Feminizing Mammoplasty

• Feminizing mammoplasty surgery is a gender affirming surgery that involves breast implants to increase the size, change the shape, and alter the texture of the breasts. Different surgical techniques are used to place implants in the chest area. Sub glandular positioning is placing implants above the muscle, and typically has a shorter recovery time. Sub-muscular positioning is placing the implants under the muscle, this procedure can increase recovery time.
• Typically, the surgeon will make a recommendation of implant positioning based on skin elasticity, desired surgical goals, and desired shape of breast. It is recommended that patients be on hormone replacement therapy for at least one year prior to surgery to support tissue growth that benefits the surgical outcome.

Your peer navigator can help you prepare for a successful consultation with a surgeon and discuss your desired goals and outcomes prior to consult.

SIZE, SHAPE, AND TYPE OF IMPLANTS

• Procedures are based on breast shape and size, skin elasticity, as well as patient’s needs and preferences.
• During your consultation, you and your surgeon will work together to discuss your preferences, to determine what type of procedure is best for you.

LIMITATIONS

Surgeons will discuss surgical limitations related to the sizing and shape of implants during your consultation. It is important that you understand possible limitations prior to surgery.

HOSPITAL STAY

The surgery typically takes 1-2 hours. This is an outpatient procedure, meaning after your procedure you will need to confirm safe transportation home

SCARRING

Scarring is a part of surgery. It is important to discuss where incisions will be made and potential impact of scarring on the chest area.

Your PCP, surgeon, and Gender Health Navigator can help you achieve optimal surgical outcomes by actively preparing for your surgery and making sure expectations are surgically possible.

PHYSICAL HEALTH

• Maintain a healthy body weight, high body weight can increase complications and interfere with wound healing.
• Although there is not a strict Body Mass Index (BMI) requirement, your surgeon may discuss specific anesthesia risks or considerations, depending on your BMI. It is beneficial to reach your own personal sustainable goal weight prior to surgery

MENTAL HEALTH/WELLNESS

• Having surgery takes both physical and mental preparation.  Surgery is stressful, some people feel an increase in depression or anxiety after surgery. 
• If you notice any changes in your mood or sleep, especially with anesthesia, please discuss with your care team.
• If you struggle with mental health, reach out to your mental health provider or navigator for support.

SMOKING

• Nicotine intake by smoking, patches, chewing gum, or vaping may interfere with wound healing. If you use nicotine, you should discuss a quit date with your PCP and surgeon. Surgeons require patients to stop nicotine prior to surgery and may test for confirmation.
• If you inhale cannabis, it’s important to find another way to use it, for example, topical, edibles, and tinctures, or to stop altogether.

SUPPORT

Build your network of support with providers, family, and community to help you plan and organize your recovery prior to and after surgery

• Transportation to and from appointments 
• Meal planning and preparation
• Providing a calm and supportive healing space

Everyone heals differently. Patients will experience— pain, bruising, swelling, and fluid or blood drainage. You will leave the hospital wrapped in a bandage garment on your chest area, it is recommended you keep this on until 1-week post-op visit. You may need to sleep in specific positions, on your back and slightly elevated for a couple of weeks after surgery

MOBILITY

After your surgery, you will have less mobility/ability to move and lift your arms. It is important to rearrange your recovery area so that you won’t lift or reach for anything above your shoulders during your recovery.

PAIN MANAGEMENT

Ask the doctor what will be provided for pain management. If you have a history of substance use, you may want to talk to your doctor about the safest ways to control pain after surgery.

Aftercare can differ by a patient and depends on the post-op care plan you discuss with your surgeon. For optimal results and to help avoid complications, it is essential to follow all post-op care instructions from your surgeon.

Make sure to review the instructions with your navigator and surgeon. The following questions can guide your conversation with your surgeon:

• What will post-op recovery look like over the course of 3 months?
• What are recommendations for limiting physical or sexual activity?
• When can I start to lift or carry heavier items?
• When can I lift my arms above my shoulders?
• What impact to my sleeping positions should I expect?
• How long should I expect to take off from work/school?

• Medicare A&B
• Full Scope Medi-cal
• San Francisco Health Plan (Medi-cal, Healthy Workers and Healthy Families)
• Anthem (Medi-cal)
• Healthy San Francisco (Health Access Program)