Male to Female (MTF) Top Surgery Is a Personal Choice

The transitioning process is highly personal. Individuals on a gender-transition journey must decide which steps to take and when to take the steps. A major consideration for transgender women involves plastic surgery. Some consider breast augmentation, also known as augmentation mammoplasty, critical to their transition process.

The Consultation

Farzad R. Nahai, MD, board-certified plastic surgeon at The Center for Plastic Surgery at MetroDerm, P.C., is an experienced and empathetic doctor.  If you are considering MTF top surgery, make a consultation appointment with Dr. Nahai. When you come, bring a list of any medications you are currently taking.  Dr.  Nahai will discuss your medical history and your aesthetic goals in an unhurried meeting where he will thoroughly explain the procedure and discuss recovery. Your questions will be answered, and you will feel confident in choosing Dr. Nahai to do your surgery.

A Customized Procedure

When you make the decision to schedule surgery, Dr. Nahai will talk with you, in detail, about his plan to customize your procedure including type and size of implant and incision locations.

  • Saline implants are filled with saltwater. They can be less costly and are inserted through a smaller incision.
  • Silicone implants are filled with silicone gel. They have a reputation for being more natural/soft.

Preparation for Male to Female Surgery

To prepare for surgery, Dr. Nahai makes several recommendations:

  • Avoid alcohol the week leading up to your surgery.
  • Stop smoking 3 weeks before and after surgery. Smoking can cause complications and delayed healing.
  • Schedule transportation to and from surgery.
  • Ask a friend or relative to care for you after surgery until you can live independently.
  • Dress comfortably in loose clothing with a zipper or buttons down the front.

Male to Female Surgery

The procedure, which is done under local anesthesia, takes between 1 and 2 hours. Incisions are commonly located along the nipple or under the fold of skin where your chest meets your breast tissue and under the armpit. Dr. Nahai places the implant in a pocket above or below the pectoral muscle.


  • The recovery time for MTF top surgery varies. In general MTF patients can return to work about one week after surgery.
  • Sleeping on your back is recommended for at least a week.
  • Nahai will discuss personal hygiene and with you. Until the dressings are removed, the area must remain dry.
  • To speed your recovery, use ice packs. Most patients experience some swelling and bruising after surgery.  Ice packs can help with pain and inflammation. There is swelling which diminishes after 2-3 weeks but can take several months to completely disappear.
  • To avoid excess scarring, avoid reaching/lifting.
  • Nahai will advise you about resuming your normal activities. Generally, it takes 6-8 weeks to return to a rigorous exercise routine.
  • Don’t overdo it; eat healthily; no smoking or alcohol.
  • At your first post-op appointment one week after surgery, the dressing comes off, and Dr. Nahai will check your progress.

If you have any questions during the pre-op or post-op period, call Dr. Nahai’s office. His friendly and knowledgeable staff will answer your questions and make you feel comfortable   Dr. Nahai’s patients know he is dedicated to their welfare.

Each patient is unique; therefore, results of treatment may vary.

Transgender individuals seeking MTF or FTM Top surgery should call Dr. Nahai, an experienced, board-certified plastic surgeon.  He and his staff provide excellent patient care at The Center for Plastic Surgery at MetroDerm.  If you are from Atlanta, Dunwoody, Sandy Springs, Brookhaven, Roswell, Alpharetta, or Johns Creek, call today for a consultation appointment.