Most guides to breast augmentation are written for cisgender women, and trans patients are left to read between the lines.
That does not work well, because the operation is genuinely different. The chest wall is a different shape. The distance between the nipples is usually greater. The starting tissue is different — and so the implant that produces a natural result on a cisgender chest often does not produce a natural result on a transfeminine one.
This guide covers what actually changes, what we recommend and why, what it costs, and what you can combine it with.
Breast surgery at APS Gender Care is led by Dr. Rapeepat Sapruangthong (Dr. Tee), who completed his medical degree at Phramongkutklao College of Medicine and his residency in Plastic and Reconstructive Surgery at Phramongkutklao Hospital. Breast augmentation is one of his core specialties. You can find his full profile on our breast augmentation page.
Do you need to be on HRT before breast augmentation?
No. Breast augmentation at APS does not require you to have been on hormone therapy.
This surprises people, because many clinics treat a fixed period of HRT as a precondition. We do not, for a straightforward reason: some of our breast augmentation patients never go on hormones at all, and that is a legitimate choice we are not going to gatekeep.
That said, being on hormones for at least a year before surgery is beneficial if it is available to you and something you want. Hormone therapy produces real glandular development, and operating after that development has occurred means your surgeon is working with more of your own tissue and planning around a more settled starting point.
So the honest position is: a year of HRT helps, but it is not a requirement, and not being on hormones will not disqualify you.
It is worth noting that hormone history is treated differently for other procedures. For vaginoplasty, orchiectomy, mastectomy and hysterectomy, your hormone status is clinically relevant in ways it is not for breast augmentation.
If you are considering starting HRT, whether before surgery or independently of it, our HRT program in Thailand and our guide to getting an HRT prescription cover the process.
Why a transfeminine chest needs a different surgical plan
This is the part most generic guides skip, and it is the part that determines your result.
Transfeminine patients typically have a wider chest wall and a greater distance between the nipples than cisgender women. Those two facts change the surgical math considerably.
If you place an implant sized for a narrower frame onto a broader chest, you get a predictable problem: the breasts read as too small for the body, and the gap between them looks wider than it should. The result can be technically well executed and still not look right.
Dr. Tee’s approach accounts for this directly. For transfeminine patients he generally recommends a larger implant, at high profile with moderate projection.
Unpacking that:
- Larger volume fills a broader chest proportionately, rather than leaving the implants looking marooned on a wide frame.
- High profile means the implant has a narrower base relative to its volume, concentrating fullness where you want it rather than spreading it thinly across a wide chest.
- Moderate projection keeps the result natural. High profile combined with excessive projection starts to look obviously surgical, which is the opposite of what most patients want.
This is why a consultation matters more than a catalog. The right implant for you depends on your chest width, your inter-nipple distance, your skin envelope, and how much tissue you already have.
Breast implant options and prices at APS
We use Mentor and Motiva implants. Both are established manufacturers with long clinical track records, and we name them because you deserve to know what is going into your body. “High-quality implants” is not an answer.
| Implant | Price | What it’s like |
|---|---|---|
| Mentor | ฿120,000 | A traditional, reliable silicone implant designed to feel soft and natural. Available in profiles from low to high projection, making it versatile across body types. |
| Motiva | ฿140,000 | Known for a very smooth surface and natural movement. Soft and adaptive, with options that add upper-pole fullness while still looking natural. |
| Mentor Extra Gel | ฿180,000 | A firmer, higher-projection version of the classic Mentor. Provides more fullness and definition, for patients who want a more defined shape. Our most popular choice. |
| Motiva Ergonomix | ฿180,000 | One of the most advanced options available. The gel adapts to your body position — rounder when you are lying down, more teardrop-shaped when standing. Chosen by patients who want the most natural look and movement possible. |
You can see the full range on our breast augmentation page.
Why we use silicone, and why round
Two defaults worth explaining.
Silicone rather than saline. Silicone gel behaves more like breast tissue, both in how it feels and how it moves.
Round rather than anatomical. This sounds backwards if you have read that teardrop implants look more natural — but in combination with the dual plane placement described below, round implants consistently produce the more natural result on a transfeminine chest. The muscle and tissue shape the upper pole; the implant does not have to do that work alone.
The exception is Motiva Ergonomix, where the gel changes shape with your position, giving you a round profile lying down and a teardrop profile standing.
The 400cc surcharge threshold
A surcharge of ฿20,000 applies to all implants over 400cc.
We flag this clearly because most of our patients choose around 400cc, which puts a lot of people right at the threshold. You should know that before you are quoted, not after.
Placement and incision
Dual plane placement
Dual plane is our standard approach. The implant sits partly beneath the pectoral muscle and partly beneath the breast tissue. This gives soft coverage at the top — where a hard implant edge would otherwise be visible — while allowing the lower pole to fill out naturally.
Dr. Tee deviates from dual plane only in specific circumstances: muscular builds, extremely thin skin, or previous scarring that changes what is possible. If any of those apply to you, he will explain the alternative at consultation.
The inframammary fold incision
The incision is made in the inframammary fold — the crease beneath the breast.
We prefer this to the transaxillary (underarm) approach because it gives the surgeon far better visibility of the chest wall during the operation. On a chest where placement precision matters more than usual, that visibility is worth having.
The resulting scar sits in the natural crease under the breast, where it is concealed by the breast itself in most positions, and fades considerably as it matures.
Combining breast augmentation with other surgery
We work to an eight-hour ceiling on any single anesthesia session. That limit governs what can be combined.
What combines well
- Zero-depth vaginoplasty
- Two to three FFS procedures
- Orchiectomy
- Abdominoplasty
For patients traveling internationally, combining is often the difference between one trip and two — with the cost and recovery savings that implies.
Our guide to combining zero-depth vaginoplasty with breast augmentation covers the reasoning in more detail.
What is off the table
Anything requiring you to recover face-down. That includes rib remodeling, hip lipofilling, and buttock implants.
The reason is simple: breast augmentation means roughly two weeks recovering on your back. A procedure requiring stomach recovery is directly incompatible, and no amount of scheduling cleverness gets around it.
Full-depth vaginoplasty: assessed case by case
This one is not a straight yes or no.
It can be done. Dr. Ae performs the vaginoplasty — potentially working alongside a colorectal or abdominal surgeon depending on the technique — while Dr. Tee performs the breast augmentation in the same session.
But it is a long operation involving multiple surgical teams, and whether it is appropriate depends on your health, your anatomy, and which vaginoplasty technique you are having. We evaluate this case by case, and we will tell you honestly if we do not think it is the right plan for you.
Breast augmentation recovery timeline
| Stage | What to expect |
|---|---|
| Sleeping position | No need to sleep propped up |
| Arm movement | No lifting anything above chest level. Go gently on overhead movement generally |
| Compression | Compression garment for one month, then a sports bra through month three |
| Drains | None used |
| Flying home | After day 14, following your follow-up appointment with Dr. Tee or Dr. Ae |
| Desk work | Two to three weeks |
| Light lower-body training | One to one and a half months |
| Full-body training, cautiously | Two months |
| Back to normal | Two and a half to three months |
| Implants settle into final position | Six to ten months |
Plan for a fourteen-day stay in Thailand
The most important line in that table is the flight home. You need to be in Thailand for at least fourteen days, because we want to see you at your day-14 follow-up before you get on a long-haul flight.
Build your budget around that. Flights, accommodation, and time off work for a full two weeks are part of the real cost of surgery abroad, and any clinic that lets you book a shorter trip is not doing you a favor.
Our complete guide to SRS costs in Thailand breaks down what to budget for beyond the surgical fee.
The arm movement restriction
Worth expanding on, because patients consistently underestimate it.
No lifting above chest height means no reaching for the overhead bin, no lifting a suitcase, no putting things away on high shelves. For roughly two weeks you will need help with the ordinary business of daily life. If you are traveling alone, plan for that — it is one of the most common things patients tell us they wish they had thought about beforehand.
When implants settle into their final position
Six to ten months.
Implants sit high initially and gradually drop into their final position as the tissue relaxes around them. The shape you see in the first weeks is not the shape you will keep.
This is normal, and it is worth knowing before you start worrying about how they look at week three. Most patients who contact us concerned about their result are looking at implants that have not finished settling.
What MTF breast augmentation costs in Thailand
Your implant choice sets the base price:
- Mentor — ฿120,000
- Motiva — ฿140,000
- Mentor Extra Gel — ฿180,000
- Motiva Ergonomix — ฿180,000
- Plus ฿20,000 for any implant over 400cc
Included: the surgery, anesthesia, facility fees, nursing care, and your post-operative follow-up.
Not included: flights, accommodation, and living costs for your fourteen-day stay.
If you are combining procedures, we quote the combination rather than adding the individual prices together — combining reduces the total, because you are using one anesthesia session and one recovery period.
FAQs
No. Hormone therapy is not required for breast augmentation at APS. A year on hormones is beneficial if it is something you want and can access, but plenty of our patients have surgery without ever starting HRT.
Mentor Extra Gel, at ฿180,000. It offers higher projection and a more defined shape than the standard Mentor.
Yes, with the right plan. That usually means a larger implant at high profile with moderate projection, which fills a wider chest proportionately rather than leaving a visible gap between the breasts.
With zero-depth vaginoplasty, yes, routinely. With full-depth vaginoplasty it is possible but assessed case by case, since it involves multiple surgical teams within our eight-hour anesthesia limit.
A minimum of fourteen days. You fly home after your day-14 follow-up appointment.
In the inframammary fold, the natural crease beneath the breast. It is concealed by the breast in most positions and fades as it matures.
Light lower-body training at one to one and a half months, full-body training cautiously at two months, and back to normal at two and a half to three months.
Six to ten months. Implants sit high at first and gradually settle. The shape at week three is not the shape you will keep.
If you are unsure which implant suits your frame, whether to combine augmentation with other surgery, or how long to wait, send us your details and Dr. Tee will advise during a free consultation.
We would rather have that conversation properly than have you guess from a price list.
Further reading: Breast augmentation at APS · Combining zero-depth vaginoplasty with breast augmentation · HRT program in Thailand · SRS costs in Thailand