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For many surgeries considered elective procedures, BMI limits exist to prevent high-risk patients from undergoing the surgeries. However, this can unfairly alienate patients who may have a high BMI but are otherwise healthy. Especially when it comes to gender-affirming surgeries such as MTF breast augmentation, patients are sometimes unfairly turned away. With that said, high BMI surgery can come with additional risks, and not all patients with a high BMI are good patients. Dr. Javad Sajan at Allure Esthetic Plastic Surgery evaluates patients holistically to gauge their overall health and candidacy for the procedure. Allure Esthetic offers the best high BMI MTF top surgery.

What Is MTF Top Surgery?

Male-to-female top surgery—more commonly called MTF breast augmentation—uses breast implants or the patient’s fat to create breasts and a feminine silhouette. The gender-affirming procedure is most frequently performed for transgender women to help alleviate gender dysphoria.

What BMI Measures

BMI stands for body mass index and it compares your height and weight to estimate the amount of body fat a person has. While this can be helpful in some circumstances and should not be fully discounted, BMI rarely holds the amount of weight many surgeons place on it.

A BMI measurement does not take into account a person’s muscle mass, medical conditions, genetics, or environmental factors. Therefore, someone with a high muscle mass and relatively low fat may have a high BMI because of their overall weight.

Even when BMI accurately predicts a person’s fat ratio, it does not account for medical conditions, medications, or other factors that may contribute to a person’s weight. Thus, it cannot serve as the sole determiner of health before gender-affirming breast augmentation surgery.

Benefits & Risks

A high BMI transgender breast augmentation comes with benefits and risks patients need to consider before undergoing surgery. Possible benefits include:

  • Creation of breasts and a shapely, feminine figure
  • Reduced gender dysphoria
  • Body is more congruent with gender identity
  • Supports a public feminine identity
  • Improved quality of life
  • Enhanced social interactions
  • More confidence in everyday life
  • Highly customizable to fit a patient’s body type and goals
  • Versatile surgery with multiple incision location options
  • Several implant options
  • Can often achieve natural-looking results
  • Minimal scarring
  • Combinable with other gender-affirming procedures
  • Long-lasting results
  • Often covered by insurance
  • Performed by a surgeon with years of experience and training in gender-affirming surgeries

All surgeries—regardless of BMI—come with some level of risk. In some cases, a high BMI can increase risk during surgery, especially if other conditions such as diabetes or high blood pressure are present. With that said, many patients with a high BMI can still safely undergo a transgender breast augmentation. Possible risks include:

  • Infection
  • Implant rupture
  • Capsular contracture
  • Prolonged or severe side effects
  • Scarring
  • Poor healing
  • Blood clots
  • Uncontrolled major medical conditions

In general, an MTF breast augmentation is extremely safe, even for many patients with a high BMI. Dr. Sajan will review the patient’s unique medical history, lifestyle, and medications to gain an understanding of whether or not they would be a good candidate for surgery.

Considerations For Performing High BMI MTF Breast Augmentation

MTF breast augmentation is similar to traditional breast augmentation, but some considerations—such as a thicker chest muscle—must be accounted for. When operating on a high BMI patient, there may be additional considerations to make before surgery that could impact the patient’s results and the safety of the surgery.

Implant Size

Most of the time, patients want their breasts to be roughly congruent with their body size. Therefore, some high BMI patients may opt for larger implants or higher profile implants to better accentuate their breasts and ensure a proportionate result. Implant type may also factor into the decision because patients with some significant breast tissue already may see the best results from saline implants because their size can be adjusted and the implants overfilled.

Surgical Technique

There are four main techniques Dr. Sajan may use when performing an MTF breast augmentation:

  • Inframammary: With MTF patients, the inframammary fold—or the fold beneath the breast—may be nonexistent, malpositioned, or generally small. The inframammary incision can help create the ideal positioning for the breasts. However, it does have the potential for visible scars on the chest.
  • Periareolar: Placing breast implants through a small incision around the areola is rarely used during gender-affirming procedures. In general, it is falling out of popularity for all forms of breast augmentation, but it is possible for patients who do not care about nipple sensation or being able to breastfeed.
  • Transaxillary: This surgical method uses an incision in the armpit to place breast implants. This is increasingly popular for transgender patients because it can normally bypass the chest muscle without cutting through it. The transaxillary technique keeps scarring away from the breasts and often offers a less painful and quicker recovery.
  • Fat Transfer: Fat transfer to the breasts can be used for gender-affirming breast surgery. For patients with a high BMI, this can offer a lucrative option to address their breasts and remove excess fat. However, the results tend to be subtler than those using breast implants.

Length Of Surgical Session

The length of the surgical session depends on the complexity of the breast augmentation and if any other procedures are being performed. Generally, patients can expect the surgery to take one to two hours. Patients undergoing high BMI MTF top surgery may do best with shorter surgical sessions.

High BMI MTF Top Surgery Recovery & Aftercare

Recovery and aftercare instructions may vary based on a patient’s needs and specific surgery. Directions may include:

  • Wear the surgical bra 24/7 until directed otherwise (or briefly wash it)
  • Prevent the incisions from getting wet
  • Massage breasts as instructed
  • Attend all post-op appointments
  • Do not lift your arms above your head
  • Avoid heavy lifting and strenuous exercise
  • Rest and take at least one week off work
  • Understand what to expect from your results

Frequently Asked Questions

Is There A BMI Limit For MTF Surgery?

No, Dr. Sajan does not have a specific BMI limit. He evaluates each patient based on hundreds of criteria. BMI is only one of these factors.

Should I Lose Weight Before MTF Breast Augmentation?

It depends. If you are currently working toward losing weight, the results may be better once you are close to your goal weight. This also allows patients to combine their surgery with a lift to remove extra skin if necessary for the best results. In some cases, Dr. Sajan may recommend that some patients lose weight before undergoing surgery. He will help the patient create a plan to lose weight before surgery.

Will My BMI Affect Insurance Coverage?

Usually no, your BMI will have little bearing on if your insurance will cover gender-affirming procedures. Still, it is recommended that patients check their insurance requirements and the specifics of their coverage before seeking high-BMI transgender breast augmentation. Allure Esthetic accepts all private insurance.

How Much Is MTF Breast Augmentation In Seattle?

Gender-affirming breast augmentation is often covered by insurance. But, patients are welcome to pay out of pocket. The out-of-pocket cost starts at $5,995 for saline breast implants. The exact cost is best determined at a consultation appointment where patients can choose the implants that fit their needs best and Dr. Sajan can gauge what is necessary for the best possible results.

The Best High BMI Transgender Breast Enlargement

Dr. Javad Sajan is a world-renowned surgeon who specializes in gender-affirming surgeries including MTF breast augmentation, FTM top surgery, and facial feminization. He believes in evaluating patients holistically and has performed transgender breast augmentation on people with a range of BMIs. Allure Esthetic Plastic Surgery performs the best high BMI MTF breast augmentation surgery.

To learn more and schedule a consultation, call us at 206-209-0988. Patients can also reach out online via chat, contact form, or Price Simulator.

Allure Esthetic Plastic Surgery

(206) 209-0988

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