breast augmentation Archives - DeLuca Plastic Surgery - Albany NY

Considering Transgender Top Surgery? What You Need to Know!

Each year, more than 9,000 patients across the United States undergo transgender top surgery. Also called sex reassignment surgery, both FTM (female-to-male) and MTF (male-to-female) variations are widely performed, with patients most appreciating the marked improvement in confidence, body image, and overall quality of life. 

If you’ve been considering transgender top surgery, you probably have questions. Are you a good candidate? What is the preparation and recovery process like? Will this procedure affect any other part of my transition?

At DeLuca Plastic Surgery, we’re here to help. We want to make every procedure as transparent and beneficial as possible. Before you decide on FTM or MTF transgender top surgery, here’s what you need to know. 

a ftm transgender top surgery candidate looking at the camera wearing black

Transgender Top Surgery: MTF

MTF transgender top surgery, also known as transfeminine top surgery or transgender breast augmentation, aims to feminize the patient’s chest by enhancing the size and shape of the breasts. As the latter name suggests, the procedure most commonly involves breast augmentation–or implants–to recontour, reshape, and revitalize the chest for a fuller, feminine look. 

More importantly, for many patients, the procedure means no more wearing artificial breasts or padded bras–or dealing with body or gender dysmorphia. 

Transgender Top Surgery: FTM

FTM transgender top surgery, or masculinizing chest surgery, aims to masculinize the patient’s chest by removing breast tissue. However, the goal is more than just a flat chest–it’s a sculpted, masculine aesthetic. Whereas MTF procedures enhance and fill the breast via implants, FTM procedures reduce and flatten the chest through subcutaneous mastectomy. 

Like its MTF counterpart, masculinizing chest surgery can help alleviate body and gender dysmorphia and avoid the risks and complications of chest binding. 

Portrait of attractive stylish fashion teenager confident and happy with his gender identity. Trans boy posing in cool urban fashion t shirt. In Beauty, Transgender people and Equality concept.

Preparing For Your Procedure

During your initial consultation, we’ll go over your goals, medical history, and overall physical and mental health to ensure you’re a good candidate. 

Before top surgery, most surgeons recommend patients obtain a letter of support from a mental health provider. This letter asserts that patients meet the World Professional Association of Transgender Health standards of care criteria. 

Additionally, like any other procedure, patients must be in good physical health.

Once approved for surgery, patients should discontinue smoking or nicotine use as well as caffeine and alcohol intake. Patients taking testosterone, estrogen, or other hormone treatments may continue taking them depending on your schedule. 

Your surgeon will give more precise instructions on what you can and cannot take as the date of your procedure approaches. 

a ftm transgender top surgery patient post-op showing operative scars

What to Expect During Your Procedure

FTM top surgery is done outpatient under general anesthesia. Depending on your breast size, we’ll work with you to develop the best surgical method for optimal results. 

During the procedure, we’ll make incisions in the skin to remove breast tissue, contour and reduce the breast wall, reposition the nipples and areola, and reshape the chest. 

MTF top surgery is also done outpatient under general anesthesia. Again, depending on your intended breast size, we’ll work with you to develop the best surgical method for optimal results. 

During the procedure, we’ll use silicone or saline implants to augment breast shape and increase breast size to reshape the breasts into a feminine look. 

Both procedures take anywhere from 2-4 hours and patients are free to return home post-procedure. 

Recovery & Outlook

Recovery time varies from patient to patient, but most patients can return to work within a week or two post-procedure. 

For most patients, the first-week post-procedure is the most uncomfortable, but most side effects, including swelling, discomfort, and soreness, typically subside within a few weeks. 

During that first week, we recommend patients sleep on their back and avoid both showering and strenuous activity. To control swelling and discomfort, we recommend the use of an ice pack.

About a week after your procedure, you’ll meet with your surgeon for a postoperative appointment. At this point, we’ll remove the dressing and you’ll get to see your new chest for the first time. 

a transgender top surgery candidate standing in front of trees

Ready to Schedule Your Consultation?

Research–including scientific studies–has found an overwhelming majority of patients approve of their decision. Less than 1% of study participants expressed regret. The consensus is clear: FTM and MTF transgender top surgery helps patients achieve a new lease on life. 

DeLuca Plastic Surgery is proud to offer the most advanced, cutting-edge techniques in FTM and MTF transgender top surgery. From your initial consultation to your stunning results, we’re in your corner to answer all your questions, alleviate your concerns, and improve your confidence, body image, and quality of life. 

If you’ve been thinking about transgender top surgery, don’t wait. Schedule an in-person, phone-in, or instant email consultation with us today! 


Is Fat Transfer Breast Augmentation Right For You?

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Woman in bra with measuring tape

Typical breast enhancements involve the use of either saline or silicone gel placed under or over the muscle through an incision in the breast. Breast augmentation surgery with fat, on the other hand, is a newer procedure and could be a great option for patients looking for a relatively modest increase in breast size and more natural-looking results.

What is fat transfer breast augmentation?

Fat transfer breast augmentation involves using liposuction to harvest fat from other areas of the body, like the belly, waist, back, or legs. That fat is then cleaned, filtered, and transferred to the breasts. This allows patients to enjoy double results; excess fat is trimmed from unwanted areas and used to increase the volume of breasts naturally. In a nutshell, it’s just what the name suggests: transferring your own fat to make your breasts bigger. 

What to expect before, during, and after the procedure

Before the procedure, we will work with you to determine the type of breast augmentation you’re looking for. Patients with minimal ptosis looking to increase breast volume by about one cup size are typically the best candidates for fat transfer breast augmentation. Importantly, this procedure is not suitable for patients with minimal body fat.

Breast augmentation with fat is an outpatient procedure performed under sedation as well as a local anesthetic. The first step, liposuction, involves harvesting the unwanted fat from predetermined, marked areas. We will then drain the excess fluid and clean the harvested fat. Finally, we will make small incisions in a circular pattern around the breast, through which we transfer the cleaned, filtered fat. Finally, we close the incisions and you wake up, spend a brief amount of time recovering, and go home. 

Compared to traditional breast augmentation, recovery from fat transfer breast augmentation is more focused on the areas from which the fat was harvested. To reduce pressure on the breasts, we recommend avoiding sleeping on your chest for at least four weeks post-procedure. Exercise can start about a week after the procedure, with full activity resuming four weeks post-op. Patients can expect to see the best results after about three months. 

Woman in bra with orange

The benefits of fat transfer breast augmentation

Using a patient’s own fat to enhance their breasts has numerous benefits. First off, think of the procedure as a two-in-one; patients receive liposuction to remove unwanted fat and use that fat to improve the shape, look, and feel of their breasts. There are no large incisions to heal or hide, the surgery does not cut or change the position of the muscles in the chest, and there is no risk of implant-related infection.

Interested in fat transfer breast augmentation?

At DeLuca Plastic Surgery, we tailor every procedure to each patient’s individual desires. We can work with you to help you achieve the breasts you’ve always wanted. If you’ve been thinking about breast enhancement, contact our office today to see if fat transfer breast augmentation is right for you!

Get more details on the management of swelling and scars in blog post: Post-Operative Care After Plastic Surgery.


Do I Really Need A Breast Lift?

The decision to do a breast augmentation without lift versus a breast augmentation with a breast lift, however, is less based on patient preference and more dictated the saginess, the nipple position, and the ratio between the breast volume and the amount of excess skin that is present.

How Ptotic Are My Breasts?

The gold-standard method of assessing the need for a breast lift is the “pencil test.” Standing in front of a mirror, lift the breast and lay a pencil in the fold under the breast and allow the breast to settle over the pencil. Look at the position of the nipple in relation to the pencil.

Pencil Test For Determining Degree of Breast Ptosis
Pencil Test For Breast Ptosis

The lower the nipples and breast are below the pencil and the more excess skin you have, the greater the chance you will need a breast lift and the more of a breast lift you will need. If your nipple and a majority of your breast are at or above the pencil (Normal), you will likely get a great result from a breast augmentation alone. Larger implants can shift this equation slightly for patients that have borderline ptosis (Grade 1).

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Breast Q&A: What’s the Best Way to Correct Grade 1 Breast Ptosis (Sagging)? Implant, Lift or Both?

Question – What is the best way to correct breast ptosis, high or moderate profile implants, a breast lift or both?

Stage I Breast Ptosis

Breast sagging after pregnancy

I am 36 years old, breastfed 2 kids, and have lost volume in my breasts. I have some sagging but my nipple is still over the fold. I weigh 130 pounds and am very fit and toned.

I am 5″4″ and my breast size is a 34B. Before my kids I was a 34C cup. When I was breastfeeding I was a 34D cup. I would like to be a D cup and wonder what type of procedure would be best to correct my ptosis?


Answer – Since you have a small amount of glandular ptosis (pseudoptosis), you not only want to fill-OUT, but lift-UP a little as well. Therefore, my approach would be a dual plane breast augmentation, which would fill out the inferior/lower pole nicely, give you muscle coverage across the upper two thirds of the breast and a nice, slightly lifted appearance.

More specifically, given your body measurements and photo (which shows pseudoptosis with mild Grade 1 ptosis), I suspect that 450cc moderate plus profile implants are needed to give you both the breast size (D cup) and breast lift you desire.

How To Classify/Grade Breast Ptosis

Simply put, grade 1, 2 or 3 glandular ptosis, which refers to how far the areola is sagging below the inframammary fold beneath the breast, the lower attachment point of the breast to the chest wall.

  • Grade 1: Mild Ptosis – The nipple is at the level of the inframammary fold, but most of the breast tissue is below the nipple.
  • Grade 2: Moderate Ptosis – The nipple is located below the inframammary fold and below the majority of the bottom breast tissue.
  • Grade 3: Advanced Ptosis – The nipple is far below the inframammary fold and points towards the floor.
  • Pseudoptosis – The nipple lies above or at the level of the inframammary fold while the majority of the breast has descended below the level of the fold. This is not true ptosis, or sagging.

Diagram of breast ptosis (drooping/sagging) degrees/stages

The degrees/stages of breast ptosis (drooping/sagging)

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Breast Q&A: Will High Profile Breast Implants or Moderate Plus Give Me Natural Looking Breasts?

Question – Will High Profile breast implants give me natural looking breasts vs Moderate or Moderate Plus?

I am 5’4″ 125lbs, 31″ ribcage, 34C (wanting at least a DD) and my breast measures 13cm wide. I told my PS I wanted large, very nice looking (not high and ball-looking) breasts. He told me he will use a smooth, round, High Profile, 500cc silicone implant and it will look “very nice” with a “nice downward slope”. Everywhere on the internet says that high profiles don’t give a really nice natural look, and that moderate profiles do. Will high profile breast implants give me large, full, and natural-looking breasts with nice cleavage?


Answer – Although I use Moderate Plus or Moderate Profile prosthesis in the vast majority of cases, given your base width dimension of 13.0cm and your wanting a 500cc implant, a High Profile implant would be appropriate.

In answer to your question, it is not so much the size of the prosthesis that results in a ‘natural’ or ‘unnatural’ look but rather the surgical technique used in relationship to the pre-operative breast appearance.

If, on examination, your nipple to inframammary fold distance is 5.0cm – 6.0cm (meaning that the fold does not need to be lowered excessively), then a high profile implant can be placed in a position that provides adequate inferior/lower pole projection and avoids creating an overly round upper half of the breast (i.e. the “high, ball-looking” and ‘unnatural’ look you don’t like).

That said, there are many women who like the look of round, projecting breasts with upper pole fullness (high cleavage) – neither look is ‘right’ or ‘wrong’ so to speak, they’re just different. Every plastic surgeon has a certain aesthetic style they prefer (re: some aim for the most natural looking shape and size possible while other find the ‘high and round’ look more attractive), but at the end of the day, if the patient is clear about the way they want their breast to look after surgery, it’s my job as their surgeon to achieve it (within reason of course).

Breast implant profiles: high profile vs moderate vs moderate plus

Breast implant profiles: high vs moderate plus vs low

Before diving into a few specific recommendations given the measurements you provided, here are my general thoughts on each of the 3 Mentor breast implant profile types:

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Breast Q&A: Undecided – Lift vs Implants for Deflated Breasts

Question – Undecided, Lift or Implants. Surgery in 3 Weeks, Opinions Please

Hello. I have my breast surgery scheduled in June, however, am still undecided which route I should take. Would 500cc saline implants be sufficent to give me some volume, or will I end up with large, saggy breasts? If I decided to go just for a lift, my boobs will be tiny and scared. Hence, I’d rather go for implants even if I will have to get a lift 10 years down the road. I don’t want both surgeries, so it will be either tiny or big. What to do? I’m 40, 1 child. Thank you.
via RealSelf.com

Deflated breasts before surgery - lift & implant needed to obtain the best possible result

With deflated breasts, a lift + implant is needed for best result


Answer – For the best result possible, a vertical breast lift + submuscular, moderately sized implant is needed

In response to your question and based on your photos, this is not really a one or the other type of situation. You really need to have both a lift and an augmentation. If you do them separately you will probably not be satisfied with the eventual outcome. You have significant loss of volume, and if you were to only proceed with skin tightening all that would be accomplished is a higher position of the nipple areola complex. There would be no superior fill and an even smaller appearing breast mound.

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Breast Q&A: Is a Perfect Breast Augmentation Result Possible in My Case?

Question – I think my “goal” photo = a perfect breast augmentation. Is it possible for my breasts to look similar after implants? Am I being realistic about what’s possible for me?

My plastic surgeon wants me to bring in pictures of what I want to look like after breast augmentation so he can be sure that he understands what “look” I like best. We’ve discussed this at my consultation; however I did not bring any pictures with me. My surgery is on the 5/26/2011. At my pre-op appointment, we will go into the specifics of the look/result I am hoping for. The first two pictures are “before photos” of my breasts and the third is what I believe is a perfect breast augmentation. The measurement from my collar bone to my nipple is 21 cm on both breasts. Am I being realistic? Thank you!

Perfect Breast Augmentation Example Before & After Photo

Patient provided two 'before' photos of her own breasts and one 'goal' photo
of what she feels are 'perfectly augmented breasts'.


Answer – For a similar result to the “perfect breast augmentation” look you like, a lift is needed.

I agree with my colleagues that it is difficult to compare apples to oranges since every breast has its own unique characteristics, but since the photo you chose as an example of your ideal postoperative outcome is mine, I will give you my thoughts on the situation. (n.b. here’s a link to the ‘perfect breast augmentation’ case you cited as an ideal result).

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