What is breast augmentation (gender affirming care)?

Breast Augmentation (Gender Affirming Care)
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Breast augmentation surgery for gender affirmation: Overview

Breast augmentation surgery for gender affirmation changes the size and shape of your breasts to align with your gender identity. The doctor will place an implant under the breast tissue or chest muscle. An implant is a soft silicone shell filled with a saltwater solution or silicone gel.

The doctor will make cuts (incisions) under the breast or around the nipple. The doctor will place the implant and adjust it to the correct shape, size, and position. Then the doctor will close the cuts.

You will be asleep during surgery. You will go home the same day. Most people can go back to work or their normal routine in 3 to 6 weeks. You will have scars from the cuts, but they will fade.

Over time, you will need surgery to replace your implants. Implants last about 10 to 15 years.

How can you care for yourself after breast augmentation surgery for gender affirmation?

Activity

  • Allow your body to heal. Don't move quickly or lift anything heavy until you are feeling better. Do not lift anything over your head for 2 to 3 weeks.
  • Rest when you feel tired. Getting enough sleep will help you recover.
  • You may shower 24 to 48 hours after surgery, if your doctor okays it. If you have a drain, follow your doctor's instructions for showering. Do not take a bath or soak in a hot tub for about 3 months.
  • Sleep on your back with your head and shoulders raised with a pillow. This will help keep your implants in place and prevent them from slipping or shifting.
  • Ask your doctor when it is okay for you to have sex.
  • Ask your doctor when you can drive again.
  • Your doctor will tell you when you can return to work. This will depend on the surgery you had and the type of work you do.
  • Be active. It can help prevent problems and help you recover. Walking is a good option for many.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines, including hormones. Your doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • If you were given medicine for nausea, take it as directed.

Incision care

  • If your doctor gave you specific instructions on how to care for your incision, follow those instructions.
  • You may be wearing a tight elastic bandage after the surgery. Your doctor will tell you when you can switch to wearing a special bra. You will need to wear the bra all the time for several weeks, except when taking a shower.
  • Ask your doctor when it's okay to wear an underwire bra. Choose a bra that is supportive and doesn't put too much pressure on the healing incision.
  • If you have strips of tape on your incision, leave the tape on for a week or until it falls off. Or follow your doctor's instructions for removing the tape.
  • Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
  • Keep the area clean and dry.

Other instructions

  • You may have one or more drains near your incision. Your doctor will tell you how to take care of them.
  • Follow your doctor's instructions for scar care. Protect scars from the sun when you are outdoors. If the area isn't covered by clothing, use sunscreen.

How do you prepare for breast augmentation surgery for gender affirmation?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • If you are taking hormones, your doctor will tell you whether to keep taking them or to stop before your surgery.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.
  • If you smoke, try to quit. Smoking slows healing and increases surgery risks. Your doctor may require that you quit for a period of time before and after surgery. You have the best chance for a healthy recovery if you quit smoking completely. If you need help quitting, talk to your doctor.
  • Be sure to tell your doctor if you have any changes in your physical or mental health that might affect the surgery or your recovery.

After breast augmentation surgery for gender affirmation: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have sudden chest pain and shortness of breath, or you cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incision comes open.
  • You are bleeding from the surgery site, and it won't stop with pressure.
  • You have symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in the calf, back of the knee, thigh, or groin.
    • Swelling in the leg or groin.
    • A color change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin color.
  • Watch closely for any changes in your health, and be sure to contact your doctor if:
    • You do not get better as expected.

After breast augmentation surgery for gender affirmation: Overview

Breast augmentation surgery for gender affirmation changes the size and shape of your breasts to align with your gender identity. The doctor placed implants under the breast tissue or chest muscle. An implant is a soft silicone shell filled with a saltwater solution or silicone gel. To place an implant, the doctor made cuts (incisions) under the breast or around the nipple.

You may have soreness, swelling, and mild bruising. You may have a pulling or stretching feeling in your breast area. You may lose feeling in your nipples. This may be short-term. But it may not. You will have scars from the cuts, but they will fade.

You may need pain medicine for a week or two. You may get tired easily or have less energy than usual for several weeks after surgery. Most people can go back to work or their normal routine in 3 to 6 weeks.

What happens on the day of breast augmentation surgery for gender affirmation?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 2 hours.

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