Can your breasts still grow after breast augmentation when you go on HRT for trans women?

Estrogen fluctuations can definitely affect breast volume. Presumably, you would be on a maintenance HRT which would most likely be relatively stable and therefore following breast augmentation surgery, your volume wouldn't change significantly. It is ideal to be on HRT first for at least 6 months to see where your breast volume goes. You would not want to have significant hormonal changes following breast augmentation surgery so in order to achieve the most predictable outcome, I would recommend HRT for at least 6-12 months prior to surgery.

Your breasts are likely to grow after starting HRT even after you have breast enlargement with implants.  However, it's impossible to predict exactly how much your breasts will grow.  If you have a very specific goal size, then I would recommend beginning the HRT first and letting your breast growth plateau and then consider breast augmentation so that you can determine what implants (shape, size, style) would be most suitable for you.  

Hello and thank you for your question.  The presence of breast implants is unlikely to prohibit further breast growth under hormone stimulation.  Your breasts will likely grow under estrogen stimulation, but will plateau at some point.  Implants do flatten your pre-existing breast tissue, which would likely not grow as much under hormone stimulation under this "mechanical tension", however, I would discuss this further with your endocrinologist.  I cannot tell you for certain.  Once cleared for surgery by your PCP or endocrinologist, I would seek out a board certified plastic surgeon who specializes in aesthetic plastic surgery.  In your consultation, be sure your surgeon addresses all your concerns and discusses the surgery details including the position and size of the incision used, the type of breast implants available, the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar breast appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. 

And lastly, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired breast outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.  

For more information on breast augmentation, please refer to my link below.

Good luck.  

Mark K Markarian, MD, MSPH, FACS Harvard-trained Board Certified Aesthetic Plastic Surgeon

If you have not been on hormone treatment prior to your augmentation, there is a real possibility that the breast tissue will grow larger after hormone treatment is started. I usually advise patients who are undergoing augmentations to start hormone treatment prior to surgery if they are considering it, as this will have a strong bearing on final results/size. If you are seeking insurance coverage for the augmentation the insurance company will often require 6-12 months of hormone treatment prior to approving the augmentation surgery.