Top surgery is a procedure where you're given a more feminine chest area. Feminising hormone therapy already encourages breast development, but some people choose to also have a breast augmentation procedure to achieve the final desired size and shape of their breasts. Usually, it's best to have been on oestrogen for at least a year to maximise your natural breast growth.
Breast Augmentation Surgery
There are two main forms of breast augmentation surgery:
Breast Implants
This is where a surgeon makes a small incision under the breast, then insert a breast implant. These are made from high quality silicone, or a silicone shell filled with saline. These change the shape, size, and fullness of the breasts. The implants can move (implant migration) or, in the case of the silicone shell, rupture.
Fat Transfer
This procedure increases the breast size by using your own body tissues. This involves removing fat from areas of the body where it isn't wanted, processing it, then reinjecting it into the breasts. The results are often preferred over implants because they can look more natural, and also have no risk of implant migration or rupturing.
Recovery
Immediate Post-Surgery Period
Recovery time and post-op care differ depending on the type of top surgery:
- Keyhole Surgery typically has the shortest recovery, minimal scarring and fewer activity restrictions.
- Double Incision: Involves longer healing, drains, and activity limitations during the early recovery phase..
- Complex Techniques may require longer recovery period, extended activity limitations and additional follow-up care.
Long-Term Healing Considerations
Each top surgery technique carries unique long-term factors:
- Scar maturation and fading can take 6-18 months, depending on individual healing and incision type.
- Sensation may return gradually or remain altered, nipple grafts often have reduced sensitivity.
- Physical activity may need to be modified for weeks to months, especially for athletes or manual labourers.
- Follow-up appointments and potential revision procedures vary based on healing and aesthetic goals.
Risks and Complications
While top surgery is generally safe, it’s important to understand potential risks associated with any surgical procedure. Being well-informed helps you make empowered decisions and prepare appropriately.
Common Risks Across All Techniques:
- Infection at the incision site
- Bleeding or hematoma
- Scarring (hypertrophic or keloid)
- Reactions to anaesthesia
- Asymmetry or uneven results
Technique-Specific Risks
- Free Nipple Grafts: Possible graft loss, pigmentation changes, or permanent loss of sensation
- Keyhole Surgery: Risk of inadequate breast tissue removal or contour irregularities
- Complex Techniques: Longer healing periods and higher chance of visible scarring
Cost Considerations
Top surgery costs vary based on several factors:
- Chosen surgical technique: the more complex the procedure the higher the cost
- Surgeon experience : Highly experienced or in-demand surgeons may charge higher fees
- Location of Clinic: Prices vary significantly by country or region
- Facility and anaesthesia Fees: Hospital operating room time, anaesthetist services, or overnight stays can add to the total cost
- Post-operative Care: Follow-up appointments, dressings, compression garments or revision procedures may incur additional costs
Choosing a Surgeon and the Consultation
A thorough consultation is an essential step in preparing for top surgery. It ensures that you and your surgeon are aligned on goals, expectations, and safety. Your consultation should include:
- A detailed assessment of your chest anatomy and skin elasticity.
- Discussion of realistic outcomes based on your goals and body type.
- Review of before-and-/after photos of previous patients with similar characteristics.
- Clear explanation of potential risks, benefits and limitations of each surgical option.
- A transparent cost breakdown, including all fees, hospital charges and follow-up care.
- This process is your opportunity to ask questions, express preferences, and ensure you feel confident in your care team.
This article can help you find a surgeon.