Many transgender women and nonbinary people are often faced with the uniquely individual decision of how to address their chest dysphoria. While some transgender women use hormone therapy to stimulate breast growth, they oftentimes don’t achieve what they consider an adequate breast size. Still, others use padded bras or artificial breasts, and others look for more permanent solutions like MTF top surgery.

To address chest dysphoria and align your gender identity and physical characteristics, one of the biggest strides you can take is MTF top surgery. But what does it mean to take this step, and how do you know if you’re ready to take this leap? There is quite a bit of information you should know before getting your MTF top surgery, and below, we discuss how you can determine if you’re ready for MTF top surgery and how you can prepare yourself for the procedure.

At Zinsser Plastic Surgery, Dr. John Zinsser and our expert team are here to help you navigate your MTF top surgery journey to help you achieve your aesthetic goals so you can finally feel comfortable in your own skin.

What Is MTF Top Surgery?

The goal of MTF top surgery is to increase breast size and change the shape of the chest to help you feel more comfortable and confident. By aligning your internal sense of self with your external physical characteristics, MTF top surgery, or transgender breast augmentation surgery, can provide you with an elegant, natural-looking figure and improved self-esteem.

In the procedure, Dr. Zinsser will create a beautiful, feminine chest contour by placing saline or silicone breast implants. During your initial consultation, Dr. Zinsser will answer your questions, address your concerns, and customize a treatment plan tailored to achieve your unique goals.

How Do I Prepare My Body for Top Surgery?

One of the most essential steps to prepare for top surgery is to meet with a board-certified plastic surgeon who is highly experienced with breast procedures. During your consultation, your surgeon will explain your options and their possible results. They will also provide you with a thorough list of activities to help you prepare for your MTF top surgery. Here are some examples.

• If you haven’t already been consuming a nutritious diet, now is the time to modify your eating habits. Before surgery, focus on preparing your body with nutrient-rich foods, including fresh vegetables, lean proteins, and low-sodium foods.
• Starting a healthy exercise program prior to your top surgery can help not only get your body in better shape, but it can also help make your recovery process more manageable.
• Quit smoking, vaping, or using other nicotine products at least one month prior to your surgery. Tobacco and nicotine affect the body’s healing process and can significantly impact your recovery and results. It’s also vital to remain smoke-free for at least one month after surgery.
• If you are seeing a mental health provider, continue that practice. During your MTF top surgery preparations, a therapist can help you with coping skills that may be crucial during this transition.  
• About two weeks before your procedure, stop taking herbal supplements, especially those that contain garlic, fish oils, ginseng, or zinc. You should also avoid taking medicines that contain aspirin, as they can cause additional bleeding. During your consultation, your surgeon will advise you on how to proceed with the medications you currently take.
• Limit caffeine and alcohol consumption for at least two weeks. Avoid alcohol altogether for at least 48 hours before your procedure.

Plan for Your Recovery

Recovery is one of the most important aspects of any surgical procedure. While you’re preparing your body for top surgery, it’s a good idea to prepare your environment. Here are some tips for planning a safe and healthy recovery.

• Fill any prescriptions a week prior to your surgery, including pain medications or antibiotics.
• Have your support system lined up. Arrange for someone to stay with you for the first few days as you may need help doing simple physical tasks.
• Rest is crucial following surgery. Create a comfortable, relaxing place to rest with plenty of entertainment.
• Arrange essential items in advance. Due to restricted range of motion, you won’t be able to reach items on high shelves. Ensure you can easily reach items you’ll need.
• Have plenty of pillows to sleep with your head or upper body elevated per your surgeon’s recommendations.
• Preparing nutritious meals in advance that may be frozen and easily reheated is a good option to ensure you’re not worried about food prep during recovery. If you aren’t handy in the kitchen, consider signing up for a meal delivery service or ask someone for help with meals.

How Long After Starting HRT Can You Get Top Surgery?

Hormone replacement therapy (HRT) aims to increase breast growth before breast augmentation to help you achieve optimal results. Breast growth stretches your skin and other tissues, making room for breast implants. If your breasts haven’t grown large enough with HRT, you may need to have tissue expanders placed prior to your surgery.

Unless you have a medical condition that contraindicates hormone therapy, most patients should be on HRT for at least a year prior to MTF top surgery to allow for maximum breast growth.

What Should I Not Do Before Top Surgery?

While your surgeon should provide you with a list of activities to avoid prior to your MTF top surgery, here are some examples.

• Smoking, vaping, or using any other nicotine products prior to your top surgery is prohibited for at least four weeks prior to and following your MTF top surgery.
• Avoid drinking alcohol for at least 48 hours prior to your surgery. Alcohol can thin the blood or interact with anesthesia, leading to serious complications.
• It’s important that you don’t eat or drink after midnight before your top surgery. Make sure to eat a balanced dinner the night before your surgery.
• Even if you’re having trouble sleeping, don’t take any sleeping pills the night prior to your procedure.
• Shower and shampoo before your procedure; however, don’t apply deodorant, sprays, lotions, or creams. Avoid swallowing water or toothpaste when brushing your teeth. Wear your glasses rather than contacts. Remove all piercings before heading to the surgery center.
• Avoid restrictive clothing on the day of your surgery. Instead, wear comfortable clothes that are easy to remove—a loose button or zip up shirt works great.

How Do You Know if You Are Ready for Top Surgery?

The possibility of getting top surgery can be exciting, but it’s normal to also feel scared or uncertain in making this important decision. While some doubt or hesitation can be normal, it affords you an opportunity to evaluate your feelings to ensure you are mentally, emotionally, and physically prepared for the next step.

Before having top surgery, most insurance companies and surgeons will require a letter from your mental health provider that determines you meet the criteria for the World Professional Association of Transgender Health standards, which include:

• Well-documented and persistent gender dysphoria
• The ability to make fully informed medical decisions and to consent for treatment
• You have reached the legal age to make health care decisions—age 18 in the US
• How you manage and control any significant medical or mental health concerns
• Your current support system
• How MTF top surgery may improve your quality of life

Ultimately, the decision of when to have top surgery is yours alone. Advice and support from others, including doctors, mental health professionals, and supportive family and friends, can be immeasurably important; however, only you can make the decision of if and when MTF top surgery is the right choice for you. You must follow your instincts and go with what feels right, but make sure you allow yourself plenty of time to think and avoid getting pressured into a choice you’re uncomfortable with.

Here are a few other factors to help you consider whether you’re ready for your MTF top surgery.

Gender Dysphoria

Gender dysphoria is a continual feeling of distress caused by the physical discrepancy of your biological sex assigned at birth and your gender identity. When determining whether you’re ready for top surgery, you may ask yourself how gender dysphoria is impacting your quality of life. Does the appearance of your chest cause you anxiety, depression, or stress? You may consider creating a list of ways your quality of life could be improved by having top surgery, including better self-image or self-esteem.

Support System

With any surgical procedure, it’s crucial to develop a strong support system. Prior to your procedure and during your recovery, you’ll need assistance from your family and friends, including emotional and practical physical support. Reach out to those who have supported you in the past to determine if they’re willing and able to help you after your procedure.

Mental Health Check

A therapist can help you manage many mental health concerns, including helping you talk through the deeply personal decision to have top surgery. With many physical, mental, and emotional expectations to manage, a therapist can help you handle stress, determine when to have it, and make other informed decisions about your health. Therapists can also help you in setting realistic goals throughout your transition and help you learn what to expect from the process.

Establish Your Gender Identity

MTF top surgery is a major procedure that changes your body permanently, so take adequate time to establish your gender identity before committing to a surgical solution. Exploring your gender identity in a comfortable space can help you make sure you’re making the right decisions for yourself.

Try your best to explore your gender identity for at least a year to determine how you feel before considering surgical intervention. Insurance companies and surgeons may not approve your MTF top surgery until you have been living as your gender for at least a full year.

Seek Advice

When it’s time for your MTF top surgery, one option is to seek advice from others who have been where you are. If you know someone who has had top surgery, ask if they’re willing to answer your questions. Another option for pursuing advice is searching for online support groups. Questions you might consider asking are:

• What advice do you wish someone had given you prior to your top surgery?
• Are you satisfied with your surgical results?
• What was your recovery like?
• What type of adjustments did you make after your top surgery?
• Did you face any discrimination following your top surgery? How did you manage it?

External Factors

When you’re determining when to have your top surgery, you not only need to keep your complex feelings associated with dysphoria in mind, but you may need to take other factors into account. Outside factors that can impact any surgery may include financing, fees, insurance approval, or even scheduling time off work for a healthy recovery.

Why Should I Choose a Board-Certified Plastic Surgeon?

With many options available, finding the right plastic surgeon for your unique situation can be a challenge. There are many factors to consider when choosing your plastic surgeon; they should be professional, sincere, highly experienced, and board-certified. By selecting a board-certified plastic surgeon, you’re choosing a doctor who upholds unsurpassed standards of education, knowledge, and skills.

An additional aspect to consider is the length of experience your surgeon has at performing MTF top surgery. Choosing a board-certified plastic surgeon with an impeccable reputation not only ensures your optimal results but also that your health and safety are in good hands and that you’ll receive proper care before, during, and after your procedure.

Choosing Zinsser Plastic Surgery as Your Richmond MTF Top Surgery Specialist

When you’re searching for a top surgery specialist, finding one who is highly experienced and wholly compassionate is invaluable. At Zinsser Plastic Surgery, we only have one goal: helping you achieve your goals so that you can feel comfortable in your own skin. Dr. John Zinsser and his expert team have developed an inclusive gender-affirming environment where they aim to help you create the more feminine appearance you deserve.Contact Zinsser Plastic Surgery PC at (804) 474-9805 or complete our online form to schedule your MTF top surgery consultation today.