How long on HRT before breast surgery?

    • 62 posts
    March 31, 2009 6:44 AM BST
    Hi all. To those that remember me, I apologize for my long absence. Life has been flowing! But anyway, I'll move onto my question.

    I am now 10 months on HRT. As of 3-6 months ago, my Estrogen level was around 790 and my Testosterone finally hit 130.

    Now I am an impatient girl. With my inserts I fill a 36B and I like this size on me. But of course I want that to be the reality without inserts. I haven't exactly checked, but my breasts are probably almost an A cup.Knowing my small frame and lack of a tendency to gain weight, I don't expect to gain said desired breast development.

    Given this conclusion, I am definitely considering breast augmentation surgery in the future. Being the impatient girl that I am, I even discussed with my mom about financing it sometime later this year.

    And here comes the question that affects my decision completely. I know that breast development is slow with hormones. I know that my breasts are still developing. My question(s) is/are:

    -Should you wait a certain amount of time while on HRT before considering/getting breast augmentation surgery? What are the medical/preference related reasons?
    -If there is a time period where it is "too early" to consider surgery, is this due to: 1) concerns about hormonal developmental conflicts after the surgery and/or 2) concerns about needing more adjustments in the future due to the early decision?

    Basically, being 10 months on HRT, is it plausible or foolish to be considering breast augmentation surgery anytime in the next 8-12 months?

    Thanks!

    Angel
  • a a
    • 96 posts
    March 31, 2009 11:01 AM BST
    Hi Angelyn,
    Welcome back to TW,as to your question about breast surgery,I`m no expert but I believe it takes 18 months to 2 yrs for your breasts to develop fully when taking hormones.So if you have been on hormones for ten months then I would leave it until at least 18 months before even considering surgery.Give your body time to grow and adjust to the changes it`s going through.Be patient girl!!! it`s not a race.You`ve only got one body and you need to take good care of it.
    Hugs and kisses,
    Michelle xx
    • 62 posts
    March 31, 2009 10:10 PM BST
    Thanks for all the feedback, everybody. I am really taking it into consideration and will be heeding all the advice received. It was hard to find information regarding the consideration of HRT and surgery so I figured asking on here would get me a better slew of opinions/advice.

    I guess it would be better to focus on saving up for SRS.

    Now I know legally you need to wait til you've been full time a year (in most cases) before you perform SRS, along with having a psych eval and another psychologist related letter. Is there any other reasons (preferably biological/medical) that time is needed between the start of HRT and SRS?
    • 1912 posts
    March 31, 2009 10:17 PM BST
    Lucy is right on. At 1 1/2 years on HRT I told my wife my breasts probably would not grow any larger, but instead of stopping, they doubled over the next 2 1/2 yrs. It will be 4 yrs next week on HRT and I am a 38B. I just told my wife this past weekend that I think the bra I was wearing was getting to be too small. I know a gal who concluded after only 3 months on hormones the hormones were not going to work for her so she had a boob job. All I can say about them is they look awful, they look like half of a melon stuck to her chest and don't look at all real. What I love most about mine are they are real.
    Hugs,
    Marsha
    • 1912 posts
    March 31, 2009 10:40 PM BST
    Angelyn, there is no legalities involved in any of this other than documentation like a name change or your birth certificate. What you are really asking about is Ethics. SRS is permanent surgery and an ethical doctor is going to want to know it it the right thing for you. I'm sure with money in hand you could find a surgeon willing to perform the surgery with no proof of RLE. Making the physical changes is probably the easiest part of transition, living in society as the other gender is what will give you the biggest challenge. So the one year real life experience is for you to live as a woman in society and determine if this life is really for you.
    Hugs,
    Marsha
    • 62 posts
    March 31, 2009 10:54 PM BST
    Marsha, thank you for your replies.

    Consideration between RLE and surgery isn't my primary one. Living in the female gender has become everyday life for me and rarely presents a challenge.

    What I was looking for was more along the lines of how 1-2 years of HRT does not create enough breast tissue to allow for good quality breast augmentation and that further HRT development could negatively affect the quality of the breast augmentation in the future. I was looking for considerations more along those lines with relation to SRS.
  • April 1, 2009 7:26 AM BST
    Breast implants don't always look like two "half melons" there is a wide variety of shapes and types available today, the only problem with them is the scars, these vary from person to person but will always remain visible to some degree.
    So don't listen to some of the uneducated and biased views on here, breast implants can look and feel very real, I know from personal experience!!!
    I do agree with the comments about rushing into it though, give your hormones a chance! but remember not every one will grow them.

    Huggles

    Becca

    Ps. before some clown says "you've not had implants" I know some one that had it done last year and I attended all the hospital visits with her.
    • 1 posts
    April 5, 2009 7:00 PM BST
    Hi Angelyn....
    And Hi to anyone else who reads this post.....
    It would appear Angelyn that your journey and mine do have some similarities......I have been on HRT now for a little over 9 months now.....I also am very impatient with looking more and more feminine as soon as possible....I should mention that I now live full time....(and love it)(never been happier).....Breast wise, I am lucky, I started with some male breasts and now can fill a "B" cup bra....but as I am (or think I am) large chested, I would like to have breasts that would offset my larger chest size......
    Here in Canada, it is a lot harder to get prescription drugs over the internet.....so after a lot of self searching I decided to go through my family doctor and get referred to a specialist for HRT treatment......I made a good choice and was able to acquire a very good specialist who works only with gender people like us.......At my last appointment with my specialist, he was very happy with my estrogen level and my testosterone level.....so I asked him about breast augmentation, and how long one should wait....I have read, that it takes up to 10 years for breasts to fully develop, and expected that I would have to wait some time period before getting implants.....I was surprised when he advised me that there was no reason that I needed to wait to acquire breast implants.....I trust my doctor, and I plan to go and see a cosmetic surgeon after Easter and get his advise on implants and of course other feminization surgery....
    I am telling you this, not because I am advocating what my doctor has told me, but I am telling you this, because I believe you should seek your own medical advise and make your decision from what they tell you and what you feel.....I also am going to see what the cosmedic surgeon is going to tell me, before I make my final decision......
    I have also been advised by one of my friends who is a nurse and has had SRS....she had SRS and breast augmentation at the same time, and was back at work in 10 days.....it is also something I am considering....(two birds with one stone sort of)....
    Anyways I do wish you the very best, and hopefully you will make the right decision for you.....and hope I have given you more to think about....

    Yours
    Karen

    • 10 posts
    April 6, 2009 4:46 PM BST
    Hi Angelyn,

    In my opinion 10 months is not enough time to allow you body time to adjust to the new hormones going through your system and the lack of the old ones. Give things time. Like all the other girls have commented it does take time and they have shared a lot of good advice. I myself have been on hormones since February 2003. That is over six years. At my 2 year mark I had just graduated int a very loose B cup bra still need a little padding to fill things out. Now six years later I fill out a 40 C cup quite well with no padding and no implants. It takes natal females from the age of 8 or 10 until for some well into their twenties to reach full breast growth. Just give yourself time. Enjoy becoming a woman and all the feelings associated with it. I wish you the best in what ever decision you make.

    Ginger M.
  • June 10, 2009 8:53 PM BST
    Yes it takes time but you can't really compare the time it takes for females with the time it takes for transsexuals. There is several reasons for this, one being fat… breasts contains a lot of fat so if you haven’t managed to have fat-redistribution your breasts will stay small. Another thing is age. Why speak about 9-10 year old girls when most TS are transitioning in their 30’s, 40’s or even older? Not the same thing at all because young girls has growth hormones to help them out but the most important is Progestosterone in young girls. I don’t know if you know but Progestosterone is the only natural anti-oestrogen in the body so when girls are having menstruation, the oestrogen is very low because of high levels of Progestosterone (even though Progestosterone might help on breast growth as well but then again Progestosterone also converts fat to energy so nothing is clear as black and white).

    So if we say girls have 1 week per month with low oestrogen, that is 12 weeks or 3 months with low oestrogen level per year while transsexuals taking oestrogen do so every day. So over 4 years in fact GG’s had only 3 years with high level of oestrogen even though they count 10 days per cycle. So the question is does TS have an advantage due to this?

    Males also have chest muscles that girls don’t have? and that also plays it part because these muscles are in fact UNDER the breast and goes up to your underarms. This muscles will never be soft because in fact it’s part of the breast and if you use this muscle you can move your breast with it which I believe GG’s can’t. So that makes both the shape and positioning of the breasts “typical” male breast and it’s only surgeries and breast implants that can correct all this but you really need fat on your breasts to make implants look good.

    My answer is therefore time is not a factor at all. You can have your breast implants when you feel you got enough fat to cover the implant because covering it with skin will never be good.

    xxx Natalie
    • 1912 posts
    June 11, 2009 3:15 AM BST
    Women have breast muscles also, they are very visible on women body builders. Although fat is a large part of breast tissue, it is not the only substance making up the breast. Nothing says you can't have breast augmentation at anytime but you have a higher risk of requiring it to be redone if you do it too soon. The problem is if there is significant breast growth after the BA, you are likely to have misshaped breasts requiring an adjustment. Nothing that can't be fixed, but an expense that possibly could be avoided.
    Hugs,
    Marsha
  • June 11, 2009 8:39 AM BST
    OK I agree but that is not an argument because GG’s having breast implants may also have the same problems as you can see many examples of in YouTube.

    Also don’t forget that no matter what, breast implants does not last for ever and once you are getting too old to have new implants, your breasts will look really bad. Good when you’re young but not good at all in you’re older days. I stay with my originals… big or small does it really matter?

    xxx Natalie
    • 1912 posts
    June 11, 2009 12:25 PM BST
    That's a good point Natalie about the implants not lasting forever. I have a couple friends with enormous implants which in my opinion are way too large. It will be interesting to see how things work out for them down the road. Personally I feel fortunate and happy to have 38B's. A little more would be nice but I can live with what I have.
    Hugs,
    Marsha
  • June 11, 2009 12:53 PM BST
    I've got "only" A but I'm very happy with them because they fit my body size. I know some TS that did not even reach AA so that is a bit sad but A or B is good enough I think? Beside this, it’s important to know that breasts never stands still. Some months they are larger some months they are smaller so I’m not too much worried about it but I must admit I like them better when they are larger (smile).

    xxx Natalie
    • 1912 posts
    June 11, 2009 1:04 PM BST
    I have a friend that is in awe of mine so she got her doctor to switch her to injections like me in hopes her's would grow. She has been on HRT for over 7 years now and she is maybe not even an AA. If anything the last time I saw her she looked smaller not larger, poor thing.
    Hugs,
    Marsha
  • June 11, 2009 1:46 PM BST
    What Rose said that even the best is for 10 years but I would say “only?” – I find it scary if I knew that I would have to go trough the same expensive operation again in 10 years time because I’ve seen how the tissues are totally growing around the implants after a while and just to remove them must make a lot of damages to the breast itself. For FFS I don't tink I would go trough the same pain ever again. Don't know about breast surgeries but I bet it hurts.

    If I would go for an option, I would then go for herbal products and breast creams because even a little improvement is worth a lot as it’s natural but since I’m happy with what I have I don’t need herbs nor implants as the hormones I take does what I expected it to do and I still got years for further enhancements so I will wait and see – no reason to rush is it?

    Yes I can also see (and feel) that when people starts to talk to you they first look at your breasts (and maybe your feet) and then into your eyes before they start talk and I can also “feel it” even if I don’t look at the person first.

    xxx Natalie
  • October 30, 2010 4:33 AM BST
    You can have implants after 5 months it is the doctors that make us wait for some strange reason, I am having mine done next year March D cups and I will have only been on for 6 months, your breasts will carry on developing after the implants so if you are ready go for it girl, I am paying R25000.00 which is about $3500.00 I can't wait 2 years no way I want my breasts yesturday.. I live in South Africa and help here is almost non existant but we do have great plastic surgens...
    • 2017 posts
    March 31, 2009 1:40 PM BST
    I'm not even on hormones so am not really qualified to answer but I have to say that I have read about the 'two year rule' before, there was a thread on it here somewhere too but I can't find it, sorry. One way to look at it though is consider how long it takes a teenage girl going through puberty to develop fully, having two teenage girls myself, I think two years is a fair comment by Michelle.

    That said, I think it does no harm in shopping around just in case you don't get the desired results. At least it gives you time to save for it and find a reputable surgeon.

    Nikki
    • Moderator
    • 1652 posts
    March 31, 2009 6:38 PM BST
    Hi Angelyn,
    Please take note everybody: THE “TWO YEAR RULE” IS A MYTH.
    Genetic females’ oestrogen levels start increasing around the age of 7 or 8, ramping up further from the age of 10 or 11 onwards. Girls do not achieve full breast growth in two years so why anyone should think a genetic male would is almost beyond me, except that I realise it’s a myth perpetuated by the internet…
    Full breast growth in genetic females AND in m2f’s on HRT takes SEVEN TO TEN YEARS. You may know a young girl and noticed her breasts growing and think that a couple of years later she is fairly well-developed, but her hormones will have been active for many years by this time; MUCH more than two years.
    Everyone IS different, but it is unrealistic to expect hormones in a genetic male to work that quickly. My mum was a B-cup for years, until her mid-twenties when she grew further to a C-cup. At this age she could well have been producing high levels of oestrogen for 18 years! I have a long way to go…
    I’ve been on hormones for 4½ years and am still growing. Development varies wildly, but it’s usually pretty slow and gradual. Slow and gradual is not a bad thing, it probably means a more natural shape will be achieved in the long run. Development with synthetic (and more dangerous) hormones such as ethinylestradiol or Premarin is usually quicker, but may or may not end up in a less natural shape due to the unnaturally quick growth. Conical or tubular breast shapes are not uncommon with these types of synthetic hormones.
    I’m taking bio-identical estradiol (ie exactly the same as is produced in a genetic female body) and I would advise anybody to try this first, but above all BE PATIENT.
    So what type of hormones are you on Angelyn? It makes a difference.
    But generally speaking I would say yes you are foolish to plan breast implants at such an early time. Give it years not months; several years, minimum five before you seriously think about it, in the meantime just be patient. It takes time. If you have implants too soon they will look extremely unnatural due to the lack of breast tissue for them to sit behind. I’ve seen dreadful pictures of girls who have gone this way; imagine a tennis ball, or a grapefruit cut in half and implanted under the skin, that’s what implants without sufficient breast tissue look like, even if implanted under the muscle.
    The downsides to implants are many. I personally would rather end up with small breasts that are my own body tissue and which look, feel and behave as such, than have silicone implants and associated scars.
    Implants don’t last forever, they will need replacing usually after about 10 years, more surgery, more hassle, more expense, more risk, perhaps more scarring. They are also more “obvious” than people may think.
    I have a very close friend who had implants done after 18 months on Premarin. They look fine, but she slightly regrets rushing into it. I was with her recently when a guy she had become friends with remarked out of the blue on her “nice boob job”. She doesn’t like her scars, they’re not bad, but they show, and always will. When she lies down her breasts look entirely false, of course, such is the nature of silicone.
    I’m now an A-cup and have done away with inserts, I often wear gel bra’s which give a knockout cleavage, but even with an unpadded bra my breasts just look “right”. They are small but a nice shape. They feel great, especially when someone else touches them! They look fine even without a bra, even on a topless beach, guys still like them even though they are small. And like I say, I am still growing.
    This two year thing is nonsense, so girls, please stop repeating unsubstantiated stuff you’ve heard on the internet. 7 – 10 years is normal. Go and read a biology book or just ask yourself, how many 9 – 13 year old girls do you know with fully developed breasts? Yeah, sure, everyone knows of a well-endowed 13 year old girl… but when she’s 21 she will be truly fully developed!
    So do yourself several favours, Angelyn and heed this advice – WAIT! It is WAY to early to have implants.
    xx
  • March 31, 2009 8:17 PM BST
    One other point to add if eventually you opt for SR surgery, you will probably find that you will go up a cup size within a year of being post op. But Lucy is spot on, especially the point about developing beast tissue before implants just imagine a condom stetched over half an orange that would be what the effect would be and another consideration if you do have implants too early and as you delvelope natural tissue it can distort the original shape, making your nipple go to the sides, top or bottom. Gender born females develope slowly from an early age then go through growth spurts.
    • Moderator
    • 1652 posts
    March 31, 2009 11:00 PM BST
    I don’t think Angelyn was actually asking about the ethical or legal implications, but rather the “biological/medical” benefits/disadvantages of being on HRT pre-srs. I can’t really think of any reason medically why you need to be on HRT for any length of time before having SRS. If you were on it for too long it may affect the amount of donor material available.
    Some say it doesn’t make a difference, I was on hormones for almost 3 years before SRS and I found donor material WAS affected, but with Dr Suporn’s skill and technique, the outcome was absolutely fantastic with no problems like lack of depth.
    So it probably won’t make much of a difference, but it may depend on your surgeon and his technique. “Old-fashioned” penile inversion is certainly more dependant on the size of penis though, so be warned – don’t leave it too long. And to those who think that depth won’t be important – just you wait! It is.
    I certainly can’t think of any advantages of being on hormones for a long time before having surgery.
    And yes, Angelyn, save your money, have SRS sooner and by then you won’t be fretting about the size of your boobs.
    xx
    • 2573 posts
    April 2, 2009 5:03 AM BST
    Whenever we discuss hormones with TG/TS people, it may be important to remember that many of us are here because we had abnormal sensitivity to androgens and estrogens as fetuses. We know so little about what makes us us, that it would be foolish to ignore the fact that hormones may affect us differently than GG/RG/GM. The variation of sensitivity to hormones, even within our community, means that the recommended "wait and see" approach is probably far more practical when estimating maximum growth. My male body took a spurt in my mid thirties and I "buffed out" significantly, much to my later dismay. Hormones are VERY POWERFUL drugs and the body is a very complex system. I recommend erring on the side of caution.
    • 2017 posts
    April 2, 2009 1:04 PM BST
    Danique, you looked very natural to me.

    Nikki
    • 2017 posts
    April 2, 2009 1:05 PM BST
    Danique, you looked very natural to me.

    Of course, I'm insanely jealous now!

    Nikki
    • 530 posts
    April 4, 2009 7:27 PM BST
    All my doctors and shrinks recommended wait for a MINIMUM of two years on hormones before considering augmentation.
    I had mine done after five years, having gained only size A/B naturally. The younger you start, the higher the chances are of you getting bigger naturally. (This is not writen in stone, more a generalisation).

    And because I am quite big in myself, I needed a fairly large implant to keep things in proportion. (I am now a C/D). Therefore my surgeon (who specialises in breast augmentation surgery privately and for the NHS) went for the long route, inserting expandable implants and gradually increasing the size over a period of months until they looked right. This gave my own tissue time to accommodate the implant, giving a very natural result.

    I have since had the 'expandables' replaced with sealed ones, but this is entirely a matter of personal choice, and not necessary. And over the last couple of years they have settled, and lost that initial 'boob-job' look of sitting high and firm.

    Have patience, and like others have mentioned already, natal females grow slowly and we get the best results by copying them.

    Good luck.
  • June 11, 2009 1:00 PM BST
    I was on hormones for over 4 years but never grew more that a A+ which didn't give me the correct looking chest to pass on the street...fisrt glance from EVERYONE was at my chest then my face then OMG! So I had about 2 sizes implants and am now I'd say basically a B but because of the fact that the implants are put under the muscles I find a C cup best.
    Surgoens prefer under the muscle as that keeps the implants from sliding about. GG boobs grow in the soft tissue which mean they are soft and floppy but will drop eventually.
    But if you look at a pix of a bodybuilder (for research!) you see that the pectoral is a very flat bottomed muscle and there is quite a gap in the middle. This means that 'maybe' my boobs wont sag but also I can't get the lovely squashed together cleavage look!
    My implants were best French make and leaftlet said to think about a life of ten years.

    Did anyone see the youtube of the poor woman with the monster implants? Tiny little woman - not sure from where maybe Phillipine/Puerto Rica - with soccer balls. Said they weighed 4 bags of sugar each = 8pounds? Had them to be the new record holder. Reporter asked how her back would stand up to the strain but husband quickly chipped in to say she exercised regualry.