FFS and Breast Augmentation

For transwomen and transfeminine people, the face and breasts are often the two most important areas to enhance in order to affirm a feminine identity. These parts of the body are often focal points for gender dysphoria, and it is for this reason that many individuals wish to combine facial feminization surgery with breast augmentation. Dr. Deschamps-Braly and Dr. Xu each have extensive experience in these procedures, and offer a unique experience for trans patients who wish to undergo both procedures at the same time.

Facial Feminization Surgery

feminization surgery
 (FFS) may refer to several or a combination of
individual procedures designed to create a softer, more feminine appearance.
Dr. Deschamps-Braly understands the subtle differences that create a more
feminine or masculine appearance and has advanced training and experience in
this surgery. The procedures and plan vary from patient to patient depending on
their unique facial structure, insecurities, and aesthetic preferences and
goals. Dr. Deschamps-Braly will help guide you to the specific procedures that
are best suited to you.

Your FFS Surgery Options include:

Gender-Affirming Breast Augmentation

Breast augmentation for trans patients is also commonly called male-to-female (MTF) top surgery. While similar to a standard breast augmentation, there are some unique considerations for trans patients receiving the operation. Dr. Ginger Xu is uniquely trained and experienced in performing breast augmentation for male-to-female transgender patients.

Creating a Feminine Breast

MTF top surgery is accomplished by using breast implants and
techniques that are virtually the same as any other breast augmentation.
However, transwomen typically share the following characteristics which require
special attention and should be addressed by their surgeons:

  • Smaller nipples and areolas
  • Wider-set nipples and breast tissue
  • Higher, ill-defined, or constricted breast folds
  • Lower overall breast volume
  • Thicker chest muscles

For these reasons, more care must be taken in the position and size of the implants, the surgical method, and re-shaping or augmenting the nipples and areola.

Breast Implant Options

Breast augmentation can be completed using either saline or
silicone implants, which have their own advantages and disadvantages.

Saline implants typically require smaller incisions to
place. In the case of rupture, the breast will deflate and the body will naturally
absorb the leaked saline. Saline implants also have a less natural look and
feel than silicone options. Finally, saline implants tend to be less expensive
than silicone options.

Silicone implants tend to have a more natural look and feel.
In the case of rupture, it will not be obvious as the silicone gel will not be
absorbed by the body and must be removed surgically. A newer type of silicone
gel, known as “gummy bear” implants, is more cohesive than a standard silicone
implant and holds its shape better.

Both saline and silicone implants utilize an outer silicone
shell which may be either smooth or textured, however, Dr. Xu chooses to
exclusively use smooth implants because they do not run the risk of Breast
Implant-Associated anaplastic Large Cell Lymphoma (BIA-ALCL). Either saline or
silicone implants may be round or teardrop shaped. The best option for a
natural looking result will vary from patient to patient.

Finally, patients must choose a size for their implants. Generally, this is determined by “trying on” sizers in a bra. Dr. Xu will advise an implant size that is both suited to your proportions and safe to achieve.

Fat Grafting

Fat grafting is an option for some patients as an
alternative to breast implants. In fat grafting for breast augmentation, breast
volume is created by using fat harvested from the patient’s own body during
liposuction. For transwomen, the fat can be taken from areas such as the outer
regions of the chest, back, flanks, thighs, or abdomen. This simultaneous
creates a more feminine body contour while also increasing the size of the