MTF Top Surgery (Male-to-Female Breast Augmentation / Chest Feminisation Surgery)

Overview
MTF top surgery enhances the chest with breast implants or fat transfer to create a feminine contour. It is a gender-affirming procedure for transgender women and some non-binary individuals seeking alignment between physical appearance and gender identity.

Who It’s For

  • Transgender women or non-binary individuals desiring breast development beyond hormonal changes

  • Completed at least 12 months of feminising hormone therapy (where possible) to maximise natural tissue growth before surgery

  • Stable physical health and realistic expectations

  • Non-smokers (or willing to cease pre- and post-operatively to reduce risk of complications)

Procedure

  • Performed under general anaesthesia (1–2 hours duration)

  • Incision options:

    • Inframammary (under-breast fold): most common, allows precise implant placement and minimal visible scarring

    • Periareolar: around the areola edge (for small implants or good tissue coverage)

    • Transaxillary (armpit): avoids chest scars, used less frequently

  • Implant placement:

    • Submuscular (under pectoral muscle): for natural slope and implant protection

    • Subglandular (above muscle): suitable for patients with sufficient soft-tissue coverage

  • Implant selection: silicone implants (preferred for natural feel) or saline, in round or anatomical (teardrop) shapes

  • Fat grafting may be added to smooth contour or enhance cleavage

Recovery

  • Usually day surgery

  • Mild discomfort, swelling, and tightness for several days

  • Compression garment or surgical bra worn continuously for 4–6 weeks

  • Return to light activity within one week; avoid upper body exercise for 6 weeks

  • Implants settle into natural position over 2–3 months

Results and Scarring

  • Softer, feminine chest contour with visible cleavage and projection

  • Scars are minimal and well-concealed in natural folds or around the areola

  • Final appearance achieved after swelling subsides and tissues relax (2–3 months)

  • Results are long-lasting; implants may eventually require replacement

Risks

  • Bleeding, infection, delayed healing

  • Capsular contracture (scar tissue tightening around implant)

  • Asymmetry or implant malposition

  • Altered nipple sensation

  • Implant rupture or need for revision surgery

Long-Term Considerations
Results are durable but implants require long-term monitoring. MRI or ultrasound imaging may be advised periodically to assess implant integrity. Weight stability and hormone maintenance preserve contour and softness. The surgery often produces significant psychological and social benefits through enhanced body congruence and self-confidence.