MTF (TOP SURGERY) - Thomas G. Crabtree, MD, FACS
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MTF (TOP SURGERY)

The transgender person who chooses to have breast augmentation (commonly referred to as “top surgery”) takes a major step in establishing a feminine identity. This is a procedure in which plastic surgeons like Dr. Crabtree shape the breasts to achieve a more feminine structure using breast implants.

 

The surgical procedure for male-to-female (MTF) transgender breast augmentation is similar to traditional breast augmentation. It involves similar decision-making processes and surgical techniques.

 

One primary concern the MTF patient may have is whether there will be enough chest skin to accommodate the newly-enlarged breast area. The nipple-areola complex placement in MTF patients requires special consideration to properly create a feminine shape. The genetic male nipple-areola complex is more lateral and smaller in size when compared the genetic female. Dr. Crabtree will help you decide on the size of implants to match your natural anatomy, as well as any adjunct procedures.

Your Consultation

Dr. Crabtree accepts referral patients from the Lavender Clinic and other supportive clinics.  After receiving the referral, our staff will set up your initial consultation. During your consultation with Dr. Crabtree, you will be counseled on exactly what to expect from your top surgery. To begin, he will examine your breast and torso skin, assess your breast tissue and evaluate your medical history, medications (including current testosterone use), prior surgeries, drug sensitives, lifestyle and habits.

 

MTF breast implants are usually silicone or saline and there are sizes depending on your augmentation goals. Breast implants can be selected to give a low, moderate, or high projection and either a round or anatomical shape. Dr. Crabtree will also discuss the positioning of your implants (behind the breast tissue, or partially or completely under the chest muscles.

 

From there, Dr. Crabtree will explain the surgical approaches and anesthesia options that are available to you. He will discuss the pros and cons of each method, and help you make an informed decision that is in your best interest and can deliver the feminine chest you desire. He’ll talk to you about the risks associated with surgery, and make sure you’re entirely comfortable with the process before moving forward. He and his staff will then counsel you on all the pre- and post-operative, recovery and follow-up steps you’ll need to take to ensure an optimal outcome.  You will have photos taken to submit to the insurance company for the pre-authorization process. This process can take a week to up to a month to get a decision. Dr. Crabtree can also provide you with a proposal for surgery if the insurance company denies coverage for the procedure.

Your Procedure

Traditionally, the surgery is performed using a small incision along the natural crease of the breast. Your implants will be placed and the incisions closed with sutures. After the procedure, Dr. Crabtree will apply dressings to the incision wounds and place an supportive binder around you.

 

Your top surgery generally takes about two to three hours depending on the procedures planned and will be performed under general anesthesia administered by a Board-Certified Anesthesiologist or a Board-Certified Nurse Anesthetist at Windward Surgery Center in Kailua, Hawaii.

Your Recovery

You will be encouraged to begin walking as soon as possible after surgery, but it’s important to avoid strenuous activity until you’re fully healed. In about one week, Dr. Crabtree will have you return to his office where he will evaluate your progress.

 

Throughout the initial recovery period, some discomfort in the treatment area is to be expected. The results of your surgery will be evident immediately and should continue to refine over the next several months as post-surgical swelling resolves. During your post-operative appointments, Dr. Crabtree will provide you with detailed steps that you can take throughout your individual healing process to optimize your recovery.