Top Surgery

Transfeminine chest surgery involves breast implants and sometimes fat grafting to increase the size and improve the shape of the breasts. It is typically performed after at least one year of hormone therapy to allow for maximal breast growth. You will be required to temporarily stop the hormones prior to surgery to decrease the risk of blood clots.

WPATH Standards of Care

The providers follow the WPATH Standards of Care, which recommend one letter from a qualified mental health care prior to the surgery:

Criteria for Breast Augmentation in Transfeminine Patients

  1. Persistent, well documented gender dysphoria;
  2. Capacity to make a fully informed decision and to consent for treatment;
  3. Age of majority in a given country;
  4. If significant medical or mental health concerns are present, they must be reasonably well controlled.

Although not an explicit criterion, it is recommended that transfeminine patients undergo feminizing hormone therapy (minimum 12 months) prior to breast augmentation surgery. The purpose is to maximize breast growth in order to obtain better surgical (aesthetic results).

Before Your Appointment

Before your appointment, we advise that you contact your insurance carrier to determine whether transgender chest surgery is a covered benefit. After you have had your first appointment, we can contact them to obtain a pre-authorization prior to the surgery. 

Insurance companies use the pre-authorization process to ensure that your surgery is covered. This process can take up to six months depending on your insurance provider. Our team will keep you in the loop as we receive status updates. However, you can always call your insurance for updates too.

For any questions about the pre-authorization process, please call us at 801-213-2195, option 1. If you reach our voicemail, please leave your:

  • name,
  • phone number, and
  • date of birth.

If our providers are not in-network, ask your insurance company if you would qualify for a gap exception. A gap exception can sometimes be granted as a covered service if there are no other in-network providers in the area that offer that service.

You can check our insurance information to verify whether University of Utah Health is in your network of coverage. If you do not have coverage, we will provide you with an out-of-pocket cost estimate.

Please note that we are actively working with all of the payers in Utah to advocate for medically necessary care as a covered benefit. 

Traveling from out of State?

Are you traveling from out-of-state? Good preparation is critical to a having a good outcome. You will be required to stay in Salt Lake City for a minimum of one week after the surgery and will need someone to accompany you and assist during that time.

We Want Your Feedback

We are constantly evolving as a program and welcome any feedback from the community that will help us meet our mission to provide safe, gender-affirmative care at University of Utah Health. Please email us at