(413) 731-7877
100 Wason Avenue
Springfield, MA 01107
Pioneer Valley Plastic Surgery
Pioneer Valley
Plastic Surgery
Reconstructive & aesthetic plastic surgery

Breast Augmentation (MTF) Top Surgery

Male to female breast augmentation, or MTF top surgey, procedures shape male breasts to female. Implants are placed under your chest muscle to provide fuller, firmer, female breasts. Prior to scheduling your surgery, we will require a letter from your therapist documenting how long you have been in therapy. A minimum of 3 months of therapy is required. See FAQs and photos of M to F breast augmentation surgery performed by Dr. Johnson.

Saline Implants

Saline implants have a silicone outer shell and are filled with saline solution at the time of your surgery.  This allows for a smaller incision. We use FDA approved saline implants from Allergan and Mentor.

Silicone Implants

Silicone or gel implants have a silicone outer shell and are pre-filled with a cohesive silicone. We use FDA approved gel implants from Allergan, Mentor, and Sientra. 

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Male to Female breast augmentation before & after photos

all photos are of actual procedures performed by Dr. Melissa Johnson
BEFORE & AFTER: Breast augmentation #1
Chest Reconstruction (Male to Female) case #1
Age: 56. Height: 5' 11".
Weight: 201 pounds.
After photos were taken 8 months after surgery.
BEFORE & AFTER: Breast augmentation #1
Chest Reconstruction (Male to Female) case #2
Age: 29. Height: 5' 6".
Weight: 123 pounds.
After photos were taken 3 months after surgery.
You can see other plastic surgery procedures in our

Am I a good candidate for MTF breast augmentation?

During your consultation, Dr. Johnson will provide you with her expert opinion as to whether a breast augmentation with implants is a good option for you. She will help you decide which size and shape would fit you best. The risks and benefits and possible complications of surgery will all be discussed. Once you are fully informed, you will be able to determine whether having breast augmentation surgery is for you.

What do I need to schedule MTF top surgery consultation?

If you do not plan on using insurance coverage
call us at (413) 731-7877 and schedule the consultation. You are required to pay the $100 consultation fee over the phone when you schedule the appointment. The fee will be applied to the overall surgery cost.
If you want to use your insurance for coverage
Contact your insurance company and find out if Gender Reassignment Surgery is a covered benefit in your policy as well as verifying that Melissa Johnson MD is contracted with your insurance.
If it is a covered benefit, you will need to obtain a copy of the medical policy listing the criteria that is required and document the person you spoke with.
Fax or email the medical policy AND proof of covered benefit to our office (fax # 413-731-7870) or email to info@pvps.net along with the required documentation (i.e. therapist letter). Include your phone number so we can contact you with your appointment.
Once we have received all of the documentation, we will call you to schedule your consultation. If you have not received a phone call from us after 7 days, please check in with us to make sure we have received everything.

In addition, some insurance companies require referrals. If your insurance plan requires a referral, please contact your primary care doctor for the referral and ask them to fax it to us. The appointment cannot be scheduled without the referral.

Will I be charged for an initial top surgery consultation?

Yes. There is a $100 cosmetic consultation fee for your initial visit. If you choose to have surgery with Dr. Johnson the $100 consultation fee will go towards your surgery cost. We will deduct $100 from the surgery quote given at the consultation. Please keep in mind that the consultation fee is due at the time that you schedule your consultation by telephone.

Will I be seen by the surgeon?

Yes. You may begin your consultation with Christina, our Physician Assistant first, and Dr. Johnson will meet with you to discuss all your surgical options. We'll answer all your questions and provide you with all the necessary information so that you'll feel confident and comfortable with your surgical decisions.

Is the plastic surgeon board certified?

Yes. Dr. Johnson is board certified by the American Board of Plastic Surgery, is a fellow of the American College of Surgeons, and is a proud member of the American Society of Plastic Surgeons. Additionally, she is a member of the American Society for Aesthetic Plastic Surgery, which recognizes surgeons who specialize in cosmetic plastic surgery.

Are there different types of breast implants?

Yes. There are a few different brands that are FDA approved, Natrelle by Allergan, Mentor, and Sientra. All implants are either filled with silicone or saline. The implants can be either smooth or textured. There are also different shaped implants, such as round or anatomical. And finally, the projection of the implant can be low, moderate, or high.

Where is the breast implant placed?

There are two locations to place breast implants. They can be placed under your chest muscle called submuscular placement or the implant is placed over the muscle but under the breast tissue called subglandular placement. During your consultation Dr. Johnson will discuss with you the pros and cons of either procedure and she will determine the best option for you.

Where will my breast augmentation incision be?

The most common sites for incisions are: inframammary, periareolar, and transaxillary. The inframammary incision is placed at the breast fold. A periareolar incision is made around the nipple/areola complex. A transaxillary incision is made under the arm.

What is the surgical process for male to female breast augmentation?

The surgery is performed at a hospital. During surgery you will receive general anesthesia. The surgery will take between 1-2 hours. Once you are awake you are taken to the recovery room for another 1-2 hours and then discharged home.

How should I prepare for my MTF top surgery consultation?

Research on reputable internet sites such as the World Professional Association for Transgender Health and the American Society of Plastic Surgeons can be very informative to help provide an overview. At the time of your consultation it may also be helpful to review before and after photos of patients that have had the procedure. At the time of your consultation it's a good idea to write down any questions or concerns you have so they can be fully addressed. Know what your surgical expectations are so Dr. Johnson can discuss them with you. If you are a smoker we recommend you quit to help reduce the risk of wound healing. We also recommend a healthy lifestyle to help your recovery process.

Can I have top surgery without seeing a therapist?

No, Dr. Johnson requires a letter from your therapist. The requirement is at least 3 months of therapy.

What does the therapist letter for MTF top surgery need to state?

The letter must be from a licensed social worker or Psychiatrist or Psychologist. It must state how long you have been in therapy, as well as hormonal therapy, the diagnosis of Gender Dysphoria, the duration of time that you have been living full time as the desired gender, and that the therapist feels you are ready for the next step of the process (surgery).

What is the recovery process for MTF top surgery?

The first couple of days you may feel pressure and tightness of the chest due to the implants. You will notice that the pressure decreases with each passing day. You are sent home on pain medications which will decrease your discomfort. We will recommend that you wear a sports bra after surgery to provide support. We request that you do no heavy lifting for at least one month following surgery.

Where will my MTF breast augmentation surgery be performed?

Dr. Johnson has privileges at Baystate Medical Center and Mercy Medical Center. Both are accredited by the Joint Commission and have been awarded the Gold Seal of Approval, and both are conveniently located in Springfield, MA.

Are there risks involved with MTF breast augmentation?

Yes, there are risks with any surgical procedure. The most common risks with breast implants are rupture, capsular contracture (firmness of the scar tissue that develops around the implant), and the need for another operation due to asymmetry, implant malposition, hematoma/seroma or unsatisfactory results. Other risks are pain, changes in nipple sensation, or infection.

Can I get a letter from Dr. Johnson after my MTF top surgery to change my birth certificate?

Yes, we will be happy to provide a notarized letter upon request after your surgery.

Is hormone therapy a requirement for MTF top surgery?

Yes, we require a letter from an Endocrinologist. A minimum of 12 months of hormone therapy is required.

How much does MTF breast augmentation cost?

Breast Augmentation can range between $6,500-8,300 depending which implants you choose. That cost is approximate and includes the surgeon’s fee, hospital fee and anesthesia.

Does my insurance cover MTF breast augmentation surgery?

Currently, there are no insurance companies that cover breast augmentation. However, there have been many changes with insurances, so if your insurance is telling you that they do cover, please let us know so we can look into it.

Is MTF breast augmentation with implants considered a cosmetic procedure?

If you are placing implants because you are not satisfied with the size and shape of your breast, it is considered a cosmetic procedure. However, if you have breast asymmetry from a congenital breast deformity, a traumatic injury to your breast, or a deformity from breast cancer surgery, your insurance carrier may consider it medically necessary and not a cosmetic procedure.

Do you offer payment plans or financing for MTF breast augmentation?

financingYes. We offer patient financing through CareCredit. You can apply on their website at CareCredit Online Credit Application. If you choose not to do financing, you can make payments to our office; however the entire amount must be paid in full by 3 weeks prior to the surgery.