurance pay for your surgery, your insurance company will have to approve your request. The surgeon’s office will send codes and, if needed, a letter from your therapist and/or primary care doctor, and any other necessary paperwork. Our office uses the informed consent model and therefore does not require any letters from therapists, but the insurance approval process often requires it. Our office has a dedicated Insurance Concierge who handles the entire process of insurance approval for patients and keeps you updated throughout the process.
Once surgery has been approved by your insurance or you have decided to pay out-of-pocket, you can schedule a surgery date. If you are traveling for surgery, you can plan travel, book airfare, request time off work for recovery, and, if necessary, find accommodations.
About 3 weeks before surgery, you will have a preoperative visit when you can ask your surgeon any additional questions you may have. As part of the informed consent process, you will sign consent forms stating you are aware of the type of surgery you are having and all of the benefits and potential risks involved. This can be a virtual visit for patients who don’t live in the San Francisco Bay Area, or in person if you live close by. If your visit is in person, we will take preoperative photographs. If it is virtual, we will usually take photographs the day before surgery in our office. You will receive all of the information you need regarding what to expect around surgery, how to stay comfortable, how to prepare for recovery, medications to stop taking (if any), and your expected activity milestones after surgery. We do not require any patients to stop taking hormones.
For patients who don’t live in the Bay Area and have had their consultation and preoperative visit virtually, there will be an in-person visit with your surgeon 1 to 2 days before surgery. At this visit, we will take photographs, and you will undergo a physical exam to make sure you are ready and your surgical plan is finalized.
Once your surgery is completed, you’ll recover for an hour or so and then be able to leave the surgery center or hospital. Patients are rarely admitted to the hospital for one night for monitoring and discharged the following morning, so be aware that this can happen, though it is unlikely.
During this first week after surgery, you’ll take it easy and keep comfortable. Your body knows how to heal. If you have any questions you can reach out to your surgeon. It’s extremely important that you keep your first postoperative appointment visit, which is usually 6 to 7 days after surgery.
On day 6 or 7 after surgery, you will have an appointment to see your surgeon. Your surgeon will remove your dressings and give you some additional instructions.
After that first visit, you can head back home. It’s a good idea to have help with any heavy luggage and make sure the trip is not too strenuous.
There is a routine schedule for follow-up appointments. This will be listed in your preoperative packet so you know what to expect. These visits can be done in-person or virtually. If done virtually, you will use our secure and private internet-based portal where you can upload photos and ask your questions, which your surgeon will respond to within one day.
You will receive comprehensive information about your recovery process and resuming activity during the educational process around surgery. But in brief: you should limit lifting to nothing more than 5 pounds until day 21 after surgery. On day 21, you can begin cardio activities such as running or cycling. You may then lift up to 20 pounds until day 42 (6 weeks) after surgery. After 6 weeks, there’s no limitation on how much you can exert yourself or lift. However, breast augmentation patients should refrain from activities that involve the chest muscles (including yoga and pilates) for 8 weeks after surgery. Your surgeon will also share some breast implant massage techniques when appropriate.