Transgender Reaffirmation
*DISCLAIMER: THIS SITE CONTAINS GRAPHIC & SURGICAL IMAGES THAT MAY BE DISTURBING TO SOME VIEWERS.
THIS SITE IS INTENDED FOR INDIVIDUALS OVER THE AGE OF 18.
**None of the images on this site have been enhanced or photoshopped.
Navigate to:
Male to Female
The Operation
Before & After Photos
Navigate to:
Female to Male
The Operation
Before & After Photos
Patient B - Transgender Female to Male
Patient B - Transgender Male to Female
Transgender Reassignment: Breast Reduction (FTM)
+ What are the surgical options for Transgender patients regarding Breast Reduction Surgery?
Transgender reassignment patients may seek an alteration in their breasts. The options for the female to male transformation include:
If the patient has small to very large breasts:
Removal of the majority of the breast and all of the nipple areola; this is called a skin sparing mastectomy
A recontouring of the chest wall to a male appearance
Retention of a smaller nipple areola, as a free nipple graft, which is placed in a male chest location
All of the nipple sensation is lost
This technique will leave a scar that follows the natural crease under the existing breast on the chest wall, and a circumferential scar around the nipple areola.
A drainage tube would be placed under the chest wall tissue.
A binder bandage would be applied and left alone for one week.
At one week following surgery, the Binder and the drainage tube, as well as the special dressing on the nipple, are removed. The patient can then shower.
The remainder of the care is consistent with Breast Reduction Surgery. Please see FAQ Breast Reduction
If the patient has very small breasts:
Removal of the small amount of breast tissue through an incision around the lower half (3-9 o’clock) of the nipple areola.
Please see FAQ Breast Gynecomastia
This technique maintains the circulation and sensation to the nipple, but the size of the nipple areola remains unchanged.
If the patient wants to retain a female shape, but desires a much smaller breast, a standard Breast Reduction technique is used.
Please see FAQ Breast Reduction
This technique retains the nipple sensation and reduces the nipple areola size, but also retains a more female breast contour.
+ Besides the standard risks listed in FAQ BREAST REDUCTION, and FAQ BREAST GYNECOMASTIA surgery, are there any additional complications?
Risks of doing Transgender Breast Reduction Surgery:
With any surgery, there are surgical and anesthetic risks. Aside from the rare risks of an anesthetic event, some of the general and specific surgical risks for this procedure would include:
- scarring
- infection
- complete loss of sensation to the nipple
- nipple graft loss
- discomfort
- time off work and exercise
- contour abnormality
- asymmetry
- bleeding (hematoma)
- dog ears
This list is not complete. During the consultation with the patient, Dr. Giuffre will outline and explain each of the risks in detail.
Please see www.pclsc.ca under Breast Augmentation.
+ What are dog ears and what can be done about them?
Some breasts have a lateral extension into the lateral chest wall and axilla, beyond where the natural breast stops. The tissue is reduced at the time of surgery, but is not completely removed. To remove all of this tissue, would leave a much larger scar. The goal is to keep the scar within the patient’s natural breast crease. This extra tissue can be fat, or skin, or both. This is called a “Dog Ear".
After the healing is complete, at one year, if the dog ear persists, (it often decreases or subsides) the patient may wish to have this corrected. Fees would apply, as this is not covered by Alberta Health Services.
This would be discussed at the one year follow up visit with Dr. Giuffre.
+ Is there any breast tissue left after this surgery?
Yes, there is a significant amount of breast tissue that may remain following this surgery which contributes to the chest wall contour. All patients must be aware that ongoing breast surveillance for breast lumps and the risk of breast cancer is strongly advised. This also applies to cervical cancer and routine followups with the family doctor for PAP smears.
+ Is this procedure covered by AHS (Alberta Health Services)?
Alberta Health Services covers transgender Female to Male reaffirmation patients for chest wall reconstruction surgery.
AHS guidelines include that:
- A patient live in their chosen gender lifestyle for two years.
- Be under the care of a medical endocrinologist for hormone management.
- Be under the care of a psychiatrist for consultation and referral.
Cosmetic revision of dog ears is not covered by Alberta Health Services.
Before & After Photos
*Tap a patient image to enlarge & view the full series of pre and post-operative images.
Transgender Reassignment: Breast Augmentation (MTF)
+ What are the surgical options for Transgender patients regarding Breast Augmentation surgery?
Transgender reassignment patients may seek an alteration in their breasts. The options for the male to female transformation include both medical and surgical:
Medical:
A male to female transgender patient will require medical hormonal adjustments to eliminate the effects of the male hormone, testosterone, and the use of the feminizing hormone, estrogen. This is done under the guidance of a medical Endocrinologist.
The effects of systemic estrogen will stimulate the small amount of breast tissue on the chest wall. If the amount of breast growth from the estrogen hormone is not adequate, further breast enlargement can be accomplished using a Breast Augmentation technique.
Surgical:
Breast Augmentation surgery is the same in Transgender male to female patients, as it is for smaller breasted women wanting to enlarge the breast for cosmetic reasons.
The implant type, the implant placement location (in front of, or behind the muscle) options, the incision site, the size considerations, the pre and post operative considerations, the risks, and lastly, the risks and complications, are the same.
Pease refer to FAQ Breast Augmentation for Female Breasts
+ Is this procedure covered by AHS (Alberta Health Services)?
Recently, Alberta Health Services has made transgender reaffirmation male to female breast augmentation a covered procedure in the Alberta Schedule of Medical benefit. In order to qualify for this coverage, a patient has followed the hormone regime of their medical endocrinologist , but has failed to respond to hormones that would promote natural breast development. This coverage must be sanctioned by the medical endocrinologist, the plastic surgeon, and the psychiatrist caring for the patient.
+ Does Dr. Giuffre offer Genital Reassignment Surgery?
In Canada, the major centre that offers genital reassignment surgery is in Montreal. Dr. Giuffre does not offer this surgery.
Before & After Photos
*Tap a patient image to enlarge & view the full series of pre and post-operative images.
“Life is full of choices; your character reflects those choices.”