Male-to-female (MTF) breast augmentation, or top surgery, is the most popular gender-affirming procedure for a reason. The chest is one of the most visible gender markers, and for trans women, the absence of a feminine silhouette can be distressing. Breast augmentation provides an immediate, transformative change with a relatively simple, low-risk surgery.
Based on Bookimed’s research, this guide covers available options, healing timelines, costs, and expert tips—so you can move forward with confidence.
Table of Contents
- What is MTF Top Surgery?
- MTF Top Surgery Results: What to Expect
- MTF Top Surgery Options
- MTF Breast Augmentation Cost
- Requirements & Preparation
- MTF Top Surgery Procedure: Step-by-Step
- Recovery & Post-Operative Care
- Potential Risks and Complications
- How to Choose the Right Surgeon for MTF Top Surgery
- Key Takeaways
What is MTF Top Surgery?
MTF top surgery is a gender-affirming procedure that creates a more feminine chest shape. It uses breast implants or fat grafting to enhance breast size and contour.
MTF top surgery 🆚 Traditional breast augmentation: What’s the difference?
MTF top surgery uses similar techniques to traditional breast augmentation. However, there is a key difference:
✅ MTF top surgery is specifically designed for transgender patients, considering factors like chest anatomy, skin elasticity, and hormone therapy effects. MTF top surgery may require different implant shapes, placements, and techniques to achieve a natural-looking result based on a wider chest and different pectoral muscle structure.
✅ Traditional breast augmentation is performed on cisgender women and focuses solely on increasing breast volume.
Who is a good candidate for MTF top surgery?
MTF top surgery is ideal for trans women and non-binary individuals who:
✔️ Want a fuller, feminine chest that aligns with their gender identity.
✔️ Have undergone hormone therapy and want additional breast volume.
✔️ Are in good health and have realistic expectations about the surgical procedure.
✔️ Meet surgical requirements, which may include a letter from a mental health professional per WPATH guidelines.
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💡 You may also be interested in the following procedures:
- Technique: Premium MTF Vaginoplasty
- Dr. Pichet Rodchareon Md is a board-certified plastic surgeon specializing in a wide range of gender-affirming surgeries.
- Bangkok Plastic Surgery has performed over 3,000 procedures with remarkable patient satisfaction and functional results.
- Included Services: General anesthesia, medications, post-op medications, consultation with an anesthesiologist, consultation with a surgeon, hospitalization, transfer airport-hotel-clinic-airport.
- Stay Info: 4 days stay in the hospital, 14 days stay in the hotel, both included in the price.
- Technique: High intensity focused ultrasound ablation (HIFU)
- Dr. Baris Nuhoglu provides a wide range of operations.
- AquaHealth Clinic serves 50 patients annually, primarily from Europe and the Commonwealth.
- Included Services: 5* hotel, transfer airport-hotel-clinic-airport.
- Stay Info: 2 days stay in the patient room, 10 days stay in the hotel, included in the price.
- Method: Colon Laparotomy
- Saran Wannachamras achieved a graduate diploma in clinical science from Chulalongkorn University in 1993.
- Wansiri Hospital provides comprehensive sex reassignment surgery services with advanced techniques and personalized care.
- Included Services: Personalized beauty advice, video or text consultation, general anesthesia, preoperative tests, blood tests, follow-up examination, post-op medications, chest X-ray, language assistance, full board, hospitalization, hotel stay, transfer airport-hotel-clinic-airport.
- Stay Info: 7 days in the hospital, 14 days in the hotel, included in the price.
- Dr. Park Young Kyu is a distinguished plastic surgeon recognized for his academic accomplishments and substantial contributions to plastic surgery.
- SAERO Plastic Surgery serves patients from Europe Commonwealth, Asia, the USA, Canada, and Australia.
- Included services: Apartment, transfer is not included.
- Stay info: 0 days stay in the hospital, 8 days stay in the hotel, included in the price.
MTF Top Surgery Results: What to Expect
MTF top surgery is a low-risk procedure with a high success rate. 98.2% of procedures proceed without complications, and 100% of patients don’t require revision surgery.
Despite the short surgical time(2–3 hours), the impact of the procedure is profound—helping transgender women feel more aligned with their identity, increasing confidence, and improving overall quality of life.
✅ High satisfaction rate. 92.7% of transgender women report feeling more aligned with their gender identity and happy with their results.
✅ A feminine chest shape. The procedure reshapes the chest to create a fuller, rounder, and more traditionally feminine contour.
Soft, natural feel.
✅ Soft, natural feel. Silicone implants closely mimic natural breast tissue, while fat grafting offers an even softer, more organic texture. In the months following surgery, implants settle into position, and surrounding tissue softens.
✅ Increased perception of femininity. Studies found that top surgery significantly enhances patients’ femininity. Post-surgery, transgender women were rated almost or equally as feminine as cisgender women.
✅ Reduction in gender dysphoria. 100% of patients report that MTF top surgery has improved their gender dysphoria. For trans women experiencing distress due to a flat chest, surgery can eliminate the need for chest padding or push-up bras to achieve a feminine look.
✅ Better mental health. Patients experience a significant improvement in self-esteem and emotional well-being after top surgery. In general, gender-affirming surgeries lead to a 42% reduction in psychological distress and a 44% reduction in suicidal thoughts.
✅ Minimal and well-hidden scarring. Incisions are typically placed in discreet areas, such as under the breast fold (inframammary) or around the areola (periareolar). Over time, scars fade and can be further minimized with scar treatments, massage, and laser therapy.
MTF Top Surgery Options
Augmentation types
- Breast implants. The most popular and effective option, offers a wide variety of sizes, shapes, and placement techniques.
- Fat grafting. Involves harvesting fat from other areas of the body and transferring it to the chest. While not as common for larger volume changes, it can be used to refine results or add a subtle increase in size.
Though fat grafting can provide benefits, breast implants remain the go-to solution for most trans women seeking MTF surgery.
Breast implant types
There are two primary types of implants:
1. Silicone implants
Silicone implants are the most popular choice for top surgery due to their more natural appearance and feel. These implants are filled with a cohesive gel that maintains its shape, closely mimicking the look and texture of natural breast tissue. While they require slightly larger incisions than saline implants, they are less likely to show visible ripples or wrinkles.
2. Saline implants
Saline implants are firmer than silicone implants and are filled with sterile salt water. They are inserted while deflated and filled after placement, allowing for smaller incisions. However, saline implants are more likely to ripple or become visible through the skin, particularly if there is not enough breast tissue to cover them.
MTF Breast Augmentation Cost
The cost of MTF breast augmentation varies significantly by country. On average, the procedure costs $5,000 to $10,000, but prices can be substantially lower outside the US and UK.
According to Bookimed research, the cost of MTF breast augmentation in the United States ranges from $8,500 to $13,000. However, it is two to five times cheaper in countries like Thailand and Turkey—between $2,500 and $6,000.
❗In the US and UK, prices typically cover only the surgery itself, so patients should factor in additional expenses like consultations, anesthesia, post-op care, and hospital stays. However, medical tourism destinations like Thailand and Turkey offer all-inclusive packages with extras such as accommodation, transportation, and aftercare.
You can compare approximate MTF breast augmentation costs across different destinations in the table below.
Country | Price Range (USD) |
|---|---|
United States | $8,500–$13,000 |
United Kingdom | $10,000 –$12,000 |
Australia | $7,000–$10,000 |
New Zealand | $10,000–$12,000 |
$2,600–$6,000 | |
$2,500–$5,000 |
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Does insurance cover MTF breast augmentation?
About 68% of insurance companies cover breast augmentation for transgender women. However, even if your policy includes coverage, you must still prove it is medically necessary by providing:
- A diagnosis of gender dysphoria from a licensed mental health professional.
- A letter of support from a mental health professional.
- Proof of hormone therapy (typically 12+ months) unless medically contraindicated.
- Evidence of real-life experience living in the desired gender, if required by a mental health professional.
MTF Top Surgery Requirements & Preparation
1️⃣ Eligibility requirements
✔️ 1 letter from a licensed mental health provider confirming readiness for surgery.
✔️ While not mandatory, many surgeons recommend 12 months of estrogen therapy to maximize natural breast development before implants.
✔️ Being at least 18 years old (some surgeons may consider younger patients with parental consent).
✔️ Most surgeons require stable body weight and good general health. Any chronic conditions should be well-managed.
✔️ Standard pre-surgery blood work and chest examination. Some providers may request a baseline mammogram.
2️⃣ Surgery preparation
✔️ Quit smoking at least 6 weeks before surgery. Smoking increases complications and can delay wound healing.
✔️ Adjust your medications. Stop blood thinners, supplements, and estrogen therapy as directed by your surgeon.
✔️ Schedule 2-3 weeks off work for initial recovery.
✔️ Purchase front-closure surgical bras and loose-fitting clothes.
✔️ Maintain healthy habits. Focus on nutrition and hydration in the weeks leading up to plastic surgery.
MTF Top Surgery Procedure: Step-by-Step
MTF top surgery is an outpatient procedure that typically takes 2 to 3 hours under general anesthesia. Most patients go home the same day.
Below is a step-by-step breakdown of what to expect before and during surgery.
1. Consultation & pre-surgical preparation
📌 Initial consultation
- The surgeon assesses body proportions, skin elasticity, and chest structure to recommend the best implant size, type, and placement.
- The surgeon reviews the patient’s medical history, current medications, and hormone therapy.
2. Surgical procedure
1️⃣ Marking the incision site
The surgeon marks incision sites while the patient is standing to ensure symmetry.
2️⃣ Administering anesthesia
General anesthesia is administered for a comfortable, pain-free experience.
3️⃣ Making the incision
The surgeon creates an incision using one of the following techniques:
- Inframammary (under the breast fold) – Most common, allows precise implant placement, and hides scars naturally.
- Periareolar (around the nipple) – Less visible scar but is not ideal for larger implants.
- Transaxillary (in the armpit) – No scars on the chest, but a more technically complex approach.
4️⃣ Creating the implant pocket
The surgeon carefully prepares a pocket behind the breast tissue to hold the implant.
Placement options include:
- Subglandular (over the chest muscle) – Less discomfort and quicker recovery.
- Submuscular (under the muscle) – Provides a more natural breast slope and reduces implant visibility.
5️⃣ Placing breast implants
- The implants are inserted and positioned to create a more feminine appearance.
- In the case of saline implants, they are filled after insertion to achieve the desired volume.
6️⃣ Closing the incision
- The surgeon sutures the incision with dissolvable stitches and applies a surgical dressing.
- A compression bra is placed to support breast implants and minimize swelling.
Recovery & Post-Operative Care
MTF top surgery recovery is gradual, with most patients resuming daily activities within 7-10 days and full healing taking several months.
⏳ First 24-48 hours: Immediate recovery
- Expect swelling, tightness, and mild discomfort, managed with prescribed pain medication.
- You will wear a compression bra to reduce swelling and support the implants.
- Avoid raising your arms above shoulder level, heavy lifting, or sudden movements.
🗓️ Weeks 1-2: Initial healing
- Rest is crucial, but light walking is encouraged to promote circulation.
- Most patients can return to work (non-physical jobs) within 10-14 days.
- Surgical drains (if placed) are typically removed within the first 5-7 days.
- Bruising and swelling peak during this period but gradually subside.
🗓️ Weeks 3-6: Gradual improvement
- Avoid strenuous activities, heavy lifting, and upper-body workouts.
- Continue wearing your compression bra 24/7 to maintain implant positioning.
- Incision scars begin fading, but sun protection is essential to prevent darkening.
🗓️ Months 3-6: Final results
- Swelling fully resolves and breast implants settle into their natural shape.
- Most patients can resume full physical activity by week 6.
- Scars continue to fade, with treatments like silicone gel or laser therapy helping minimize their appearance.
💢 Pain. Mild to moderate discomfort peaks in the first few days and is controlled with prescribed painkillers. After 4-5 days, over-the-counter medications like acetaminophen or ibuprofen are usually enough.
🛁 Bathing and showering. Clean your upper body only with sponge baths until your surgeon clears you to shower. Once approved, avoid direct water pressure on incisions and pat dry gently.
Potential Risks and Complications
MTF top surgery is a safe and commonly performed procedure. However, like any surgery, it carries some risks.
Potential complications include:
- Hematoma (blood collection). A buildup of blood under the skin that causes swelling and discoloration. If significant, it may require drainage.
- Seroma (fluid buildup). Small fluid pockets may develop but usually resolve on their own or with drainage.
- Infection. Signs include redness, warmth, or fever. Most cases are treatable with antibiotics.
- Implant-related issues. In rare cases, implants may shift, rupture, or develop capsular contracture (scar tissue tightening around the implant).
✅ The best way to ensure a safe, successful breast surgery is to work with a trusted specialist. Bookimed helps patients connect with top-rated, verified surgeons worldwide and offers expert guidance throughout treatment.
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MTF top surgery scars
Scarring is a natural part of the healing process after MTF top surgery. Although scars may appear raised and darker in the first few months, they gradually flatten and fade over 12-18 months. With proper care, most become thin and barely noticeable over time.
How to Choose the Right Surgeon for MTF Top Surgery
Selecting the right surgeon for MTF surgery is the most critical factor in achieving natural-looking, safe, and long-lasting results. Here’s how to find a qualified expert and avoid common pitfalls:
1️⃣ Check the surgeon’s credentials
A board-certified plastic surgeon with extensive experience in MTF top surgery is essential. They should specialize in gender-affirming procedures, not just general breast augmentation. Ask how many MTF top surgeries they’ve performed and if they use techniques tailored to transgender patients.
2️⃣ Review before & after photos
Look at real patient photos, especially from those with a similar chest structure to yours. Assess symmetry, implant positioning, and overall contour. If the results look unnatural or heavily edited, consider another provider.
3️⃣ Read verified patient reviews
Look for authentic reviews from transgender patients. Pay attention to mentions of surgical skills, communication, and post-op care quality.
4️⃣ Ask questions during your consultation
Be sure to ask the following:
- What incision type and implant placement do you recommend for my body type?
- How many MTF top surgeries have you performed?
- What’s included in the surgery cost?
- What are my realistic expectations based on my chest structure and skin elasticity?
5️⃣ Ensure the facility is accredited
Choose a certified, high-standard hospital or clinic to ensure proper safety, hygiene, and post-op care. International accreditation adds an extra layer of trust, especially when seeking surgery abroad.
6️⃣ Research the destination
If traveling for surgery, research local laws on transgender rights and choose a facility that offers safe, supportive care.
7️⃣ Look for clear communication & support
Your surgeon should be able to explain every detail of the procedure clearly. If they don’t speak your language, make sure translation services are available.
8️⃣ Understand pricing & what’s included
Ensure the pricing includes consultation, surgery, anesthesia, hospital fees, and follow-up care. Some surgeons charge separately for these. High-quality surgery may cost 2 to 5 times less in countries like Thailand or Turkey, where surgeons offer all-inclusive packages.
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Key Takeaways
👉 MTF top surgery is a gender-affirming procedure that enhances chest femininity using implants or fat grafting, with specific techniques tailored to transgender patients.
👉 The procedure is safe and effective, with 98.2% of surgeries proceeding without any complications.
👉 Surgery costs range from $8,500 to $13,000 in the US, while all-inclusive packages in Turkey ($2,500–$5,000) and Thailand ($2,600–$6,000) offer savings of up to 70%.
👉 MTF top surgery is done on an outpatient basis and takes 2 to 3 hours under general anesthesia.
👉 Full recovery takes 3–6 months, with most patients returning to work within 10–14 days.
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- Johns Hopkins Medicine. Top Surgery (Chest Feminization or Chest Masculinization). https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/top-surgery
- JAMA Network. (2023). National Estimates of Gender-Affirming Surgery in the US. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2808707
- Gland Surgery. (2020). Breast augmentation for transfeminine patients: methods, complications, and outcomes. https://pmc.ncbi.nlm.nih.gov/articles/PMC7347817/
- Annals of Translational Medicine. (2021). Breast augmentation in the transgender patient: narrative review of current techniques and complications. https://pmc.ncbi.nlm.nih.gov/articles/PMC8105870/
- JPRAS Open. (2019). Breast augmentation in male-to-female transgender patients: Technical considerations and outcomes. https://www.sciencedirect.com/science/article/pii/S2352587819300142
- Aesthetic Surgery Journal. (2023). Examining the Impact of Breast Augmentation vs Hormone Therapy on Chest Femininity of Transgender Women. https://pubmed.ncbi.nlm.nih.gov/36342750/
- Harvard T.H. Chan School of Public Health. (2021). Mental health benefits associated with gender-affirming surgery. https://hsph.harvard.edu/news/mental-health-benefits-associated-with-gender-affirming-surgery/