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Elliot W. Jacobs, MD, FACS - Diplomate, American Board Of Plastic Surgery

Specializing in Primary &
Revision Gynecomastia Surgery

815 Park Avenue New York, NY 10021

MTF Top Surgery: Risks and Results

As you prepare for top surgery as part of your gender transition, you’ll want to be aware of all the potential risks. At the same time, you’ll need to give some thought to the results you can realistically expect. The idea is to ensure as much as possible that the equation balances out the way you want it to.

Dr. Jacobs can help. As a board certified plastic surgeon with three busy decades of helping both men and women make decisions, he is experienced at getting to the heart of the matter with each potential patient. You can trust him to be honest and forthcoming, and to be objective in helping you consider your options. Why not contact him today and set up time to talk?

Here is some basic information about risks and results you can think over.

Top Surgery Risks

The good news about breast surgery is that it’s typically very safe. As with any type of surgery, some risks are possible, however. These include infection, hematoma (blood build up), seroma (fluid build up), excess swelling and a few others. We’ll give you information to help you be on the lookout for these.

MTF Top Surgery: Breast - Before and After photos

Specific risks of concern to MTF top surgery patients include:

  • Adverse scarring: Although most people find their scars to be completely acceptable after healing, scarring is somewhat unpredictable. Prominent scars can be treated with injections if needed, or in extreme cases minor surgical repair.
  • Loss of sensation: Nerve endings generally reattach in time after surgery. It is possible, however, to experience some permanent loss of sensation, either in patches or in a more widespread manner.
  • Capsular contracture: This condition occurs when the breast pocket created to accommodate the implant tightens up after surgery. Scar tissue squeezes the implant and can distort its appearance. The effect can range from mild-not requiring correction-to severe. In the latter case additional surgery may be required. The good news about capsular contracture is that its incidence is declining as plastic surgeons learn more about how to prevent it. Implant placement under the muscle appears to reduce this risk.
  • Rippling: Saline implants can occasionally be seen to ripple under the skin – especially when there is scant breast tissue to cover the implants. Very rarely a patient will complain about hearing the liquid sloshing inside their breasts.
  • Implant movement: Implants can become displaced after surgery. This complication happens very rarely, especially with implants of small to moderate size. If you are considering larger implants, you should know that the risk of displacement is slightly higher.
  • Regret: Patients who decide to have male to female surgery sometimes wonder what will happen if they regret the decision. The procedure can be reversed if necessary, although the skin will be stretched to some degree and telltale scars may show. Dr. Jacobs will encourage you to minimize the chance you’ll have regrets through counseling, education, lead time to consider your choices, input from family and peers and other measures.

There are two important ways you can reduce the risk of problems following MTF top surgery. First, choose a plastic surgeon who is certified by the American Board of Plastic Surgery. This ensures he or she has successfully completed formal training in plastic surgery and has undergone a rigorous evaluation process. Next, be sure to follow pre- and post-surgical instructions to the letter.

Your Results

When it comes to how you feel about your results, we look forward to hearing from you! We know top surgery brings about physical and emotional changes – some we would not presume to forecast for you.

With that said, since breasts are so integral to a feminine appearance, if looking “womanly” is your goal you can have every hope of feeling great about the change. Most patients are very satisfied with their new figure, many reporting increased confidence, excitement about shopping for clothes, heightened pleasure with intimate relations and so on.

MTF Top Surgery: Breast - Before and After photos (female)

Realistic Expectations

One very important key to post-surgical satisfaction is realistic expectations. After surgery, you will most certainly have breasts. And if looking natural is important to you, Dr. Jacobs’ surgical plan will address this goal.

Breast augmentation surgery will not modify the overall shape of your torso, however, nor bring about other changes. If you’re interested in more ways to enhance your transition from man to woman, surgery for the face and liposuction may be possibilities for you. Let us know your ideas, as we combine procedures to save our patients money and downtime whenever possible.

Be sure you give some thought to what your body will look like after surgery, and plan to discuss your expectations with Dr. Jacobs during your consultation.

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