How Is MTF Top Surgery Performed? A Visual Guide to the Procedure

For many transgender women and non-binary individuals, MTF top surgery is more than a cosmetic transformation—it’s a deeply personal step toward gender affirmation and self-alignment. If you’ve been considering gender-confirming chest surgery and want to understand exactly how the process works, this visual guide is here to help.

We’ll walk you through each stage of the MTF top surgery procedure, explain what to expect, and clarify the differences between MTF and FTM surgeries, including gender-affirming breast reductions.

Understanding MTF Top Surgery

MTF top surgery, short for Male-to-Female top surgery, focuses on creating a more traditionally feminine chest. This is typically achieved through breast augmentation, either by inserting implants or using fat grafting techniques to add volume and shape.

This procedure is especially affirming for those who have experienced chest dysphoria or discomfort with their assigned gender characteristics. It’s a cornerstone of gender-affirming surgery that helps individuals feel more at home in their own bodies.

A Step-by-Step Guide to the MTF Top Surgery Procedure

Let’s break down what you can expect from start to finish:

1. Consultation & Planning

Before the actual procedure, your journey begins with a consultation. During this session:

Your surgeon will review your medical history.

You’ll discuss your transition goals and ideal breast size/shape.

Options for implants (saline vs. silicone) or fat grafting will be reviewed.

Pre-operative tests may be scheduled to ensure you’re fit for surgery.

The surgeon may also take photographs and measurements to develop a personalized surgical plan tailored to your body frame.

2. Implant or Grafting Selection

Depending on your preference and body type, your surgeon may recommend:

Silicone Implants: Known for a more natural feel and aesthetic.

Saline Implants: Slightly firmer and inserted empty, then filled once inside the chest.

Fat Grafting: Fat is harvested from another part of your body (like the abdomen or thighs) and injected into the chest.

Implants typically provide more volume, especially for individuals with minimal existing breast tissue, while fat grafting offers a subtler, softer result.

3. Surgical Procedure Day

The surgery is performed under general anesthesia and typically lasts 1.5 to 3 hours. Here’s what happens:

Incision Placement: Surgeons usually make incisions around the areola, in the breast fold, or through the armpit (depending on implant type and desired outcome).

Pocket Creation: A space is created beneath the chest muscle (submuscular) or above it (subglandular) to hold the implant.

Implant Insertion: The chosen implants are carefully inserted and positioned.

Closing & Dressing: Incisions are closed with sutures, and surgical dressings or compression garments are applied.

For fat grafting procedures, liposuction is performed to collect fat, which is then purified and injected into the chest area in layers for even distribution.

4. Recovery Process

Most patients can return home the same day or the following morning. Here’s what to expect in recovery:

Swelling and bruising for 1–2 weeks

Compression bras worn for several weeks

Most return to work in 1–2 weeks

Avoid heavy lifting and upper-body workouts for 4–6 weeks

Follow-up visits ensure the implants or grafted fat are settling properly and healing without complications.

FTM Top Surgery vs. MTF Top Surgery

While MTF top surgery is about creating a fuller chest, FTM top surgery is about reducing and contouring the chest to achieve a flat, masculine appearance. This is often referred to as a gender-affirming breast reduction.

Both procedures are part of the broader field of gender-confirming top surgery and help align a person’s physical appearance with their gender identity.

What Real Patients Say

According to actual patient reviews featured on the 22 Plastic Surgery site:

“Dr. Reuben and his staff were absolutely amazing. We were not only cared for during my surgery—he gave me something nobody else could, my freedom.”

Another patient said:

“I’ve been on an amazing journey… It’s surreal to see my new chest and look great in a tank!”

These testimonials highlight the emotional and life-changing impact of gender-confirming surgeries. The results go far beyond aesthetics—they contribute to mental well-being, self-confidence, and body congruence.

Why Choose 22 Plastic Surgery for MTF Top Surgery?

Choosing the right surgical team is key to achieving a safe, beautiful, and affirming result. At 22 Plastic Surgery, you’ll find board-certified surgeons with deep experience in transgender healthcare and aesthetic surgery.

They understand the nuances of gender-affirming procedures and take a compassionate, personalized approach to every patient’s journey.

Let’s Talk!

If you’re considering MTF top surgery, now is the time to schedule a private consultation. Whether you’re early in your gender journey or ready to take the next step, the caring professionals at 22 Plastic Surgery are here to help you feel confident, empowered, and seen.

Frequently Asked Questions

Do I need to be on hormones before surgery?
While it’s not always required, some surgeons prefer that you’re on estrogen for at least a few months to enhance skin elasticity and prepare for implant insertion.

Can I choose my implant size and shape?
Yes, during your consultation, your surgeon will guide you through choosing the best fit for your body goals.

What’s recovery like?
Most people resume light activities within 1–2 weeks. Final results may take 3–6 months to settle.

Are the results permanent?
Yes, although implants may require maintenance or replacement after 10–15 years, the changes are lasting and affirming.