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Breast Surgery

Breast Augmentation – Male to Female

Breast implants are inserted in a manner similar to implantation in genetic females. Silicone gel or saline-filled implants are usually inserted through an incision along the border of the skin and areola. Sometimes the incision is made under the breast. Each implant is usually placed underneath the breast tissue and pectoralis major muscle, which is released to give a more natural appearance. The woman should be on ideal female hormones for at least 18 months prior to augmentation in order to develop maximum breast growth.

If the breast is distorted or deformed, more extensive surgery than a simple augmentation may be necessary to achieve the desired result.

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Chest Contouring – Female to Male

Female to male transsexuals usually need chest contouring to create a male appearance. The required surgery depends on breast size and the amount of excess skin. Small breasts can be removed through an incision around the junction of the skin and areola. At the same time, the nipple is reduced and the areola made smaller. A larger breast must be removed though a horizontal incision with a free nipple graft. Every attempt is made to minimize the scars. I do not perform a keyhole technique, because I believe the required scars are worse and the contour of the chest is inferior. Liposuction is often combined with these procedures to provide optimal contouring.

All operations are performed as an outpatient in a surgical center. Depending on your surgery, a touch-up procedure may be necessary.

I require one letter from a therapist supporting your decision to have chest contouring.

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As a best in class plastic surgeon, Dr. Gary Alter provides highly personalized and comprehensive care. His philosophy regarding the physician / patient relationship is based on trust and has earned him one of the most respected reputations in the world.

For more information about the surgeries we offer or to schedule a consultation with the board certified plastic surgeon, please contact either our Beverly Hills of New York City plastic surgery practice:


416 N Bedford Dr, Suite 400
Beverly Hills, CA 90210
Tel: (310) 275-5566


461 Park Ave South, 7th Floor
New York, NY 10016
Tel: (212) 321-0749