Breast augmentation

Technical Considerations in Trans Women

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While the surgical technique is similar to breast augmentation in cisgender women, there are anatomical differences that require specific planning for trans women:

 

• Different chest anatomy: The chest is typically broader and the distance between the nipples greater, which may influence implant placement to achieve a natural result.

• Flat chest or limited breast development after hormone therapy: This results in less soft tissue and glandular coverage for the implant.

• Skin characteristics: The skin is often firmer, especially in younger patients or those who have been on hormone therapy for a short time, which may limit the initial implant size.

 

 

Surgical Technique

 

 

The procedure is performed under general anaesthesia.

 

• High-quality silicone breast implants are used, selected according to the patient’s chest contour and personal goals for volume and shape.

• The most common surgical approach is an inframammary incision (in the crease under the breast), which provides excellent visibility, safety, and aesthetic outcomes.

• Implants are usually placed under the pectoral muscle (submuscular placement) to achieve a more natural result and reduce the risk of capsular contracture.

• In certain cases, progressive enlargement with expanders or additional fat grafting (lipofilling) may be needed to improve the result, especially in patients with very thin skin or a prominent rib cage.