Debra J. Johnson, MD
95 Scripps Dr, Sacramento, CA 95825 (916) 929-1833
(916) 929-1833

Transgender Breast Surgery Sacramento

Transgender patients may require breast augmentation or mastectomy, depending on their sexual identity. I have welcomed transgender patients in my practice, and am happy to help you achieve the outward appearance that reflects your inner sensibility.

Breast augmentation in transgender patients is relatively straightforward. Surgery is performed on an outpatient basis, under local anesthesia with sedation or general anesthesia. The implants can be either silicone- or saline-filled. Usually, due to the fact that transgender women have relatively little breast tissue, silicone implants tend to feel more natural. Saline implants can be more “feel-able”. Incisions can be along the bottom of the areola, in the bottom fold-line of the breast, or in the armpit.

If the patient needs a fairly large implant to fit her anatomy, then the inframammary fold incision may be required, as the other incisions sometimes can’t accommodate a bigger silicone implant. Surgery usually takes about two hours, and recuperation is about one week. It takes about two months for the implants to settle completely. Scars require 4-6 months to fade as much as they will.

Breast reduction or removal in transgender patients is needed when the breast size is too generous for a man. Many transgender men wear breast corsets to camouflage the breast size. Surgical reduction of the breast tissue allows for more liberal clothing choices, but does also often involve scars on the skin. If the breasts are relatively small, liposuction alone may sometimes be effective. However, there is usually some firm, sub-areolar breast tissue that remains that must be surgically excised. This can be accomplished with either a peri-areolar or inframammary fold line incision. If the areolar diameter is too large, its dimension can be reduced. This results in a scar around the circumference of the areola. If the entire breast skin envelope is large, then skin reduction surgery may also be necessary. This results in larger areas of scarring. Sometimes these scars are fairly innocuous, but in others they remain more visible. Sometimes chest hair can camouflage the scarring adequately so that going shirtless is not uncomfortable. We will need to carefully evaluate your particular anatomy to determine what kind of reduction/scarring is necessary to achieve your goals.

More and more health plans are covering the breast surgery needed by transgender patients. You should consult with your health plan regarding coverage for any desired procedures.

Debra J. Johnson, MD
95 Scripps Dr, Sacramento, CA 95825 (916) 929-1833
(916) 929-1833