The Quest for Beautiful Breasts : 7 Question for Transgender Implants

”How about really big ones, May! Like Raquel Welch or Pamela Anderson!”

“I just want a natural looking breasts,” she replied.

“But you could buy low cut tops and a skimpy bikini. It would be cool on the beach! I could take pics of you to look at when I travel and show my friends”, I tried.

“Grrrrrrrr”.

The growl was clear. Natural looking, natural sized breasts. I would not be dating Thailand’s Pamela Anderson after all. I sighed in disappointment. I was really hoping for the big ones. Don’t all men?

And so we went on a quest for breasts, after my girlfriend, May, a Ladyboy in Bangkok, Thailand, made it clear that in no uncertain terms, she wanted implants. I loved her looks as they were, but conceded to her wishes…as all wise men should!
It would be easy enough, I thought. This quest should last all of 20 minutes. They’re all the same. A sack of silicone. Stuff ‘em in. Instant breasts! Or so I thought. At our first stop, however, Doctor Arthi gave us a barrage of questions:

“Do you want saline or silicone?”

“Do you want textured or smooth implants?”

“How big do you want your implants?”

”Do you want a teardrop or round shape?”

“Do you want low, medium, or high profile?”

“Yo, yo, Doc! Slow down buddy!”

We’d never even seen an implant before let alone know what any of those options implied. I thought it was a simple matter of saying I want breast implants, fixing a price, and voila, Pamela! However, it seemed that wasn’t exactly the case.

“Do you want insertion through the armpit, nipple, underside of the breast, or belly button?”

“Do you want a sub-muscular or sub-glandular implant?”

It never even occurred to use that there were different places to insert the implant, but there were. It was all a bit daunting at first, but with each doctor we visited and each web-site we looked at, we gradually understood what all those questions meant. Frankly, our original view, that it really wasn’t so complicated, was essentially true, however, we wanted to be 100% clear about what each decision meant and its associated implications.

It was like buying a car. There were standard features and a few options, but you needed to understand both so that you could select the options that best suired your personal tastes. In fact, we found most decisions straight-forward except for one…

“I recommend smooth implants”, Dr. Thep had said.

“I recommend textured implants”, Dr. Kamol had said.

“I recommend big ones, May!” [I had to try one last time.]

Out of the five doctors we visited in Bangkok and endless hours on the internet, it turned out that the most difficult decision related to smooth versus textured implants. For all other options, the decisions were either personal or obvious for transgenders, and didn’t really require any technical knowledge.

For example, all Bangkok doctors recommended silicone implants, meaning the contents inside the implant sack were made of silicone gel versus saline (salt water). The consensus seemed to be that silicone created a more natural feel than saline, and concerns of possible health risks caused by silicone leakage in the body were unfounded, or perhaps more accurately, not proven. Admittedly, this debate continues. But for us, silicone it was.

Likewise, all doctors recommended a sub-muscular implant for transsexuals, meaning an implant below the pectoralis muscle. For women, it was also near universal that the implant should be above the muscle, and just below the breast glands, or sub-glandular. The reasons were cosmetic. The male body does not have much fatty tissue in the breast area and thus the outlines of an implant just below the skin’s surface would be visible. By putting the implant below the muscle, its outlines were hidden giving it a more natural look. The procedure required cutting of some muscle fibers at the bottom of the breast to create the implant pocket, however, this was considered normal and insignificant in its impact to muscular strength and movement. Sub-muscular it was.

As a side note to sub-muscular implants, we found it important to find a doctor who had experience with transsexuals, because the operation was simply not the same for women. While it was similar, it wasn’t identical, and we wanted someone who had experience in making a beautiful transsexual implant, sub-muscular, versus a doctor who had experience making a woman’s breasts beautiful, sub-glandular. [Granted, some doctors do perform sub-muscular implants on women.]

As for insertion point, all doctors we visited recommended inserting the implant through a cut at the bottom, front section of the armpit as it usually resulted in the least visible scar. However, we also had friends who had done insertions through the nipple and the underside of the breast. In all cases, we’d seen good and bad results, but more good results through the armpit, possibly because it was an area of skin folding already, and so, any imperfections were naturally hidden.

Profile and shape were personal cosmetic decisions, but the majority of transgenders we knew had selectied medium profile, round shapes. High and ultra high profiles were for a more dramatic appearance, making the breast stick out more than usual (the Pamela look, sigh). We had one friend who had the ultra-high profile, and, it looked great, or at least I thought it did! But May wanted natural looking, so medium profile it was. For shape, teardrops were more costly and had some slight risk of looking odd if they rotated after the operation. While we liked the idea at first, we didn’t want any risk at all of a second operation in the future to correct an unwanted rotation, so we decided on a round shape.

Size was perhaps the most important decision to make and was dependent on the patient’s body size and desired future look. Because the implant generally looked about 20% smaller after being implanted, it was difficult to pick a size by simply putting an implant in a bra and seeing how it looked in the mirror. In our case, the doctor recommended that we show him a picture of how we wanted May to look after the operation, and he would decide the implant size based on his experience. (I slipped him one of Pamela, but it didn’t work. Darn!)

However, for texture, this is where doctors and literature on the internet seemed to disagree with vigor.

Three doctors recommended textured implants. They were a relatively new technology, with small dimples on the surface of the implant that adhered to scar tissue in the body, theoretically reducing the likelihood of capsular contraction, or, hardening of the breasts over time, caused by hardening of that scar tissue. That was a good thing.

However, two doctors recommended smooth implants, citing and printing off internet articles showing how textured implants increased the likelihood of skin rippling where the surface of the skin seemed to ripple like a wet piece of paper.

Also, some doctors admitted that textured implants didn’t seem to fully live up to their objective of reducing capsular contraction. Ditto for internet literature.

For us, the fact that textured implants formed a greater bond with scar tissue making them more difficult to extract in the future, or so we thought, swayed us to smooth implants. That decision, in turn, convinced us to not go with teardrop implants. The reason is that one method to prevent teardrop rotation was to use textured implants that would stick to the body better, thus reducing the likelihood of rotation. By deciding on smooth implants, we effectively had decided to not use teardrops. Well, that was my logic anyhow.

On the positive side, we found most doctors willing to consult with us and give us their opinion, but also accepting that the final choice was ours. Ultimately we found that while doing research on the internet was valuable, it was essential to talk to the experts face-to-face, ask questions, but then make our own decisions.

So what were our final selections for May’s perfect breasts? She decided on 320 cc, smooth silicon implants, with a medium profile and round shape, implanted sub-muscular through the armpit. For May, at 5’8” in height, with a small frame, the result was a very natural look and feel. Most importantly, it created that most sought after of all things for a young Ladyboy - cleavage!

I didn’t get Pamela Anderson breasts to sleep with every night or watch on the beach, but frankly, that didn’t matter. Natural looking breasts on May were just dandy for me. I love them and her just as they are, and the same would have been true if she didn’t get any at all, really!