Chest Feminization: From Consultation to Surgery

Chest feminization surgery, most commonly performed through breast augmentation, is a safe, ambulatory procedure that allows transfeminine individuals to achieve a more traditionally feminine chest appearance. Although the procedure parallels cisgender breast augmentation, anatomic differences such as chest width, soft tissue coverage, skin elasticity, and nipple-areolar complex position introduce important surgical nuances. This article outlines a structured approach to consultation, surgical planning, implant selection, and intraoperative technique, drawing on the 26-year experience of the senior author (BF) and review of current literature. Emphasis is placed on tailoring the procedure to meet patient goals while optimizing safety, aesthetics, and long-term satisfaction.