Upper surgery is where breasts are constructed using implants. Surgery can give you larger breasts and can also allow you to decide on the shape of them. Implants are inserted through an incision either under the breast, in the armpit or around the nipple.
Not all trans women have upper surgery, and those who do may not want to have lower surgery as well.
Speak to your GP to find out whether upper surgery is available on the NHS in your area.
We all produce the sex hormones oestrogen and testosterone but people who were labelled ‘female’ at birth have more oestrogen and people who were labelled ‘male’ at birth have more testosterone. Many trans women take oestrogen and one effect of this is that it will feminise you – as well as reducing facial and bodily hair growth, it will increase the fat on your hips and breasts.
It's advised that if you're taking hormone treatment, you should wait at least 18 months before having breast implants. This is because it can take up to two years for your breasts to complete their growth once you start hormone treatment.
Although oestrogen is likely to result in minimal changes to the size your breasts, you'll have more natural-looking breasts if implants are attached to your existing breast tissue. Your nipples are more likely to get larger as a result of hormone treatment. Implants placed onto a flat chest with a smaller nipple will look less natural. You may also find that your nipple sensitivity changes after upper surgery – your nipples could be a lot more or a lot less sensitive.
After upper surgery
As with lower surgery, you'll have to take some time out to recover after upper surgery. Your surgeon will advise you on how to care of your new breasts in the days after surgery, and you'll need to rest for a week or two. You may need to ask someone to help you with housework or shopping during this time.
If you have upper surgery at the same time as lower surgery, you'll need more time to recover. Have a plan in place before going to hospital so that you get all the help you need after your surgery.
What is the lifespan of breast implants?
Breast implants do have a lifespan, so it may be that you will need to have them replaced at some point. Your surgeon should give you more information about this.
In the UK women aged between 50 and 70 are offered breast screening (known as a mammogram or breast X-ray) to look for any early signs of breast cancer. You should get a letter inviting you to attend between your 50th and 53rd birthdays – although by the end of 2012 screening will begin at the age of 47. If you don’t receive a letter, speak to your GP or clinician to ask for a referral.
You can find more information about breast augmentation at The Transgender Health Information Program.