MTF Top Surgery: Overview

Written by Dr. Jacobs

If you’re transitioning from male to female, or thinking about adding a little volume to create a more androgynous look, we welcome you to come in for a consultation. No matter where you may be in the process, we can help. If you’re just getting started, we can educate you about top surgery so you’ll have the information you need to weigh your options. If breast surgery is already part of your plan, we can review the procedure in detail and create a surgical strategy for you.

Dr. Elliot Jacobs, a board certified plastic surgeon with more than 30 years of successful practice in Manhattan, is a good choice for transgender individuals. He and his talented, caring staff work with almost equal numbers of men and women, as well as with patients of varied backgrounds, physiques and lifestyles. Why not contact him online to make an appointment?

Our MTF Surgery Philosophy

Dr. Jacobs derives great satisfaction from helping his patients refine their appearance to reflect the way they feel inside. Whether that means working with a mom get her pre-pregnancy body back, banishing man boobs for a body builder or resculpting skin for someone who has lost weight, he enjoys the process and takes pleasure in his patients’ satisfaction with the results.

Transgender individuals appreciate the way Dr. Jacobs listens. When you meet with him, he will ask about both the physical and psychological aspects of your journey. He’ll want to know whether you’re taking hormones, for instance, and about counseling and other supportive activities you might be involved in. He believes that generally his patients know what’s right, but since top surgery is a big step, an open, honest discussion is important.

Male to Female Surgery Overview

If you choose to move forward with top surgery in New York, there are several details you and Dr. Jacobs will decide together. Here are some aspects of transgender surgery to consider that cover the basics of breast implants.  If you should be considering adding a relatively small amount of volume, it's possible that fat transfer might be an option.  The best way to decide what's right for you is to come in for a consultation.  Dr. Jacobs will take all the time you need to work with you.

• Breast Implants
  For most patients, breast implants play a key role in man to woman surgery. Dr. Jacobs works with both silicone and saline-filled implants. Each type is safe and has advantages. You can read more information here.
  
  Silicone implants are often a good option for transgender patients. Those undergoing man to woman surgery may not have much existing breast tissue to cover implants, which can mean that today’s cohesive silicone gel implants create the most natural look and feel.
  
  Implant size is another important decision, and one that some people struggle with. Obviously you want to be larger, but there’s a down side to going too big. Dr. Jacobs will help you with this. He’ll point out all the factors that affect the choice, such as the shape of your rib cage and quality of your skin, and talk with you about how natural you want to look.
  
  This discussion about implants will be an exciting part of your consultation! Dr. Jacobs will show you both silicone and saline models, and help you try on sizers. You’ll begin to get a sense of how you will look after breast augmentation.
   
• Implant Placement
  You may not be aware that there’s a choice of implant placement as well as all the other decisions about top surgery. You and Dr. Jacobs will talk about whether above or below the chest muscle is best. It depends on the results you have in mind and the foundation your body provides.
  
  Here’s some general information you can think about. Many MTF surgery patients opt for breast implants below the muscle because this location yields a natural look. The “pecs” tend to soften the edges of implants, and it’s thought that placement below the muscle reduces some implant risks.
  
  If your chest muscles are large, however, implants placed on top can help disguise them. Implants located here will also not distort when you flex.
  
  Don’t worry too much about this aspect of surgery before your consultation. Dr. Jacobs will show you what to expect and be sure you understand the pros and cons. With a personal examination, he will be able to make a recommendation for you.
   
• Incisions and Scars
  Implant and placement decisions will determine where your incisions will be located. Should you choose saline implants, you may have very small incisions because the devices are filled after insertion. The resulting small scars are certainly a plus.
  
  Many plastic surgeons favor incisions beneath the breast for best access, however, and this location is best for silicone gel implants. Your scars would be larger, but most patients find them acceptable after they heal completely. Scars fade to be thin, light colored lines most often, and since your breasts will be larger than before, scars will be hidden to some extent in the fold beneath.
   
• Skin Elasticity
  Most people who elect MTF transsexual surgery have skin that’s elastic enough to cover small to medium size breast implants. If your skin cannot do this, or if you choose larger implants, it could be that surgery in two stages is the right strategy. In this case, you would have temporary implants placed first, then larger models in a second operation.

Taking the Next Step

If you’ve been thinking about MTF top surgery as the next logical move in fully embracing your identity, come in to see Dr. Jacobs. He looks forward to getting to know you and helping you reach your goals. Remember, your consultation is an information exchange—the decisions are yours. Whether you choose to schedule surgery, opt to think it over or decide against the procedure, your appointment will be time well spent.

Call us at 212-570-6080 when you’re ready. Or, if you prefer to start a conversation online, contact us via email. You can also learn more about risks and results and what you need to know before and after surgery in the meantime.