Male-to-Female (MTF)

Transgender Top Surgery

Transgender patients on the journey to aligning their physical body with their gender identity may consider aesthetic surgery to help them feel more like their authentic self. Top surgery (breast augmentation) can provide a trans woman with the shapely, feminine breasts she desires to better represent her gender identity. Dr. Schwartz understands that the journey to self-discovery for a transgender patient can be a long and sometimes difficult one. At the Beverly Hills Breast Institute, we treat all of our patients with the sensitivity and care they deserve, and our aim is to help them feel comfortable, happy, and confident in their own skin.

What MTF Top Surgery Can Do for You

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Dr. Schwartz has developed chest measurement techniques to precisely find the best implant based on your body and your desires. The goal is to create the breasts that you could have been born with.
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Hormone treatments may have provided you with minimal breast development, but it may not be enough to make the significant impact you want. With implants, we can create a full and feminine breast appearance.
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Cleavage is an important aspect of attractive breasts. Dr. Schwartz will determine the best implant placement, size, and shape to give you the eye-catching cleavage you desire. Fat grafting may also be used to achieve the final shape you want.

How Does Dr. Schwartz Stand Out?

Dr. Schwartz is one of the foremost leaders in breast surgeries in the United States. He has developed national guidelines for breast surgeries with implants and also is a principle investigator for an FDA clinical trial for Mentor® Breast Implants. His breast enhancement techniques create natural, feminine breasts that beautifully complement the shape of your body.

MTF Top Surgery Techniques

Implant Options

Saline implants are comprised of a silicone shell that is filled with a saltwater solution. These implants can be custom-filled during your surgery to ensure a more exact size. However, they are more prone to visible rippling or wrinkles in patients who don’t have enough breast tissue.

Silicone implants are comprised of the same soft silicone shell and filled with a softer silicone gel. Many patients prefer silicone implants because they better simulate the look and feel of natural breast tissue.

"Gummy bear," or cohesive gel implants, are called form-stable since they are thicker, maintain their shape, and can be anatomical. These implants are beneficial for patients who desire more natural-looking breasts since they are smaller at the top and larger at the bottom. Dr. Schwartz is one of the highest-volume users of gummy bear implants in the US.

Incision Location

Inframammary incisions are most often used because they provide easy access for implant placement and are thought to be a safer incision.

• While less commonly used, periareolar incisions can be discussed during your consultation to see if they will better help you achieve the results you desire.

Implant Placement

Subglandular placement places the implants below the glandular tissue but above the pectoral muscles. This is usually associated with a less painful recovery and does not cause implant movement during muscle contractions. However, upper pole edges are more likely to be visible in patients with thinner breast tissue, and there is an increased risk of capsular contracture.

Subpectoral placement places the implants below both the glandular tissue and the pectoral muscles. This creates a more natural slope of the upper pole and can help mask the edges of the implants. It's a better choice for thinner patients.

Fat Grafting

• Fat grafting for top surgery involves using patient-harvested fat to increase breast size and sculpt the breasts.

• Fat grafting may be used during your surgery to help improve the shape and definition of your breasts.

MTF Top Surgery Details

Consultation With VECTRA® 3D

Your consultation with Dr. Schwartz is the most important step in your breast journey. During your consultation, VECTRA® 3D imaging provides Dr. Schwartz with precise, detailed information about your breast size and tissue distribution. Other implant simulators are used during your consultation to help you better visualize your potential results. Additionally, you and Dr. Schwartz will discuss your aesthetic goals and review your medical history to ensure that you are healthy and a good candidate for treatment.

Recovery

Dr. Schwartz has developed a recovery package to help minimize the discomfort of surgery. This includes using BOTOX® in the muscles prior to surgery and EXPAREL® (a long-acting local anesthetic) placed into the muscles during surgery. Most of our patients take only TYLENOL® after this procedure. Most patients can return to work after one week, and you may be able to resume some exercise after four weeks and full exercise at six weeks.

Scars

Dr. Schwartz is a leading scar expert who has published journal articles on this subject and has been the principal investigator for an FDA clinical trial studying breast scars and their healing and improvement. He has developed and utilizes many modalities to relieve tension on the incisions, which reduces the visibility of scars, and he combines scar reduction techniques during the recovery process. While some scarring is likely to develop, it is likely to fade over time.

Pain

Dr. Schwartz uses a number of pain-minimizing techniques before and after surgery. Several days before your top surgery, BOTOX® is injected into the muscles to reduce pain during and after surgery. During surgery, we utilize twilight sedation, which eliminates surgical pain but doesn’t have the unwanted side effects of general anesthesia. Once your surgery is complete, we inject EXPAREL® (a long-acting local anesthetic), which helps reduce pain for three to four days following your procedure.

Dr. Jaime Schwartz’s Results

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Frequently Asked Questions

Transgender top surgery can only be performed on patients who have undergone the following steps:
  • On hormones for at least 18 months prior to consultation
  • Received a letter of recommendation from a therapist or licensed psychologist
  • Lived as their preferred gender identity for at least two years prior to their surgery
Dr. Schwartz does everything to ensure that your breasts look and feel as natural as possible. While some patients immediately feel in touch with their new appearance, it can take time and additional therapy for others to feel comfortable and confident in their new body.
While there's always a risk of losing nipple sensation, Dr. Schwartz, when performing this procedure through an inframammary fold incision, has had great success in keeping all nipple sensation.
No. Dr. Schwartz can insert larger implants, even in patients with less breast tissue. However, to ensure that your resulting appearance is natural, we try to choose an implant size and type that will maintain a proportional appearance with your body.