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02 9252 9262

Plastic Surgery

Pure Aesthetics is one of Sydney's most well established Cosmetic Plastic Surgery Clinics.

Male to Female “Top” Surgery

Breast enlargement (“Breast Enlargement”) in our male to female transitioning patients is done to enhance the shape and size of  the breasts to create a more feminine physique. Although technically similar to “regular” Breast Enlargement using breast implants, there are some particular differences done in this patient group to address specific needs. Differences in chest size and configuration need to be carefully considered to make your breast larger, fuller and suitable for both your overall physical proportions and desired outcome. Often larger breast implants are required, particularly in broader and taller patients. Fuller projection implants are often preferred to make up for the relative deficiency of native breast tissue. Breast enlargement is a very commonly performed plastic surgery procedure, and our plastic surgeons at Pure Aesthetics are experienced in assisting patients with gender affirmation, to improve your physical proportions, self-image and femininity.

At your two preoperative consultations, Dr Merten will explain the surgery to you in detail and plan what outcome will give you the best results for your desired goals. Please note we require our transitioning patients to come with letters of support from your treating doctors and/or psychologists for you to proceed with surgery.

Dr Merten is an active member of ANZPATH and WPATH


How can this procedure help me?

Breast enlargement (“augmentation”) may be an important part in your transition process. Breast Enlargement will enhance the shape and size of your breasts, giving you a more feminine physique. Breast implants will make your breasts fuller, larger and and more feminine, improving your body proportions, self-image and confidence.

The Consultation Process: What to Expect

For our transition patients, we require a written referral from your treating transition team confirming there are no reasons that Breast Enlargement should not be undertaken at this time. You will need two preoperative consultations with our specialist plastic surgeon Dr Merten. Each consultation will take approximately 45 minutes. You should openly discuss your expectations and goals about undergoing chest feminisation surgery.

During the consultation, your surgeon will discuss your current transition stage, your health and details about the aesthetic outcomes you desire.

It is very important to spend enough time in the first consultation to establish what you consider to be your ideal breast size and shape. It is a good idea to bring in any pictures of breast enlargements that you like. Your surgeon will carefully examine your breasts, take measurements and show you various implant options to consider. This will include various shapes, sizes and “projections”, to customise the choice specifically for your successful outcome.

Photographs of your chest will be taken and, if suitable, 3D morphing simulation will be done using the Crisalix technology, to show you what breast implants of different shape and size will look like. We aim to choose the best breast implant shape and size for your body to achieve the desired results.

Please note that our surgeons do not endorse or perform extremely large volume breast implants. If this is your desire, we suggest you find another surgeon who can assist you.

Any potential complications that could arise will also be discussed, and your recovery process explained. Please ask any questions that you may have, and come prepared with a list of these to your consultation.

A second consultation will need to be attended closer to the date of your surgery to finalise the choices that have been made.

Our surgeons only do Breast Enlargement surgery in fully accredited hospitals, under general anaesthetic conducted by a specialist anaesthetist. We do not endorse “twilight” surgery as it can have serious risks in Breast Enlargement surgery. Breast Enlargement is usually done as “day surgery;” and you go home a few hours after the surgery.

What Breast Implants Should I Choose?

Dr Merten usually recommends breast enlargement using “cohesive” silicone gel breast implants, and he is involved in clinical research in improving the long-term safety of breast implants. Saline-filled breast implants are infrequently used in Australia.

Anatomic or Round?

Breast implants come in different brands, sizes, shapes and “projections”. “Teardrop” or anatomic breast implants have a more natural shape with fullness in the lower half, tapering off as they ascend. This is similar to a “natural” breast. Round implants are more dome-shaped, and fuller in the middle segment; this may provide more fullness in the upper breast. All types of implants come in a range of “projections” or profile, which is how much they push forward, giving a more or less subtle or dramatic fullness. Equally as important are your own tissue features – skin, breast tissue and chest shape. The various choices will allow our surgeons to customise the choice to achieve your desired outcome, be it “natural” or “noticeable”.


Our surgeons customise the implant choice to each individual, depending on breast shape and desired result.

Where is the Implant Placed?

Breast implants may be placed either in front of the chest muscle (“sub-glandular) or behind it (sub-pectoral”).
implant placement

The choice depends on a number of factors, particularly the quality and volume of your own breast tissues, to make the implant itself less visible and create a natural, soft outcome. With less natural breast tissue placement behind the muscle is usually recommended.

The Surgery: What Does Breast Enlargement Involve?

After you are placed under a general anaesthetic, The implant is inserted through a small incision is made under the breast and enough space made to accommodate the pre-chosen breast implant. Using very strict sterile conditions, the breast implant is then placed and the wounds securely stitched closed, using hidden stitches beneath the skin. There are no stitches that need to be removed. Protective dressings are then placed and you wake up in the recovery ward.

Please watch our video animation to see what happens in a Breast Enlargement procedure

Will I need to be hospitalised for the procedure?

Our surgeons only perform breast enlargement surgery in fully accredited hospitals, ensuring your safety. Breast enlargement is “day surgery” procedure and usually takes 1.5 – 2 hours, and you go home a few hours after the surgery.

What is recovery like?

Breast Enlargement surgery is usually not very painful. The anaesthetists in our team are highly experienced skilled and experienced in modern anaesthetic techniques and are devoted to keeping you comfortable, pain and nausea free. You will leave the hospital with a comprehensive plan to mange your recovery

Initially after the surgery you will have surgical tape covering your breasts. This is removed after 5 – 6 days and a soft surgical bra worn day and night for 6 weeks.

Stitches used are dissolving, and do not have to be removed.

Results: What and When?

After your surgery there will be some swelling and fullness early after the surgery. This is mostly gone by around 6 weeks.

When can I resume normal activities?

You should be able to do non-strenuous clerical-type work about 1 week after your surgery. More strenuous work, however, may require more time off work.

You will be unable to exercise for 6 weeks, to allow the implants to stabilise in the correct position.

What complications can arise from breast enlargement?

With any surgery there are potential risks and complications. These include:

  • Pain
  • Infections
  • Swelling, bruising, bleeding, haematoma formation
  • Allergy
  • Anaesthetic complications, such as blood clots

Risks and complications specific to Breast Enlargement include:

  • Capsular Contracture – implant hardening
  • Loss of Nipple Sensation
  • Fluid collections around the implants
  • Wound problems or bad scars
  • Implant deflation or rupture
  • Asymmetry or other cosmetic issues

These will be discussed with you in detail before your surgery at your preoperative consultations.

Will Breast Enlargement leave scars?

Although scars are present following any surgery, our surgeons will make every effort to keep them as minor and subtle as possible. Scars fade over time, and are positioned to become less noticeable as this occurs.

What else should I consider before having Breast Enlargement surgery?

Emotional well-being is an important factor to be considered before any aesthetic surgery. Surgery does not guarantee a new life or an end to all personal problems. A positive mental attitude and realistic expectations will help you achieve a successful outcome. Breast Enlargement can help improve your feminine physique and appearance and may help your self-confidence.

Unfortunately, your breast implants will one day need to be replaced, on average, after 10 to 20 years. With careful planning and expert surgery, we hope to minimise the likelihood of needing revision breast implant surgery before this time.

Any more questions?

Please feel free to contact us with any questions that you have about this or any other procedures. Our team will be happy to address any concerns that you may have.

Crisalix 3D Imaging

Dr Merten has introduced a new tool to assist him and his patients when deciding on a Breast Enlargement. The 3D Breast Simulation software is an additional consultation tool Doctor Merten uses to visually show his patients how their augmentation would look and to assist with size and shape selection.

It’s as easy as filling in your profile, sending three photos and requesting a consultation where you will be shown your new you. Start now and you will already see your current body in 3D directly from home!

Male to Female Before & After Photos


Unfortunately, there is no Medicare provision for this surgery. A quote for surgery will be provided after your first consultation with our team.

Before & After Photos

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