Hi, I am a trans-woman and am currently a 36A. I want to have a natural looking 36C after my breast augmentation surgery. From my research, I learned that many surgeons recommend placing the implants in the submuscular regions of the chest in smaller-framed women. I am 112 lbs, and 5 feet 9 inches. Do you recommend placing the implants in the those areas? Also, do you believe that the benefits from inserting the implants in the submammary folds outweigh the risk of hyper-pigmentation?
The best argument for inframammary incisions is the lower risk of biofilm exposure from the nipples/ducts when compared to the periareolar approach. The IMF scar usually heals quite nicely both in cis- and trans- patients. Trans patients may have stronger muscle mass but because they usually do not have substantial breast volume (even after hormone therapy), subglandular placement is not advisable in my opinion due to the risk of exposure and capsular contracture.
It sounds like your research is giving you good answers! Happy to help. Good luck with everything whichever surgeon you choose!
Published on Jul 11, 2012
Yes, it does "hide" the implants better but I feel it is more unnatural for you have a bulge on top. You could even have a shaped implant put in but these are more expensive.
Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery
Newport Beach, San Francisco,Miami, Italy, Anguilla
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Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine)
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Published on Jul 11, 2012
Thank you for the question.
Ultimately, carefully communicating your goals (in my practice, I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the the plastic surgeons ability to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion regarding your desired goals with your plastic surgeon. This will be critical in determining breast implant size/type/profile, and will most likely help in achieving your goals.
In my practice, the using “goal” pictures (and breasts that are too big or too small) is very helpful. For example,
I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes for an outcome that you will be very pleased with.
Tom Pousti MD
www.poustiPlasticSurgery.com
619-466-8851
Published on Jul 11, 2012
Yes, it is important to put the breast implants beneath the pectoralis muscle to reduce the incidence of fibrous capsular contracture with the implants. A capsular contracture results in firm or even hard breasts. Hyperpigmentation is not associated with breast augmentation in my experience.
Michael Eisemann M.D.
Plastic Surgeon
Houston, Texas
Published on Jul 11, 2012