Choosing Between Implant and Fat Grafting for MTF Top Surgery: What You Need to Know
- Posted on: Jul 15 2025
Choosing the right technique for MTF top surgery is an important decision in gender-affirming care. Both breast implants and fat grafting can feminize the chest. Each method has different benefits depending on your anatomy, goals, and surgical plan.
Dr. Bardia Amirlak is a triple board-certified plastic surgeon with advanced training in breast surgery, fat grafting, and aesthetic body contouring. As director of the Residency Cosmetic Clinic at UT Southwestern and a recognized leader in 3D surgical planning, he brings technical precision to each procedure, including MTF top surgery.
Breast Implants for Transgender Women
Silicone or saline implants are the most common choice for creating a feminine chest. They offer volume and predictable shape in one procedure.
Here are the key benefits of breast implants for MTF top surgery:
- More volume in one procedure: Ideal for patients starting with limited breast tissue.
- Shape and projection control: Surgeons can select implants that match your goals.
- Smooth, cohesive gel options: Silicone implants feel more natural and last longer.
- 3D imaging during consultations: Patients can preview their results and select their preferred size.
Implants allow for a dramatic change and can be tailored to suit the body type and chest structure.
Fat Grafting for MTF Top Surgery
Fat grafting, or lipofilling, transfers fat from one part of the body to the chest. This can be used alone or with implants.
Consider the following advantages of fat grafting for transgender breast augmentation:
- More natural texture: Fat feels like native breast tissue under the skin.
- No foreign material: Ideal for patients who prefer to avoid implants.
- Contouring boost: Liposuctioned areas, such as the waist or flanks, appear slimmer.
- Subtle enhancement: Good for refining results or layering over implants.
This method works best when there’s enough body fat and the goal is modest volume.
Comparing Scarring and Recovery Times
Recovery and scarring differ depending on the technique used. Patients should weigh each factor carefully when making a decision.
Here’s how recovery and scars compare between the two options:
- Implants: Small incisions under the breast or around the areola; mild soreness for 1–2 weeks.
- Fat grafting: Tiny entry points at liposuction and injection sites; longer healing if multiple areas are treated.
- Both options: Return to light activities in a few days and resume full activity in 4–6 weeks.
Most patients return to normal routines quickly, especially with proper aftercare.
Long-Term Results and Maintenance
Every patient wants long-lasting results. Here’s what to expect over time from both methods:
- Implants: Results last 10–20 years on average; may require revision over time.
- Fat grafting: Some volume may be absorbed by the body; results stabilize after a few months.
Patients who maintain weight and hormone therapy often enjoy consistent results.
Let’s Create the Look That Feels Right for You
Choosing between fat grafting and breast implants for transgender women doesn’t have to be overwhelming. For expert help with MTF top surgery, call 972-972-4708 to explore your options with confidence.
Posted in: Breast Implant Revision Surgery
