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What to Expect with MTF Top Surgery

What to Expect with MTF Top Surgery

By Beverly Fischer on March 20, 2023

Gender Affirmation Back to Blog

Since the beginning of civilization, women’s bodies have been revered for their voluptuous curves, soft skin, and graceful movements. Men’s bodies have been similarly prized for their musculature, chiseled contours, and boldness. Both bodies are beautiful and beautifully different in their uniqueness. So when your gender designation at birth means you will become a man someday, but you know deep down that you’re destined to be a woman, what do you do?

That’s where gender affirming care comes in.

What is Gender Affirming Care?

This term refers to surgical and non-surgical procedures, as well as a variety of social, behavioral, and psychological treatments to help a patient ensure that their outer body aligns with their inner gender identity, or what’s known commonly as their “affirmed gender.” Called gender dysphoria/incongruence, this feeling is a clinical condition listed in the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM), with symptoms like “strong” desires to have the primary or secondary sex characteristics of another gender and be recognized as another gender, as well as “significant distress or impairment in social, occupational, or other important areas of functioning.”

If someone is assigned a different identity at birth, gender affirming care ensures that they can be the man, woman, or non-binary person they’ve always wanted to be. The American Psychiatric Association (APA) explains that this identity encompasses a large spectrum, including man, woman, a combination of those, neither of those and fluid identities. A number of organizations list guidelines for providing gender affirming care and therapy, including the WPATH, the AAP, and the Endocrine Society

The interventions used to make the transition are varied in scope and scale. They may include more minimal changes like behavioral counseling and speech therapy and range all the way up to full-body transformations through top and bottom surgeries. Many times a psychological evaluation must be performed before undertaking some of the non-reversible or not easily reversed surgical procedures. In fact, prior to having top surgery, the majority of insurance companies and surgeons need a letter of support from the patient’s mental health provider to ensure that the patient meets the World Professional Association of Transgender Health standards of care criteria, listed as follows. You must:

  • Have persistent, well-documented gender dysphoria

  • Be able to make a fully informed decision and consent to treatment

  • Have reached the legal age to make healthcare decisions in your country (age of majority or age 18 in the U.S.)

  • Be managing any significant medical or mental health concerns


What Is MTF Breast Augmentation Surgery?

There are a number of surgeries that a male might consider to complete his transformation, including facial feminization or tracheal shaving as well as breast augmentation and body contouring. No matter which MTF surgery (or surgeries) you may choose, you need a letter from your psychiatrist or therapist stating you are of sound mind and good judgment. At the Advanced Center for Plastic Surgery, Dr. Fischer specializes in these gender affirmation services, and she and her team have witnessed firsthand their life-changing power.

One of the more common surgeries in a male-to-female gender transition is top surgery, or MTF breast augmentation surgery, also known as feminizing breast surgery, breast augmentation, chest construction, or breast mammoplasty. Women’s bodies are traditionally known for their larger, softer breasts, and this procedure helps shape and augment a male’s breast tissue so that it has the roundness and softness of a female breast.

There are several ways to create this feminine chest. A surgeon can add breast implants under the chest tissue.  Depending upon the amount of augmentation, Dr. Fischer can recommend different types of implants and discuss the best incision site. She will work with you to craft a plan that makes the most sense and then expertly shape the breast contour using advanced tools and techniques designed to minimize scarring and maximize longevity.

Related: Breast Implants: What You Need to Know.

What’s the Recovery Like?

Directly after the surgery, you’ll receive supportive bandages and a special compression garment engineered specifically to aid healing. Any discomfort you experience can be alleviated with prescription medicine. For the first week, we recommend plenty of rest and avoiding any strenuous activities. Since you’ll be taking medications, you will not be able to drive, however we encourage as much walking as possible. After about six weeks, you can pick up your workout regimen again, and any small scars should fade within the next year. You are free to resume your regularly scheduled life, although now you’ll have the body that you’ve been waiting to unveil!

Dr. Fischer and her team love helping their patients reveal who they have always been on the inside. After a lifetime of living with the desire for their outer appearance to match their inner on so many levels, it is humbling and beautiful to watch them finally realize their dreams. We are so grateful to be a part of so many people’s journeys to finally realize their full selves. If you are interested in learning more about MTF breast augmentation surgery, please let us know. We would be honored to help you become the incredible person you already are inside.


Advanced Center for Plastic Surgery | (410) 308-4700 | Website | More posts

Dr. Beverly A. Fischer is passionate about her role as a leading female plastic and cosmetic surgeon in Baltimore, Maryland and beyond. She believes that plastic surgery makes a positive, life-changing difference, whether you’re renewing your body, face, and skin or embarking on an entire gender transition.

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