Category Archives: Breast implants

Transgender breast implant info sought

Dr. Reed, Would like transgender breast implant info.  Have been on estrogen for 4 years and seems as though my size has maxed out. About an A cup.  Roberta

Dear Roberta,

After you have been on estrogen for about 2 years, you will have achieved maximal “home grown” effect which is usually 1 cup size smaller than your mother or sister.  Please visit our web-site for numerous before and after pictures of transgender breast implants.

Breasts are universally recognized as a symbol of nourishment, love, femininity and sexuality. Breast augmentation is the second most popular cosmetic procedure performed (following liposuction), about 254,000 cases per year in the United States.

If you are a MTF transgendered patient, you will also need a letter of therapy clearance from a licensed therapist ideally with a doctoral degree.

Breast implants (prostheses) applicable for standard implantation are typically saline or silicone. Cohesive gel implants when cut on the laboratory bench maintain their shape and do not leak. Gel implants may require a larger incision. Prostheses come in difference profiles and some are anatomical in shape, i.e. tear dropped, being fuller in the lower pole.

The average expectancy of a saline filled breast implant (prosthesis) is about 16 years. However the likelihood that revision surgery will be performed within 5 years is about 25% across the board. The most common reasons for implant replacement are for request of size change 37%, leakage or rupture 24%, capsular contracture 18%.

Compare this with a 3% incidence of re operation in Dr. John Tebbetts series involving about 1662 patients with a 7 year followup. Careful matching of the implant to the unique anatomical features of the patient explains this.

Generally I subscribe to the Tebbetts formula for appropriate size. Oversizing creates many problems including early drooping (pendulous weight effect) and “double bubble.” A distortion when the base of the implant below is seen distinctly from the base of the natural breast, above, which is of lesser circumference.

Breasts as they occur naturally are not perfectly symmetrical, “sisters not twins.” Some balance can be achieved by differential filling and placement. Cleavage does not occur naturally and attempts to place implants so close as to achieve this may result in synmastia, the touching of one breast prosthesis against another.

The subpectoral approach is desired especially when pinched skin thickness is narrow in the upper pole (that breast tissue above the areola). This provides greater coverage of the implant. However, an implant is seldom entirely covered by the pectoralis muscle and is really bi-planar, partially sub-glandular in the lower outer quadrant where the pectoralis muscle is absent.

Athletes should avoid a subpectoral approach as it might impede pulling.

The two most popular in incisions are inframammary and periareolar. Other procedures include transaxillary (through the arm pit) or transumbilical.

The early detection of breast tumors may be slightly enhanced with prostheses although there may be some technical problems with compression during mammography.

Scarring can be minimized by taping over the incisional area for 3 months. Saline breast implants are inserted collapsed (like a cigarette) so a smaller incision is required.

Massaging post implantation may reduce capsular contracture which can occur in 8 percent of patients, but can also result in some migration secondary to broadening of the pocket.

Anticipate a variable degree of pain for 3 or 4 days, associated with tissue stretching.

Our office will be happy to provide additional counseling at the time of consultation.

Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery | Dr. Harold Reed | Miami

1/1 - Before

Breast implant before picture (patient of Dr. Reed)

1/2 - After

Breast implant after picture (patient of Dr. Reed)


FAQ | Breast augmentation | The Reed Centre | Miami

Dear Reed, Does is make a difference which procedure I have first, breast implants or sex reassignment vaginoplasty (bottom surgery)? Janice Dear Janice, Thank you for see our many sexual reassignment surgery before and after pics on  It makes no difference which surgery you have first. We do male to female sex change bottom…Continue Reading

“Wish to live as a woman. Had unilateral orchiectomy and breast biopsy. Seeking vaginoplasty and breast implants”

Dr. Reed,  “Wish to live as a woman.  Had unilateral orchiectomy and breast biopsy. Seeking vaginoplasty and breast implants”    Susannah Dear Susannah, This sounds awfully familiar and was re-posed under comments.  Please provide some background.  What did the breast biopsy show?  Is there a history of breast cancer in the family?  Have any followup studies…Continue Reading

Fat transfer for breast enlargement vs. breast implants

Dr. Reed, Should I consider fat transfer as a way to enlarge my breasts or do you favor insertion of breast implants for a transgendered woman.?  Lorraine Hi Lorraine, Unless performed by a very skillful doctor, or maybe used as a touch up for a non-filled area, I would discourage fat transfer. The reasons being fluids tend…Continue Reading

Breast implants, how large can you go?

Breast Implants Augmentation mammoplasty typically involves breast implants to increase the size of your breasts or restore breast volume that has been lost after weight reduction or pregnancy. We work with cohesive silicone gel implants or saline filled implants. Saline implants have the advantage of lower cost and that the filling range is flexible. When…Continue Reading

Do you work with Jim Collins Foundation, seeking vaginoplasty grant

Dear Dr. Reed  Hello, i have been on hormones for 3 years, and i’am very far along with transsexual conversion. Specific_Questions: Yes Dr. reed i’ have gone to The Jim Collins Foundation to help pay for my sexchange, MTF.. And in order to complet my application with them i need’ed to know the price and…Continue Reading

Male to Female surgery cost for vaginoplasty and breast implants

Dr. Reed, why are your Male to Female Surgery costs lower than other transgendert surgeons  in the United States? Geraldine Dear Geraldine, Our Male to Female Vaginoplasty fee as published on our web-site is $14,500 and occasionally we do have promotional offers.  Doctors who own their surgery center, as we do, can be very accommodating on…Continue Reading

Breast implants, best size

Dr. Reed,  What size breast implants do you recommend?  Sally Dear Sally, Breasts are universally recognized as a symbol of nourishment, love, femininity and sexuality.    If you are a transgendered woman, ideally you should be on estrogens for 2 years to stimulate maximum home grown breast development.  It is always best to place the implant…Continue Reading

Any sex change surgery male to female pictures

Dr. Reed,  I am looking for gender reassignment surgery before and after pictures. Are you able to show any from your own practice at the Reed Centre in Miami?  Why does a patient’s weight have some much impact with whether you can accept a patient who otherwise is ready for surgery?  Marisha Dear Marisha,  We…Continue Reading

In the “wrong body” lady seeking male to female transsexual surgery

Dear Dr. Reed,  Know I need male to female transsexual surgery.  Yes get back to me i have been a man for along in the wrong body not doing so good. Marlena Dear Marlena, Male to female transsexual surgery is the  specialty of the house.  We usually do several cases (vaginoplasty, orchiectomy, and breast augmentation)…Continue Reading