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What is MTF

Male to Female Top Surgery

If you’re transitioning from male to female, or from an obviously male appearance to a more androgynous look, your agenda might include top surgery. Boca Raton’s Dr. Elliot Jacobs understands that for most patients, this means breast augmentation with implants and an emotional journey as well.

When you choose to have transgender surgery in Florida with Dr. Jacobs, you will benefit from his 35+ years of experience with breast surgery for both men and women. You’ll enjoy pressure-free assistance in the decision-making process as well as great results. The board-certified plastic surgeon and his exceptional staff will be with you every step of the way.

MTF Top Surgery: Your Readiness

As you probably already know, MTF top surgery involves so much more than cosmetic surgery. In addition to all there is to learn about the surgical process, you’ll need to be ready to share information with us so we can ensure you have a good experience and an optimal surgical outcome.

Our goal is to learn key details about you: your background, health, support system, and so on. This will help us understand your individual needs. We’re also committed to delivering all the information you require, no matter how many questions you may have. Open, honest, complete information exchange is the best way to ensure you and Dr. Jacobs can work together to create the right strategy for your transformation.

Dr. Jacobs has the experience, training, and compassionate approach necessary to be a great partner for you during this part of your transition. Contact him at 561-367-9101 to find out more.

Male breast, before Male to Female Top Surgery treatment, front view, patient 1
Male breast, after Male to Female Top Surgery treatment, front view, patient 1
Male breast, before Male to Female Top Surgery treatment, oblique view, patient 1
Male breast, after Male to Female Top Surgery treatment, oblique view, patient 1

Psychological Readiness

An important aspect of our partnership will involve ensuring you are ready for MTF surgery inside and out. During your consultation, Dr. Jacobs will ask you about your gender confirmation journey.

You may want to bring a letter of recommendation from your primary care physician or psychologist, and we may ask for permission to contact them for a discussion. In general, we find that individuals who have identified as female for years, have already begun hormone therapy, and have a strong support system are good candidates. When people like these seek input from a plastic surgeon, they are usually ready for breast augmentation. Still, plastic surgery is a big step and we should all be certain that the time is right for you.

Achieving Great Results

During your consultation, we’ll discuss many details that directly relate to achieving the appearance you’re seeking, and you’ll have some decisions to make. If you feel most comfortable with a non-binary identity and just want to add a little volume, fat transfer to the breasts may be possible. Many MTF individuals elect breast implants, however. Here’s an overview:

  • Silicone vs. Saline Implants: You may already know that both saline and silicone gel breast implants are available. Each type has advantages. Silicone implants tend to look and feel more natural to many individuals undergoing man to woman surgery, particularly if there’s little natural breast tissue. Saline implants, which are filled with salt water after insertion, require shorter incisions and cause nearly invisible scars. Both implant types are safe. If a saline implant should rupture, the body will absorb the fluid harmlessly. The change would be noticeable and you’d need a procedure to replace the implant. Today’s silicone implants contain a cohesive gel. If an implant’s shell is compromised, you may not even notice since the gel doesn’t migrate outside the breast pocket. Dr. Jacobs will show you both kinds of breast implants during your consultation to help you make your choice.
  • Implant Size: Size is a key decision for most people transitioning from male to female. Don’t be too worried about this aspect of surgery prior to your consultation, though. There are many factors to consider such as the size and shape of your torso, how natural you want to look, and more. Dr. Jacobs will walk you through various factors and help you try on sizers to assist you.
Male breast, before Male to Female Top Surgery treatment, front view, patient 2
Male breast, after Male to Female Top Surgery treatment, front view, patient 2

Placement and Incisions

The placement of your implants above or below the pectoral muscle plays a key role in your ultimate results. The decision you and Dr. Jacobs will make about placement should take into account both your body type and the results you have in mind. For instance, if your pectoral muscles are large, you can consider placing implants above the muscles to de-emphasize them. On the other hand, this may cause your implants to be more noticeable, especially near the top of your breasts, since you may not have much tissue to conceal them.

Speaking very generally, many patients opt for placement below the muscle for a variety of reasons. In addition to a natural look, this option tends to reduce some risks associated with implants, such as post-surgical rippling. But placement below the muscle often means a slightly longer recovery, and sometimes implants under the muscle can look distorted when a patient flexes. The type of implant and placement you choose determines incision location. In most cases, incisions beneath the breast yield best access-many plastic surgeons favor this location. If you choose saline implants, it may be possible to insert them through very small incisions at the edge of the areolas.

The Role of Skin: Most people who decide to have MTF surgery have enough skin with sufficient elasticity to accommodate breast implants of moderate size. If this is not the case for you, or if you’re considering larger implants, a two-stage operation may be the best bet. You and Dr. Jacobs can discuss this during your consultation.

Why Realistic Expectations Are Important

One very important key to post-surgical satisfaction is realistic expectations. After surgery, you will most certainly have breasts. And if looking natural is important to you, Dr. Jacobs’ surgical plan will address this goal.

Breast augmentation surgery will not modify the overall shape of your torso, however, nor bring about other changes. If you’re interested in more ways to enhance your transition from man to woman, surgery for the face and liposuction may be possibilities for you. Let us know your ideas, as we combine procedures to save our patients money and downtime whenever possible.

Be sure you give some thought to what your body will look like after surgery, and plan to discuss your expectations with Dr. Jacobs during your consultation.

Are You a Candidate for MTF Top Surgery?

We follow guidelines established by The World Professional Association for Transgender Health (WPATH) to ensure a patient is a candidate for MTF surgery in Boca Raton.


Patients should be able to consent to treatment and make a well-informed decision

Older men

Medical and mental health concerns should be stabilized before treatment

Patients affected

You should have a consent form written by a psychologist or other mental health professional

What to Expect from Recovery

What will you be feeling on “the big day” of top surgery? Eager anticipation, perhaps? A measure of anxiety, maybe? How about both?

Dr. Jacobs has been performing breast surgery for both men and women for more than three decades, and he and his talented staff have worked with all kinds of people. No matter what you have to say when you walk in the door on the morning of surgery, or if you’re too nervous to say much at all, they will not be surprised. The whole team will be there to help.

After you arrive for top surgery in our Florida office, you will meet with our veteran anesthesiologist and see Dr. Jacobs again to confirm the details of your procedure. Then it will be time to get started!

What to Expect from Recovery
Benefits of Gynecomastia Revision Surgery

Benefits of MTF Top Surgery

Top surgery is great for patients looking for the following benefits:

  • Decreased gender dysphoria in social situations
  • Increased comfort in their own skin
  • Recognition as a female by society
  • Satisfaction with the procedure and an improved body image

Top Surgery Risks

The good news about breast surgery is that it’s typically very safe. As with any type of surgery, some risks are possible, however. These include infection, hematoma (blood build up), seroma (fluid build up), excess swelling and a few others. We’ll give you information to help you be on the lookout for these.

Specific risks of concern to MTF top surgery patients include:

  • Adverse scarring: Although most people find their scars to be completely acceptable after healing, scarring is somewhat unpredictable. Prominent scars can be treated with injections if needed or in extreme cases minor surgical repair.
  • Loss of sensation: Nerve endings generally reattach in time after surgery. It is possible, however, to experience some permanent loss of sensation, either in patches or in a more widespread manner.
  • Capsular contracture: This condition occurs when the breast pocket created to accommodate the implant tightens up after surgery. Scar tissue squeezes the implant and can distort its appearance. The effect can range from mild-not requiring correction-to severe. In the latter case, additional surgery may be required. The good news about capsular contracture is that its incidence is declining as plastic surgeons learn more about how to prevent it. Implant placement under the muscle appears to reduce this risk.
  • Rippling: Saline implants can occasionally be seen to ripple under the skin – especially when there is scant breast tissue to cover the implants. Very rarely a patient will complain about hearing the liquid sloshing inside their breasts.
  • Implant movement: Implants can become displaced after surgery. This complication happens very rarely, especially with implants of small to moderate size. If you are considering larger implants, you should know that the risk of displacement is slightly higher.
  • Regret: Patients who decide to have male to female surgery sometimes wonder what will happen if they regret the decision. The procedure can be reversed if necessary, although the skin will be stretched to some degree and telltale scars may show. Dr. Jacobs will encourage you to minimize the chance you’ll have regrets through counseling, education, lead time to consider your choices, input from family and peers, and other measures.
Risks of Revision Male Breast Reduction Surgery
Why Choose Dr. Jacobs for Breast Reduction Surgery?

Why Choose Dr. Jacobs for MTF Top Surgery?

If you’ve been considering top surgery for years and have begun your transition with hormone therapy, it may very well be time for a consultation with Dr. Jacobs. He will give you all the information you’re seeking and get to know you and your goals. You may decide to schedule a procedure on the spot, never, or at some point in between – it’s completely up to you. Call us at 561-367-9101 for an appointment.

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Reach out to Dr. Jacobs today to schedule your consultation!


FAQ: Search icon

What is the role of skin in MTF top surgery?

Most people who decide to have MTF surgery have enough skin with sufficient elasticity to accommodate breast implants of moderate size. If this is not the case for you, or if you’re considering larger implants, a two-stage operation may be the best bet. You and Dr. Jacobs can discuss this during your consultation.

How can you reduce the risks of MTF top surgery?

There are two important ways you can reduce the risk of problems following MTF top surgery. First, choose a plastic surgeon who is certified by the American Board of Plastic Surgery. This ensures he or she has successfully completed formal training in plastic surgery and has undergone a rigorous evaluation process. Next, be sure to follow pre- and post-surgical instructions to the letter.

What are the results from surgery?

When it comes to how you feel about your results, we look forward to hearing from you! We know top surgery brings about physical and emotional changes – some we would not presume to forecast for you.

With that said, since breasts are so integral to a feminine appearance, if looking “womanly” is your goal you can have every hope of feeling great about the change. Most patients are very satisfied with their new figure, many reporting increased confidence, excitement about shopping for clothes, a heightened pleasure with intimate relations and so on.

Where is surgery performed?

If you’re like most patients, you’ll have MTF top surgery in our private, fully accredited operating suite. Inspected by the same organization that certifies hospitals, our modern, spotless facility accommodates just one patient at a time. You will be the star of the day, and your safety is our top priority.

Chances are, your procedure will be performed using intravenous (IV) sedation, also called twilight anesthesia. This means you will sleep easily during surgery and awaken quickly and without the side effects of general anesthesia.

How long does surgery take?

Breast surgery usually takes 90-120 minutes. Afterward, we’ll put you in a soft, supportive bra and move you to the recovery room where you will be monitored closely. After an hour or two, you can have a friend take you home to rest that same day.


Dr. Elliot William Jacobs is a board-certified aesthetic plastic surgeon who specializes in FTM top surgery, gynecomastia surgery, revision gynecomastia surgery and male breast reduction. He is a native of New York and has over 40 years of experience in his field. Dr. Jacobs is a highly respected and sought-after surgeon who is known for his skill, experience, and compassion. Whether you are interested in gynecomastia for the first time, or are looking to correct a gynecomastia you aren’t happy with, Dr. Jacobs can deliver amazing results.


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