For some people, chest incongruity, in which the appearance of the chest does not match a person’s identified gender, results in marked gender dysphoria symptoms. Surgery seeks to create a better identity alignment and can allow our patients to feel much more comfortable in their daily lives. Transgender breast feminization involves reconstruction of the masculine chest to a feminine one.
The procedure is typically performed with silicone implants, placed under the muscle, with an incision at the base of the breast (at the inframammary fold). We typically recommend silicone implants because the implant to your own breast proportion tends to be high, and so the texture of the implant becomes more important. Silicone implants feel softer with less rippling than saline implants. Initially in the first month after surgery, the implants will feel very high and broad on the upper chest. This is due to the contraction of the pectoralis muscle that is stretched over the implant. Over the next 2 months, as the muscle stretches and the skin relaxes, the breast starts to appear more feminine and round. Typical return to normal activity is about 3 weeks, with 4-6 weeks before you can use you arms for heavy lifting.
