Mtf-top-surgery-uk
MTF Top Surgery
MTF top surgery (male to female breast surgery) in London at Centre for Surgery Baker Street. Breast augmentation with implants or fat transfer for transgender women and non-binary individuals. Performed by Dr Spyridon Vlachos and Mr Andreas Shiatis. From £6,500. CQC-regulated clinic — aftercare rated outstanding by the CQC.
MTF Top Surgery in London
MTF top surgery — male to female breast surgery — is a gender-affirming procedure designed to create a feminine breast profile for transgender women and non-binary individuals. The procedure involves enhancing breast size and shape using silicone implants, fat transfer, or a combination of both techniques. It is one of the most frequently performed gender-affirming procedures at Centre for Surgery.
MTF top surgery at Centre for Surgery is performed by two GMC specialist-registered consultant plastic surgeons — and — both with subspecialist expertise in gender-affirming breast procedures. Surgery takes place at our in Marylebone.
Two surgical techniques are available:
Both techniques can be combined in the same procedure where appropriate. In some cases where chest skin is insufficient to accommodate an implant, tissue expanders may be required first — your surgeon will advise at consultation.
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Your MTF Top Surgery Surgeons — Dr Spyridon Vlachos & Mr Andreas Shiatis
MTF top surgery at Centre for Surgery is performed exclusively by GMC specialist-registered consultant plastic surgeons. Two surgeons currently offer the procedure — and . At consultation you will see whichever surgeon’s availability and approach best matches your goals; both have subspecialist experience in implant-based and fat transfer techniques for transgender breast surgery.
is a specialist plastic surgeon with over 25 years of experience in plastic, reconstructive, and aesthetic surgery. He holds a Fellowship of the European Board of Plastic Surgery and has been on the GMC Specialist Register for plastic surgery since 2015. He is a member of the International Society of Aesthetic Plastic Surgeons (ISAPS). GMC registration number: .
Dr Vlachos performs the full range of breast procedures including , , , and gender-affirming breast surgery — including both and . He brings reconstructive rigour to aesthetic outcomes — an approach that consistently produces natural, balanced results. In consultation, he is known for clear, unhurried communication; his philosophy is that the best aesthetic results are those that appear entirely natural.
is a consultant plastic surgeon with specialist expertise in male-to-female chest feminisation procedures. His practice covers both implant-based breast augmentation and fat transfer techniques, allowing him to advise on the most appropriate approach for each patient’s anatomy, existing breast tissue, and aesthetic goals.
For patients seeking fuller, more defined results, Mr Shiatis has extensive experience in , selecting implant size and shape to complement each individual’s frame and chest proportions. For patients preferring a more subtle and natural enhancement, he performs , using the patient’s own fat to create soft, realistic results with the added benefit of body contouring through liposuction at the donor site.
You can verify the GMC registration of either surgeon directly on the before booking. Both surgeons are members of recognised professional bodies and operate strictly within the standards set by the .
What is MTF Top Surgery?
MTF top surgery is a surgical procedure designed for transgender women and non-binary individuals seeking a more feminine breast profile. The procedure shares fundamental principles with standard breast augmentation surgery performed in cisgender women, but the surgical technique differs to account for the anatomy of a masculine chest — typically wider, with more highly developed chest musculature, a shorter inter-nipple distance, and a larger space between the breasts.
The most common approach involves placing silicone implants beneath the pectoral muscles through an incision in the inframammary fold — the crease beneath the breast. The exact incision placement, implant size, and pocket position are selected at consultation based on your chest anatomy, skin coverage, and the result you want to achieve.
Fat transfer is an alternative for patients who prefer not to use implants. Fat is harvested from the abdomen, thighs, or flanks by liposuction, purified, and injected into the breast tissue. Results are softer and more natural in appearance but are more limited in the degree of size increase achievable.
In some cases, both techniques are combined — implants for volume and fat transfer to smooth the upper pole and improve naturalness. Where skin is insufficient to cover an implant, tissue expanders are placed first and gradually filled over several weeks before a final implant procedure.
All MTF top surgery at Centre for Surgery is performed by or under as a day case at our Baker Street clinic.
MTF Top Before & After Photos
MTF breast augmentation with silicone implants. Anterior view. Result demonstrating breast volume, contour, and feminine profile achieved through implant placement beneath the pectoral muscles.
MTF breast augmentation with implants before and after. Left: pre-operative. Right: post-operative result showing feminine breast profile and natural implant positioning.
MTF breast augmentation before and after. Result showing breast volume enhancement and natural inframammary fold positioning. Photography taken at post-operative follow-up review.
Benefits of MTF Top Surgery
MTF top surgery is one of the most effective gender-affirming procedures available for addressing chest-related gender dysphoria in transgender women. Achieving a feminine breast profile that aligns with gender identity produces direct, measurable improvements in wellbeing for most patients.
Gender dysphoria relating to the chest — the distress caused by the absence of a feminine breast profile — can cause persistent anxiety, depression, avoidance of social situations, and reduced quality of life. MTF top surgery addresses the physical source of this distress directly.
Most patients report a significant improvement in self-confidence and emotional wellbeing following surgery. Many describe feeling more comfortable in their body, more confident in social and professional settings, and less self-conscious about appearance. The ability to wear clothing that fits a feminine chest profile without binding or padding is frequently cited as one of the most meaningful practical changes.
MTF top surgery can also improve and enhance nipple projection where this is part of the surgical plan. It can be performed alongside as part of a broader feminising programme.
Am I Suitable for MTF Top Surgery?
Suitability for MTF top surgery is confirmed at a face-to-face consultation with Dr Vlachos or Mr Shiatis. In general, suitable candidates:
Hormone therapy is not a mandatory precondition for MTF top surgery at Centre for Surgery. Some patients have already been taking oestrogen and may have developed some breast tissue before surgery; others have not. Both are appropriate candidates — the surgical approach is adjusted based on existing tissue. Your surgeon will discuss this at consultation.
A psychological assessment letter is not a mandatory requirement at Centre for Surgery for MTF top surgery, though it is recommended for patients in the earlier stages of gender-affirming care.
A mandatory two-week cooling-off period applies from the date consent is given to all surgical procedures at Centre for Surgery.
Types of Breast Implants Available for MTF Top Surgery
When undergoing MTF breast augmentation with implants, patients have a range of options. Dr Vlachos or Mr Shiatis will guide you through the selection process at consultation, considering implant type, size, shape, and projection in relation to your chest anatomy and goals.
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Silicone implants are the standard for MTF breast augmentation. They are filled with cohesive silicone gel, which closely resembles the feel of natural breast tissue. Silicone implants are available in a wide range of sizes, profiles, and shapes (round or anatomical). They produce less skin wrinkling than saline implants and have a lower risk of visible rippling — important considerations for patients with limited existing breast tissue coverage.
Saline implants are filled with sterile saltwater. They require a slightly smaller incision and their size can be adjusted during the procedure. If a rupture occurs, the saline is safely absorbed by the body. Saline implants are less commonly used in MTF surgery due to a higher risk of rippling or wrinkling in patients with limited breast tissue.
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MTF Top Surgery Procedure
MTF top surgery is performed under at our Baker Street clinic. It is performed as a day case — you go home the same day. The procedure takes approximately 1.5 to 2 hours.
Once you are under anaesthesia, your surgeon makes an incision in the — approximately 5 cm in length. A pocket is carefully dissected behind the pectoral muscle on each side. Silicone implants are selected based on the measurements and discussions agreed at consultation and carefully inserted into the pockets. The surgeon makes minor adjustments to ensure symmetry before closing the incisions with dissolvable sutures. Sterile dressings and a compression garment are applied before you leave the operating room.
For patients requiring fat transfer, liposuction is performed at the donor site first (abdomen, thighs, or flanks), the fat is purified, and it is then injected into the breast tissue in multiple passes using fine cannulas.
In cases where insufficient skin coverage exists, tissue expanders are placed and progressively filled with saline injections over several weeks. Final implants are inserted 3 to 6 months later once the skin has adequately stretched. Your surgeon will advise at consultation whether this staged approach is required for you.
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Recovery After MTF Top Surgery
is gradual and requires adherence to post-operative instructions.
You will not be able to drive home after surgery — a responsible adult must collect you and stay with you for the first 24 hours. 24/7 clinical support is available for the first 48 hours after surgery.
A post-surgical bra must be worn for six weeks after surgery. It reduces swelling, supports the implants as they settle, and minimises scar tension. Wear it as instructed — removing only to wash. Avoid underwired bras during the initial recovery period.
Mild to moderate discomfort and tightness in the chest are normal in the first few days and are well controlled with prescribed pain relief. Most patients find over-the-counter paracetamol sufficient from day three or four. A local anaesthetic is injected during the procedure for immediate postoperative comfort.
Most patients can return to desk-based work within one to two weeks. Avoid heavy lifting and strenuous exercise for six weeks. Sleep on your back for at least two weeks to avoid pressure on the implants.
A wound check is included at seven to ten days. A surgeon review is included at six weeks. A three-month assessment is included as part of your surgical package.
Most swelling resolves within six to twelve weeks. Final results are visible at three months. Scars are positioned in the inframammary fold and will continue to fade over 12 to 18 months.
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Risks and Potential Complications of MTF Top Surgery
As with any type of surgical procedure, there are certain risks associated with MTF top surgery. Your surgeon — Dr Vlachos or Mr Shiatis — will explain the risks and complications associated with this procedure at your consultation, which may include:
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Other complications which can occur after any surgical procedure include excessive scarring, deep vein thrombosis, and reactions to anaesthesia. These risks are rare. Surgery is performed under , which is associated with reduced post-operative nausea and faster recovery compared with conventional general anaesthesia.
Risk is reduced through careful patient selection, modern surgical technique, sterile theatre conditions, antibiotic prophylaxis, and structured aftercare. Attending all follow-up appointments and reporting any concerning symptoms — fever, sudden swelling, increasing pain, or a change in implant shape — early is the most important thing you can do.
MTF Top Surgery Cost London — How Much Does MTF Top Surgery Cost?
The cost of MTF top surgery at Centre for Surgery depends on the technique used — implant-based augmentation, fat transfer, or a combined approach — and the type and size of implants selected where applicable.
MTF breast augmentation with implants starts from £6,500. MTF breast augmentation with fat transfer is priced based on the volume of fat transfer required and is confirmed at consultation.
A full written quotation is provided at consultation and confirmed in writing before you proceed. Your package includes your surgeon’s fee, anaesthetist’s fee, facility fee, and all postoperative follow-up appointments. There are no hidden charges.
0% APR finance is available through , subject to status. The £100 consultation fee is redeemable in full against your procedure cost.
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For transgender women experiencing chest-related gender dysphoria, MTF top surgery is one of the most effective interventions available. The clinical evidence consistently shows significant improvements in psychological wellbeing, reduced dysphoria symptoms, and improved quality of life following gender-affirming breast surgery. Your surgeon will discuss realistic outcomes at consultation so you can make a fully informed decision.
Why choose Centre for Surgery for MTF Top Surgery?
Our Baker Street clinic is regulated by the . The CQC specifically rated our aftercare programme as "outstanding" — the highest rating available. All procedures are performed under .
MTF top surgery at Centre for Surgery is performed by two GMC specialist-registered consultant plastic surgeons — and . Both have subspecialist experience in gender-affirming breast procedures and perform both implant-based and fat transfer techniques. At consultation you will see whichever surgeon’s approach and availability best matches your goals; both will recommend the most appropriate technique based on your anatomy. You can verify either surgeon’s GMC registration directly on the .
Centre for Surgery offers , , and combined implant + fat transfer — all at the same Baker Street clinic. You will receive an honest clinical recommendation at consultation on which technique is most appropriate for your anatomy, not simply the more expensive option.
MTF top surgery can be combined with , , and as part of a broader gender-affirming programme discussed at consultation.
Centre for Surgery welcomes transgender women, non-binary, and gender-diverse patients. We use inclusive language throughout and our clinical team approaches gender-affirming surgery with respect for each patient’s individual identity and goals.
A mandatory two-week cooling-off period applies from the date consent is given. No surgery is scheduled before this period has elapsed.
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FAQs
What To Expect
All patients will first need to have a consultation with the surgeon to determine suitability for MTF top surgery. At the consultation, we would encourage you to ask as many questions as you like to learn about how the procedure can benefit you. Your surgeon will be able to explain the pros and cons of the procedure. Your surgeon will also give you detailed information on potential risks and complications of male-to-female breast surgery and what to expect in the healing and recovery phase. A detailed medical history will be taken, including any previous operations you may have had and medicines you are currently taking, if any. This information will be used to determine your fitness for surgery.
If you are considered suitable for the procedure, we recommend you take at least two weeks to consider all aspects of the procedure before making a final decision as part of a two-week cooling-off period. During this time, please feel free to contact us if you have any further questions or concerns about the procedure, and if you would like to book a further consultation, we will be more than happy to arrange this for you.
Once you are booked in for surgery, a preoperative medical assessment will be carried out by one of our specialist nurses. Before the day of your surgery, we would recommend you stop smoking at least four weeks beforehand, as smoking is associated with an increased risk of wound complications. You should avoid taking aspirin-containing medicines as this is associated with an increased risk of bleeding during and after the procedure. You will be required to abstain from food for six hours before surgery and be allowed to have clear fluids up to 2 hours before your admission time.
MTF breast surgery is performed at our Baker Street clinic under TIVA (Total Intravenous Anaesthesia). Once you are under anaesthesia, the surgeon will make an incision in the skin crease below the nipples, then create a pocket to accommodate your chosen implants. The incision placement for MTF breast implant surgery will vary depending on several factors and your preferences. The procedure takes approximately 1.5 to 2 hours to perform. The incisions will be closed with dissolvable stitches, followed by a sterile dressing. You will then be transferred to our dedicated recovery suite, where you will be monitored until the effects of the anaesthetic have worn off. Any discomfort you experience can be easily controlled with prescription painkillers. Once you are ready for discharge, we will require a responsible adult to come and collect you and take you home. They should also look after you for the first 24 hours after surgery.
During the postoperative period, you should follow all of your surgeon's post-operative instructions to ensure you get the best results after male-to-female top surgery. The risk of complications may increase if you fail to follow these instructions.
We would advise taking approximately two weeks off work after surgery. It is important to wear the post-operative surgical bra for a minimum of six weeks to support your breasts. Strenuous exercise, including going to the gym, should be avoided for six weeks after surgery. It is normal to experience mild discomfort during the first two weeks after surgery. Painkillers prescribed to you by your surgeon can help to control any discomfort.
Bruising and swelling are common side effects of surgery and can be reduced with the application of cold packs. Full recovery after MTF top surgery takes approximately three months. As with any surgical procedure at the Centre for Surgery, you can call us on our dedicated nursing helpline if you have any questions or concerns about your recovery and healing.
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If you're considering plastic or cosmetic surgery in London, Centre for Surgery offers a level of clinical excellence that few clinics can match.
All procedures at Centre for Surgery are performed exclusively by GMC specialist-registered consultant plastic surgeons — the highest qualification available in the UK. Our surgeons hold positions on the GMC Specialist Register and are members of BAPRAS and ISAPS, ensuring you receive care from fully credentialled specialists, not cosmetic doctors.
Our purpose-built private hospital at Baker Street, Marylebone is independently regulated and inspected by the Care Quality Commission (CQC), which awarded us a Good rating — a standard very few cosmetic surgery facilities in the UK achieve. We use TIVA (Total Intravenous Anaesthesia) as standard, the safest and most advanced form of anaesthesia available for day case surgery.
We offer the full range of surgical and non-surgical treatments under one roof, with in-depth consultations directly with your surgeon — never a sales consultant. Flexible 0% APR finance is available through Chrysalis Finance, and our comprehensive aftercare programme includes 24/7 nursing support.
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Centre for Surgery is a CQC-regulated private hospital on London’s Baker Street, delivering plastic and cosmetic surgery through GMC-registered specialist surgeons. Our expertise spans facial procedures including and , , for men, and body contouring procedures such as and . Patient safety, surgical excellence and natural-looking results sit at the heart of everything we do.
Centre for Surgery is a CQC-regulated private hospital on London’s iconic , offering plastic and cosmetic surgery led by GMC-registered consultant surgeons.
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