Breast Surgery for Gender Reassignment

By Elena Prousskaia MD, FRCS (Plast), FEBOPRAS

Having trained in oncoplastic surgery I can offer you a full mastectomy to remove breast tissue.

Alternatively, for male to female reassignment, Elena can carry out a one-stage breast augmentation using implants. If you prefer a larger cup size, it may be necessary for the surgery to be performed in two stages using expanders first, followed by implants later.

In this page, we look at:
• How Elena can help with Breast Surgery for Gender Reassignment
• Why choose Elena Prousskaia
• Advice On Breast Implants

How Elena can help with Breast Surgery for Gender Reassignment

You will be able to make a decision about the right surgical option for you following a long conversation and examination in the clinic.

It is normal to have a second consultation, for you to ask any further questions, once you have had time to consider the different surgical options. After the decision is made we will carefully prepare for your surgery.

Elena will talk you through all the necessary pre-surgery investigations, as well as the after-care required. She will also fully explain the risks associated with the operation. We will only go ahead with the procedure once you are completely ready and happy with the choice we have made together.

Why choose Elena Prousskaia?

Ms Elena Prousskaia has been carrying out aesthetic and plastic surgery procedures for more than 20 years. Elena trained for eight years in Plastic and Reconstructive Surgery and since then has held leading Fellowships around the world and specialised in breast surgery procedures, whether a patient is having the procedure for purely aesthetic reasons or as part of breast reconstruction.

As an NHS Consultant Plastic and Reconstructive Surgeon at Southmead Hospital, she dedicated several years to complex microsurgical reconstruction and general plastic surgery. During this time at North Bristol Trust, she particularly enjoyed rebuilding patients who suffered from breast cancer giving them their body and confidence back. At present, Ms Prousskaia runs her own successful private practice performing full range of plastic and aesthetic surgery for face, body and breast. Elena Prousskaia consults in several clinics around the South West. Please see the ‘Our Locations’ tab in the menu for exact addresses or call us to discuss your closest location.

Advice on Breast Implants

Since December 2018, many regulatory bodies around the World have issued statements regarding their own position and some have limited the distribution of other textured devices. The advice does vary from country to country because the research data available is limited and not conclusive. None have called for the precautionary removal or replacement of textured devices that are already inside patients’ breasts.

Breast implants however are not lifelong devices and in general will need removal or replacement at some point. In an effort to have more robust data about both conditions, the Breast and Cosmetic Implant register (BCIR) collects breast implant data for patients in England and Scotland. The MHRA continues to collect and analyse UK information through a reporting system. It also has links with up to date information from international public health organisations. The most recent advice from MHRA on BIA-ALCL was updated on the 4th April 2019.

View the MHRA statement on Allergan

Download the BAAPS statement on ALCL

Frequently Asked Questions

What Is The Aftercare For Gender Reassignment Surgery?

The Elena Prousskaia Clinic prides itself on the quality of its aftercare so we will make absolutely sure you know what to expect, and how much rest is needed. We will give you specific instructions that may include how to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with Elena.

What Are The Risks For Gender Reassignment Surgery?

While complications are infrequent, no surgical procedure is without risks. Among the possible complications are scars, infection, haematoma, implant displacement, breast asymmetry and implant rupture. Elena will provide you with further information with the risks and provide you with a detailed consent form during your consultations. This will help you to minimise the risks.

What Does Gender Reassignment Surgery Entail?

Depending on your aim, Ms Prousskaia offers both breast tissue removal for female to male transition and breast implants for Male to Female transition. Normally both procedures are a one-night stay and are carried out under general anaesthetic.

What Does This Procedure Cost?

Please scroll down for more information on pricing.

What Is The Likely Recovery Time For Gender Reassignment?

The recovery tends to be similar to other breast procedures. The final result will be seen 12 months after surgery once swelling has settled down. You should rest and avoid any physical activity in the first 48 hours after surgery. You should avoid all sport activities, housework such as hovering, driving, dog walking for at least 4-6 weeks following surgery and any weight lifting or strenuous activities for up to 8-12 months following the surgery. Patients can benefit from taking four weeks off work, and after you have seen Ms Prousskaia for your four weeks follow up you can discuss beginning a gym routine focused on lower body strength.

Is This Procedure Painful?

After surgery it is normal to experience some discomfort, the level of which varies widely amongst patients. There is rarely prolonged pain unless there is a complication and in all cases you will be prescribed pain medication.

What Is The Difference Between This And Breast Reduction?

Breast tissue removal for Female to Male transition in most of cases is performed with horizontal scars and free nipple areolar graft to achieve male chest shape. Breast tissue removal can be combined with liposuction and skin tightening to avoid skin excess in large volume breast tissue removal.

What Type Of Implants Are Used For Male To Female Reassignment?

The shape of implants can be round or anatomical (teardrop). Both can provide an excellent result. The outer shell and the filling may vary depending on the manufacturer. Miss Prousskaia has never used PIP implants in her practice and she will offer you high quality implants from the best manufacturers. You will discuss with Miss Prousskaia which specific shape and size of implant would give you the optimal result. You should know that in the European Union (EU) 95% of implants used for breast augmentation are made of silicone gel and only 5% contains other type of fillings such as saline. Mentor Silicone Gel-Filled Breast Implants are devices with shells constructed from silicone elastomer. The shell is filled with MemoryGel®, Mentor’s proprietary formulation of silicone gel.

What Would My Expected Results Be?

Elena prides herself on taking the time to truly understand a patient’s aims and discussing what result will work best given the patient’s body shape and size. Although good results are expected, the body is not symmetric and almost everyone has some degree of unevenness, which may not be recognized in advance. The more realistic your expectations as to results, the better your results will be in your eye. You will have at least two consultations with Elena where she ensures that she meets your expectations and she will always try to achieve your desired results.

Am I A Candidate For Gender Reassignment Surgery?

Gender reassignment is a long process, which takes place with counselling and treatment by primary care doctors, psychologists, endocrinologists and surgeons. To consider suitability for surgery we would need to liaise with your GP to confirm that you fulfil the appropriate criteria, such as well documented gender dysphoria, a letter from a qualified mental health professional. You must be over 18 and not have acute mental health concerns. Usually with this kind of surgery the patient has already been living in a gender role for more than twelve months and receiving therapy.

Treatment Cost

The total cost of the surgery will be confirmed after the first consultation.

The cost includes the hospital, surgeon and anaesthetic fees. It also covers all post-operative visits. The initial consultation fee will be invoiced separately. The prices apply only at the time of publication and are subject to changes without notification.

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Initial Consultation...

£200 - £250 location dependant

Surgery Costs From...

£TBC at consultation

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Treatment At A Glance

Surgical Time TBC at consultation
Hospital Stay Over night hospital stay
Initial Recovery Time 4 - 8 weeks
Anaesthetic General anaesthetic
Final Result 3 - 12 months
Follow Up 1, 4, 12 weeks & 1 year

Treatment Downloads

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BBA RCS BAPRAS Guide to Breast Augmentation

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WHAT DO ELENA'S PATIENTS SAY...

Elena was recommended to me and as soon as I met her I felt entirely comfortable. Her explanations made sense in terms of expectations. Having made the big decision I did feel nervous but had absolute trust and confidence in Elena. I knew I was in the best hands. Elena's team is so supportive, my questions were answered with patience and understanding. My care at the McIndoe Centre was excellent. I am five weeks post op for abdominoplasty and liposuction and last week. Quite amazing to see the before and after pictures! I am so pleased that I was fortunate enough to meet Elena and have no hesitation in recommending her.

SM – Abdominoplasty & Liposuction

I have been both physically and mentally uncomfortable in my body since I was 12. I was born with ‘breast mutation’ and I first had surgery to correct this through the NHS at 16 years old. The surgery I have had with Elena, 17 years later, has removed the NHS implants, one of which had ruptured, and completely altered the shape of my chest. By doing this she has made me look and feel like a woman for the first time in my life. She is at all times quietly kind and fiercely adept. A true artist. She has surrounded herself with the most wonderful team and I cannot thank them all enough for the new lease of life that I have been given.

EG – Removal & Replacement of Implants

I have been self conscious for the whole of my adult life and I cannot express how much this surgery  has changed things for me. Both mentally and physically. I highly recommend Elena. She supported me throughout my journey from start to finish. Elena is very particular which for me is really important. Elena really took care of me from initial consultation right through to surgery and aftercare.My scaring is minimal and I am absolutely over the moon with my results. Thank you Elena!

JB – Breast Reduction

Elena is an OUTSTANDING surgeon. I had PIP implants and was looking to have them changed. I knew Elena was the surgeon to help, she put me at ease and explained my options. The lovely ladies in her office were helpful, I wanted to get sorted asap, when an alternative date was available contacted me straight away. I received outstanding care from start to finish from Elena, her team and the hospital.  The aftercare is amazing, nothing is too much trouble, can call any time. I was so relaxed, I knew I was in great hands.  The final results are fantastic. Elena has worked magic and I couldn’t be happier.  I’m so glad I found her. I can’t thank her and her team enough.

LMS – implant Removal & Replacement

Had surgery with Elena in September, I was extremely anxious about the whole thing, but Elena and her whole team, from admin to the hospital staff were amazing with me and reassured me throughout my journey. I can not recommend Elena enough, and she has changed my life for the better! Already saving for my next operation with her!

SM – Abdominoplasty & Arm Lift

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