17Mar
The transgender breast augmentation procedure
What is transgender breast augmentation?
Transgender breast augmentation — also called feminizing augmentation mammoplasty or MTF breast augmentation — is a gender-affirming surgical procedure that uses implants to create fuller, more feminine breasts with natural projection and shape. It is one of the signature feminizing surgeries performed at Argaman Plastic Surgeries Mexico since 2012.
The surgery is performed under general anesthesia in an accredited private hospital and typically lasts between 1.5 and 2.5 hours. The surgeon makes a discreet incision (in the breast fold, around the areola, or in the armpit), creates a pocket either above or below the pectoral muscle, and inserts the chosen implant. Because transfeminine patients often have a wider chest and a firmer pectoral muscle, implant size, projection and pocket are planned carefully to build feminine fullness and cleavage.
Who is a good candidate?
Ideal candidates are transgender women in good general health and at a stable weight who want a fuller, more feminine chest. Many have been on feminizing hormone therapy for at least 12 months, so the breasts have reached their natural baseline — though hormones are not mandatory. Candidates should be 18+, have realistic expectations and no active breast disease. Your hormone therapy is reviewed and coordinated around the surgery. A complete pre-operative consultation determines the most appropriate implant size, type and placement for your chest anatomy and goals.
Expected Results
You will see immediate volume, with the final feminine shape settling between 3 and 6 months as the implants drop into position. Modern cohesive silicone implants feel soft and natural to the touch and help build cleavage and projection on a wider frame. Scars fade significantly over the first year. Results last 15 to 20+ years, with implants only needing replacement if a complication occurs or if you wish to change size.
Implant placement options
Where the implant sits relative to your chest muscle shapes how natural the result looks, how visible the edges are and how the breast ages. There are four positions, and none is best for everyone.
Why it’s different for transfeminine patients
- Thinner soft tissue (growth on hormones usually reaches Tanner stage 3) — less cover to hide implant edges.
- A wider chest, nipples further apart — affects base width and cleavage.
- A stronger pectoral muscle — more force on an implant beneath it.
- A high, tight inframammary fold — often lowered so the lower pole can fill out.
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1. Subglandular — in front of the muscle
No muscular cover: shorter, less painful recovery and no distortion when you flex — but where tissue is thin the upper edge and rippling can show. Suits the minority of patients with substantial breast development.
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2. Subfascial — under the pectoral fascia
On the muscle but beneath its thin fascia: a little more upper-pole cover, recovery close to subglandular, no flex distortion. A useful middle option when tissue is too thin for subglandular alone.
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3. Submuscular — fully behind the muscle
Best upper-pole cover and lower capsular-contracture rates, but a more uncomfortable recovery, possible flex distortion (animation deformity) and a lower-pole “double bubble” risk. Reserved for very thin tissue.
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4. Dual plane — the placement we recommend most
Behind the muscle on top, behind the tissue below: the muscle hides the upper edge while the lower pole fills into a natural slope, with animation deformity and double bubble minimised. Ideal for a thin, wide, strong-muscled chest — our first choice for most transfeminine patients.
How we choose
Your surgeon measures upper-pole tissue thickness, chest and implant base width, nipple position, nipple-to-fold distance, muscle development and skin quality. These measurements — not a preference chosen in advance — decide the placement, so two patients wanting the same size can get different recommendations.
Before surgery
We ask for at least twelve months of hormone therapy first: breast growth continues for about two years, and operating too early means planning around a chest that is still changing.
General information only — every recommendation depends on an individual assessment by your surgeon.
Incision Options
The choice of incision is guided by three key criteria — each weighing the comfort of the patient, the precision of the surgeon, and the safety of the implant itself.
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01Discretion of the scar
For the patient: the scar must remain hidden and of high aesthetic quality once healed.
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02Visual comfort for the surgeon
The approach must allow optimal visibility to create the implant "pocket" with precision.
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03Safety of the implant
The opening must be wide enough to slide the implant through without trauma — reducing the long-term risk of rupture.
Many surgical approaches have been described over the decades, but few combine all three advantages. Below are the techniques most frequently discussed during consultation:
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Sub-mammary — under the breast fold Preferred technique
Our preferred approach. The scar is concealed in the inframammary fold, fully covered by the breast when standing. It allows a precise dissection without touching the mammary gland, and the implant is slid in safely — never traumatised on insertion. Suitable for all implant types and sizes.
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Lower hemi-areolar — around the areola
Thanks to its central position, this approach offers excellent visibility for the surgeon. However, it is not recommended when the areola is small. There is also a rare risk of scar retraction, which can create a small notch on the areolar border.
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Axillary — through the armpit Not used at our facility
Although the resulting scar is highly inconspicuous, this technique is not part of our practice: visibility during pocket dissection is limited, which can compromise precision and long-term implant positioning.
A Lower hemi-areolar incision · B Sub-mammary incision
The final choice is decided together during your consultation, based on your morphology, implant choice and personal preference regarding scar location.
