The concept of breast augmentation, or reconstruction, in trans women goes far beyond the enhancement of breast size. It is an essential step in body feminisation surgery and therefore it is equally important to simultaneously address the key differences between the male and female chest. These include a prolonged nipple-to-inframammary fold distance, a prominent décolleté, a short distance between both breast (about one finger wide) and possibly more central positioning of the nipple. All this can be achieved by thorough selection of the type and size of silicone prothesis, right pocket positioning, and careful understanding of patients wishes. Further enhancement is possible by additional fat grafting. Breast augmentation is often performed simultaneously with gender reassignment surgery as a single surgical session.
This hard-won credibility come from surgical skills, but also, and perhaps most importantly, from the ability to consider me as a responsible partner of my life and not just as a patient to treat.