I am transitioning, and have been on hormones for about a year with
some breast growth. I would think a small A. At what point should
I be considering breast implants and which type do you prefer?
Dear Alyza (what a pretty name),
Generally speaking it takes about 2 years on properly adjusted
estrogen dosages to max out in “home grown” breast size. By
properly adjusted we like to see blood tests every 3 months, and
lab results of 125 to 150 pg/ml if you have not had an orchiectomy,
and are on.oral or sublingual estradiol. Orchiectomized patients should
be in the range of 100 to 125 pg/ml.
If you are on injectable then we favor a blood test being drawn a perfect
week after injection (peak and trough (not fairly representative).
If you are happy with your medically induced result you can temporize
or avoid surgery. If not, we favor the subpectoral approach to help
conceal the implant and avoid the “double bubble” effect.
Silicone implants are somewhat more expensive, require a larger
incision and if you follow FDA guidelines need an MRI scan every 3
years to rule out occult rupture. I am of the opinion “walking”
a larger silicone implant through a small incision (finger after finger)
could possibly indue subtle tears or injury to the implant membrane.
The last thing you want associated with a beautiful implant result is
a prominent scar.
Harold M. Reed, M.D.
The Reed Centre for Ambulatory Urological Surgery – Miami