MTF breast augmentation is an important step in the transition process for many trans women. However, is feminizing hormone therapy—or more specifically, estrogen—really needed in order to undergo breast augmentation surgery?
The short answer is no. However, there are a variety of factors to take into consideration when deciding whether to undergo MTF breast augmentation with or without estrogen hormone supplements.
Feminizing hormone therapy can also be called hormone replacement therapy (HRT). What this process does is in the name: it replaces the dominant hormones in your body (for trans women, this is likely testosterone) with hormones that are generally more prevalent in your gender identity. For a male to female transition, this typically involves a medication to block the production of testosterone and estrogen to replace it.
Estrogen can play a fairly important role in MTF breast augmentation surgery. Although, it does so before the procedure even happens. It is recommended that MTF patients undergo feminizing hormone therapy roughly 12 months minimum prior to their breast augmentation in order to maximize optimal results.
The main benefit is that taking estrogen will trigger your breasts and nipples to grow on their own without the assistance of implants. Estrogen will significantly change your breast size and shape, slowly and gradually over an extended period of time. It is recommended that you wait at least 18 months in order to give your breasts time to develop through the hormones. However, there is a limit to how much your breasts will grow on their own from hormones alone. If you are looking to achieve larger results with your breasts, pairing feminizing hormone therapy with MTF breast augmentation is most likely the best option for you.
Estrogen will not only increase the size of your nipples, but it will also help the skin of your chest to stretch. This means that when you undergo MFT top surgery, you will achieve a more natural-looking implant than if you were to have surgery with a flat chest.
Your doctor will let you know the right timeline, but prior to your surgery, you will want to reduce the amount of estrogen you are intaking in order to reduce the risk of blood clots during surgery. After some time has passed after completing your MTF breast augmentation and you have recovered enough, you will be able to slowly start taking estrogen through feminizing hormone therapy once again.
There are various benefits to taking estrogen before undergoing MTF breast augmentation as part of your transition. Through feminizing hormone therapy, you can avoid potential physical and psychological side effects such as:
That being said, feminizing hormone therapy is not for everyone. It is possible to undergo MTF breast augmentation without taking estrogen.
There are a variety of reasons why you may not wish to go through feminizing hormone therapy. Some doctors might discourage increasing your body’s production of estrogen for medical reasons such as if you had/have hormone-sensitive cancer (e.g. prostate cancer), have a thromboembolic disease, or even significant mental health concerns. Introducing higher levels of estrogen in these scenarios may do more harm than good.
Additionally, you may not want to experience the side effects that are typically associated with feminizing hormone therapy. This list includes weight gain, decreased libido, and erectile dysfunction among many others. There are also risks that come with estrogen hormone replacement therapy such as blood clots, type 2 diabetes, cardiovascular disease and more. If you do not want to experience these potential effects, that’s okay! Estrogen is not a mandatory requirement when it comes to MTF breast augmentation. While estrogen will help in the process,
A good tip to keep in mind if you decide to undergo MTF breast augmentation without taking estrogen is to keep your breasts on the smaller side so that their size matches the size of your nipples.
It is always highly recommended that you speak with your personal physician before starting feminizing hormone therapy. Everyone’s transition journey is different and whether or not you take estrogen is just a part of that. There is no exact step-by-step procedure to follow, which is why it is important to discuss what’s best for you with a trusted physician who specializes in hormone replacement therapy and/or FTM breast augmentation.