Despite the fact that hormonal therapy helps the growth of the breasts, in many cases this is not enough or does not turn out to be the one desired by the patient. In these cases a breast augmentation is recommended (augmentation mammoplasty).
The male and female thorax have a different morphology and distribution. The male thorax is more conical and has a more lateralized nipple situation and looking a little down, while the female thorax is more oval and has a nipple situation a little higher and more centralized. In transsexual women, depending on breast development, it is often necessary to adapt the shape of the thorax to make it look more feminine, for this the approach to make these changes is the axillary zone because it is more comfortable, more natural and leaves less scarring.
Through an incision in the armpit, the surgeon will place a prosthesis below the pectoralis major with a technique adapted to transsexual women. Since having an more strong pectoral, the prosthesis is more probably to move upwards, for this reason, a larger cavity must be done, allowing to place the prosthesis a little lower.
Then in the post-operative the patient must wear a compression girdle so that the result is the closest thing to the female structure. The most suitable prostheses for these cases are round cohesive gel prostheses that allow the gel to move with gravity just as the breast naturally does.
Type of anesthesia
Type of surgery
Surgical procedure and hospital admission
Blood analysis evaluation
Augmentation mammoplasty is a surgical technique that allows us to increase the size, volume and shape of the breast by placing implants (prostheses). This allows us to convert a flat, male-looking thorax to a female-looking one.
When the prostheses are placed behind the pectoralis major, there is less risk of encapsulation and the result is more natural, they are better covered, they are not palpable or noticeable.
The ideal approach for a trans woman is the axillary zone. This technique allows us to place the prostheses below the pectoral muscle and below the fascia (tissue that surrounds the muscle and is above it) without the need to open it, leaving the prostheses camouflaged by a large amount of tissue. This is reflected in a very natural result, the prosthesis is not palpable, visible or wrinkled (the appearance of rippling is avoided).
The best results are obtained with the placement of round, cohesive gel prostheses. They are very flexible prostheses, the best to place under the axilla and allow a very natural fall of the breast. This type of gel, achieves with gravity to simulate the appearance of the anatomical mammary gland of a CIS woman.
High cohesive gel prostheses (anatomical prostheses) are also usually used, but they cannot be placed by the axillary zone, they must be placed by making an incision around the areola or in submammary zone. This technique does not have the advantages of placement by the axillary zone, it leaves scars and does not have the natural fall that intermediate cohesive gel prostheses have.