What will my breasts look and feel like after implants?
Surgically augmented breasts typically look and feel different than non-implanted breast. Augmented breasts tend to be further apart, firmer, and rounder than naturally developed breasts. This is particularly true for MTFs or non-trans women who get implants later in life, as their breasts have not gone through the age-related process seen in non-transwomen without implants (with age the skin stretches and the breastsroop).Additionally, MTFs often have larger chest muscles and a wider chest than non-trans women. Working with a surgeon who understands how MTF skin, muscle shape, and breast development is different than in non-trans women can be helpful in deciding on an implant shape and technique that will get the result that looks and feels like you want it to.
What are breast implants made from?
In Canada most breast implants are filled with saline (salt water) or silicone. As part of thinking about whether or not to get implants, it is important to be realistic that all types of breast implants commonly leak or rupture and need to be removed. According to Health Canada:
Breast implants are not considered to be lifetime devices…you will likely need additional surgeries and visits to your surgeon over time. At some point, your implants will probably have to be removed, and you will have to decide whether or not to replace them.Implants stretch the skin. If you have implants removed and do not replace them, your skin will likely be wrinkled, dimpled, or puckered.
Timing of breast augmentation
Estrogen can significantly change breast size and shape in some MTFs.While breast growth starts soon after taking estrogen, it is slow and gradual, and it typically takes two or more years for breasts to reach their maximum size. If you can take hormones, it’s recommended that you wait at least 18
months, to give your breasts time to develop with hormones.Hormonal development will help your nipples grow, and will also stretch out the skin of your chest so you can have a more natural looking implant.Implants look more natural if they’re used to augment existing breasts,rather than implanted into a flat chest.
Some MTFs can’t take hormones for medical reasons, don’t want the side effects of hormones, or just want breasts without the other effects of hormones. Implants can be an option if you can’t take hormones. You will need to work with the surgeon to find a size that will look balanced with your nipples, as they will still be small.
Breast surgery can be done as a first (or only) step in surgery, or after you’ve already gone through other types of SRS (e.g., genital surgery). In BC, MTF breast augmentation is usually done as a single surgery, but in SRS programs where there is a team of surgeons working together, it can
be done at the same time as genital surgery to reduce the number of times you have to go through general anesthetic. The new SRS program that is under development in Vancouver is aiming to offer MTFs the choice of having both surgeries done together.
What to expect before and after breast augmentation
At the hospital
If you are getting breast implants alone (not with genital surgery), you will most likely be admitted to hospital the same day as your surgery. You may be asked to come to the hospital the day before surgery to go over information about the surgery and to have a last-minute physical checkup. You will be told not to eat or drink after midnight the night before you have surgery.
After your surgery, you will be monitored by hospital staff as you come out of the anesthetic. Breast augmentation is a relatively simple procedure and you will probably be sent home the same day as surgery with medication to help control pain. You will need to have someone drive you home or take a taxi, as it’s not safe to drive right after surgery (when you’re still woozy from the anesthetic). You will probably be given antibiotics in the hospital to help reduce the risk of infection as your wounds are healing.
After breast surgery
You will wear a special bra and leave the surgical dressings on for 3 days after surgery. After 3 days, you can take the gauze pads off. There will be adhesive tapes (“steri-strips”) along the incision line; leave these on. At this point you can shower, being careful not to soak the steri-strips (it’s OK if they get splashed with a bit of water, but don’t run water directly over them). After showering, gently pat the steri-strips dry. They will fall off on their own in 7–10 days.
It is normal for the incisions to be red, but the redness shouldn’t go beyond the incision for more than 1–2 cm (if this happens, see a doctor right away, as it can be a sign of infection). It is also normal to see or feel the knot in the stitches at the end of the incision. The stitch knot is not a problem; it will either dissolve on its own or come to the surface of your skin, in which case a doctor or nurse can clip it free.
A medium level of bruising and swelling is normal. Your breasts will probably feel sore and swollen for at least a month after surgery. If you have a large amount of swelling, see a doctor. Feelings of sharp shooting pain, burning pain, or general discomfort are common as part of the healing process and will eventually go away. Usually serious discomfort passes 1–2 days after the surgery. Three to five days after surgery, you can start special breast massage exercises that your surgeon will show you.
You can go back to your usual routine when you feel well enough to do so (i.e., normal movements don’t cause pain). This is typically 1–2 weeks but can take longer in some cases. You should avoid any activity that is vigorous enough to raise your heart rate for 3–4 weeks.
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