How Transgender Breast Augmentation Surgery Differs from Cisgender Implants
In many technical aspects, cisgender and transgender breast augmentation (often incorrectly and insensitively referred to as “MTF breast augmentation”) share a number of medical similarities: during both procedures, an implant is placed into the breast which consists of muscle, breast tissue, skin, and nipple. Additionally, the surgical instruments used are essentially the same.
That being said, the characteristics and dimensions of the breast tissue between cisgender and transgender patients are profoundly different. Another common, unfair misconception is that transgender patients typically desire unnatural-looking breasts; when in actuality, the requests of transgender patients are as varied as those of cisgender patients.
In most cases, Dr. Ali’s transgender breast augmentation patients request natural-looking, balanced and proportionate breasts, but Dr. Ali works closely with all of his patients to meet their exact goals when undergoing transgender breast augmentation surgery.
Anatomical Differences in Transgender Breast Augmentation Surgery
Far too often, the anatomic differences between cis and transgender augmentations go unrecognized by both patients and surgeons. Fortunately, Dr. Ali is acutely aware of the 7 anatomical differences between cis and transgender augmentations and takes them into account when caring for all of his patients.
Trans women will usually have a wider ribcage than will a cis woman of the same height and weight. In crafting the perfect breast shape that naturally fits onto the thorax, Dr. Ali considers height, width, volume, and projection in proportion to the transgender breast augmentation patient’s ribcage.
Generally, a trans woman’s nipples will be situated to the outside of the breast mound. This will factor into where the implant is placed, resulting in a nipple that is relatively centered on the breast mound.
In many cases, a trans woman’s nipples will be situated lower on the breast mound. The ideal breast is said to have the breast volume roughly 45% above the plane of the nipple and 55% below. While achieving balance in cisgender women occasionally requires the implant be placed below the natural crease of the breast, it is a far more common occurrence in transgender patients.
All breasts, cis and transgender, are composed of a combination of gland (firm) and fat (soft). Transgender patients typically have firmer and more dense breasts, as their breasts are, for the most part, comprised of glands that, through hormone therapy, have been enlarged. In is imperative for transgender breast augmentation surgeons to account for their patient’s breast tissue malleability, as it affects size of the implant.
The skin of transgender patients is usually thicker and tighter than cisgender patients. As cisgender women’s breast size can fluctuate significantly over the years from weight changes, monthly periods, and pregnancy, their skin can relax and soften over time in a way transgender patients’ often have not been afforded.
In many (but not all) transgender women, the pectoralis major muscle is thicker than in cisgender women. It is almost never thick enough to create any kind of problem, but will require a greater level of attention during surgery, particularly in regard to anesthetic. Over time, this can occasionally result in the muscle pushing the implant slightly out and/or down, but this issue is also faced by cisgender patients, and is not specific to transgender breast augmentation surgery.
Transgender Breast Augmentation Surgery
Dr. Ali performs every gender affirming breast augmentation surgery with the goal of creating natural, beautiful breasts for his patients. By employing an innovative surgical technique that allows for the most successful and predictable transgender breast augmentation surgeries possible, the concerns associated with the 7 anatomical differences in transgender breasts are all taken into consideration, avoiding pitfalls often faced by transgender patients in the hands of lesser surgeons.