MTF Top Surgery in Bellevue
Surgeon Who Sees You
MTF top surgery is one of the most personally meaningful procedures Dr. Day performs. At Pacific Sound Plastic Surgery in Bellevue, he brings double board certification, Ivy League surgical training, and a genuinely affirming surgical environment to every patient who walks through the door. Whether you are pursuing implant-based breast augmentation, fat grafting to the breast, or a composite approach combining both, you will receive honest, individualized guidance — and a surgeon who treats you with the dignity you deserve.
Double Board-Certified (ABPS + ABS)
Ivy League Trained
Highly Rated Bellevue Plastic Surgeon
Proudly Serving Bellevue, Seattle, Kirkland, Redmond, Mercer Island, Issaquah, Renton
What Is MTF Top Surgery?
MTF top surgery encompasses surgical procedures that create or enhance feminine breast contours for transfeminine patients. At Pacific Sound Plastic Surgery, Dr. Day performs three primary MTF approaches: implant-based breast augmentation, fat grafting to the breast, and composite breast augmentation (combining implants with fat grafting). The right approach depends on each patient’s existing breast tissue, hormonal history, chest wall anatomy, and aesthetic goals. Dr. Day treats MTF top surgery with the same clinical rigor he applies to every breast augmentation case — paired with the personalized, identity-affirming consultation every transfeminine patient deserves.
Unlike many surgeons who see a limited number of gender-affirming cases per year, Dr. Day has built a dedicated patient community in the Pacific Northwest. His training in advanced soft tissue contouring and aesthetic balance directly benefits MTF surgical outcomes — particularly in achieving natural, proportionate, feminine breast contours.
Surgical Approaches: Finding the Right Technique for Your Body
Not every patient is the same, and MTF top surgery is not one-size-fits-all. During your consultation, Dr. Day will evaluate your existing breast tissue, hormonal history, chest wall anatomy, skin envelope, and aesthetic goals to recommend the most appropriate approach from three primary techniques:
The Benefits of Top Surgery at Pacific Sound
Top surgery is consistently ranked among the highest-impact gender-affirming procedures in terms of patient-reported quality of life improvement. The benefits extend well beyond aesthetics — for most patients, this procedure addresses dysphoria that affects daily function, mental health, and self-perception. At Pacific Sound, you’ll work with a surgeon who approaches this procedure with the clinical rigor it deserves:
- Relief from gender dysphoria and significant improvement in day-to-day comfort
- A natural, proportionate chest contour tailored to your unique anatomy
- Surgery performed by a double board-certified, Ivy League-trained plastic surgeon
- Transparent, supportive consultation process — your goals drive the plan
- Insurance accepted — for qualifying patients
- Close clinical follow-up with Dr. Day personally available post-operatively
- A trans-affirming surgical team that respects your identity and pronouns
Am I a Good Candidate for Top Surgery?
- Ideal Candidates
- Persistent gender dysphoria affecting quality of life
- Physically healthy with no uncontrolled medical conditions
- Non-smoker or committed to quitting before surgery
- Stable weight maintained for at least 6 months
- Able to take at least 1–2 weeks off demanding work; desk work often possible by Week 1
- Has (or is working toward) required insurance/WPATH documentation
- When to Consider Waiting
- Active smoker not willing to stop prior to surgery
- Unstable or rapidly changing weight (active weight loss)
- Uncontrolled diabetes, bleeding disorders, or cardiac conditions
- Currently adjusting hormones in ways that may affect healing
- Unrealistic expectations about scarring or nipple aesthetics
Not Sure If You're a Candidate?
Schedule a consultation with Dr. Day to discuss your goals and options.
Your Top Surgery Journey
Step 1 — Your Consultation
Your first consultation with Dr. Day is the foundation of your surgical plan. Expect a thorough review of your goals, surgical options, body anatomy, and any insurance or documentation requirements. Dr. Day will be direct and honest about what is achievable and will explain his recommended technique in detail. Most patients leave their first consultation with a clear surgical plan and a scheduled date — often within 4–6 weeks.
Step 2 — Pre-Surgery Preparation
Once scheduled, our patient care team will guide you through pre-operative requirements: lab work, medical clearance (if needed), stopping certain medications, and nicotine cessation. Our office initiates insurance pre-authorization after your surgical consultation — this process typically takes at least 4–6 weeks. A WPATH Support Letter from a licensed mental health professional or primary care physician is required for insurance approval; the patient is responsible for obtaining this letter from their own provider.
Step 3 — Day of Surgery
Top surgery is performed under general anesthesia at one of Dr. Day’s accredited surgical facilities. Procedure time is typically 2–4 hours depending on technique. You will go home the same day with drains in place (if applicable) and a compression wrap. Dr. Day personally calls patients after surgery to check in.
Step 4 — Recovery Timeline
Day 1 (Day After Surgery):
What to Expect
Walking encouraged from Day 1. Rest, compression wrap, and limited upper-body activity. Drain care if drains placed. Pain manageable with prescribed medication.
Week 1
What to Expect
First post-op visit with Dr. Day. Drain removal (if applicable). Most patients return to desk work. No reaching overhead or heavy lifting.
Weeks 2-4
What to Expect
Light activity resumes. No strenuous lifting or chest-focused exercise. Scars beginning to settle. Chest contour becomes more visible as swelling resolves.
Weeks 4–6 & Beyond
What to Expect
Full activity cleared. Final results emerging at Month 3. Scars continue to fade. Follow-up visits to confirm healing trajectory.
Step 5 — Follow-Up Care
Dr. Day schedules multiple follow-up visits over the first three months to monitor healing, address any questions, and confirm you are on track for the results you planned. His availability extends beyond the clinic — he personally calls patients when concerns arise.
Does Insurance Cover Top Surgery?
For many patients, insurance coverage is the deciding factor in whether and when they can pursue top surgery. The good news: coverage for gender-affirming top surgery has expanded significantly in Washington State, and Pacific Sound Plastic Surgery is experienced with navigating the pre-authorization process.
Private Insurance
Most major commercial health plans in Washington State offer some level of coverage for gender-affirming top surgery when medical necessity is properly documented. Requirements typically include:
- A letter from a licensed mental health provider (WPATH-aligned documentation of persistent gender dysphoria)
- A referral letter from a primary care provider in many cases
- Prior authorization submitted to the insurer before scheduling surgery
- Confirmation of in-network status with Pacific Sound Plastic Surgery
What Results Can I Expect?
Top surgery results are visible immediately after surgery, though the final outcome takes time to emerge as swelling resolves and scars mature. Most patients describe their final result as noticeably better than their expectations — a testament to the personalized planning that goes into each procedure.
Results Timeline
- Day 1: New breast contours visible with surgical bra or compression in place — early shape apparent even with swelling
- Weeks 2–4: Swelling begins to resolve, contour becomes clearer
- Month 3: Scars softening, final chest shape emerging
- Month 6–12: Scars continue to fade; results are stable with maintained weight
Top surgery results are long-lasting. Weight stability is the single most important factor in maintaining your outcome.
Significant weight changes can affect chest contour over time, which is why Dr. Day discusses weight stability during your candidacy evaluation.
Top Surgery Cost in Bellevue
MTF top surgery is increasingly covered by commercial insurance in Washington State as a medically necessary gender-affirming procedure. We encourage all patients to explore insurance coverage first — for many patients at Pacific Sound, top surgery is fully or substantially covered after pre-authorization. For self-pay patients, the total investment depends on the technique selected (implant-based augmentation, fat grafting, or composite augmentation), facility, and individual surgical plan. Specific cost figures are reviewed during your consultation after Dr. Day designs your personalized plan.
What Affects Price
- Surgical technique selected (implant-based augmentation, fat grafting to the breast, or composite augmentation)
- Whether fat transfer is performed (in fat grafting and composite augmentation, liposuction is used to harvest fat from donor sites)
- Anesthesia type and facility fees
- Any additional contouring procedures
What’s Included in Your Top Surgery Investment
Your surgical fee covers all of the following at Pacific Sound Plastic Surgery:
- Surgeon's fee
- Facility / operating room fee
- Anesthesia (administered by a board-certified anesthesiologist or certified registered nurse anesthetist)
- Enhanced Recovery After Surgery medication (Exparel)
- Cosmetic surgery insurance coverage (Cosmetasure)
- High-end compression garment (Isavella)
- High-end scar ointment (Biocorneum)
- Swelling and bruising ointment (Arnica)
- Clara Recovery Supplements
- Chlorhexidine Anti-Septic Scrub Cloths
- Post-operative recovery and follow-up care
Financing Options
Pacific Sound Plastic Surgery accepts CareCredit (6-month financing) and Alphaeon Credit, two of the most widely used healthcare financing programs. Both allow patients to begin their journey without paying the full cost upfront.
Pricing is discussed in full detail during your consultation so there are no surprises. Call (425) 818-8991 to get started.
Why Patients Choose Dr. Day for Gender-Affirming Top Surgery?
Gender-affirming surgery requires more than technical skill — it requires a surgeon who understands the significance of what they are doing. Dr. Kristopher Day has earned trust within the Pacific Northwest trans community through consistent results, honest communication, and a team that genuinely supports patients through a complex process.
✓ Double Board-Certified Surgical Expertise
Dr. Day holds dual board certification from the American Board of Plastic Surgery and the American Board of Surgery — a distinction that reflects comprehensive training in both reconstructive and aesthetic surgery. His expertise in breast aesthetics, soft tissue contouring, and proportional results is applied to every MTF top surgery case, producing natural, feminine outcomes aligned with each patient’s goals.
✓ A Trans-Affirming Surgical Environment
Pacific Sound Plastic Surgery is a practice where every patient is treated with dignity. Dr. Day corrects pronoun misuse without prompting, leads consultations without judgment, and communicates directly and transparently — including about limitations and realistic outcomes.
✓ Ivy League Trained
Dr. Day’s Ivy League surgical training, combined with 10+ years of surgical experience and 30+ peer-reviewed publications, brings an academic rigor to every case that his patients feel from the first consultation.
✓Insurance Navigation Expertise
Our patient care team has deep experience with the insurance pre-authorization process for gender-affirming procedures. Patients who work with Pacific Sound report a streamlined experience from documentation to surgery date.
Surgical Facilities
Swedish Medical Center · Carillon Point Surgery Center ·
Virginia Mason Franciscan Health · Sound Plastic Surgical Center
Conveniently Located for Eastside Families
Pacific Sound Plastic Surgery is centrally located in downtown Bellevue, making Dr. Day’s expertise accessible to families throughout the region — without the stress of navigating Seattle traffic. Our patients enjoy a private, boutique surgical experience with on-site validated parking, just minutes from the communities they call home.
Seattle
~15 minutes
World-class plastic surgery results without the downtown Seattle parking hassle. A quick drive across SR-520 or I-90 to our private Bellevue office.
Kirkland
~10 minutes
Just minutes from downtown Kirkland and the Juanita waterfront via I-405 or surface streets.
Redmond
~10 minutes
Convenient for the Redmond tech community via SR-520 or surface streets.
Mercer Island
~10 minutes
A quick drive across I-90. Our discreet, private environment is ideal for discerning Mercer Island residents.
Issaquah
~10 minutes
Convenient for Issaquah Highlands and Gilman Village area families via I-90.
Renton
~5 minutes
Easy access from Renton and the Landing via I-405 North. Boutique care and personalized attention just minutes away.
Frequently Asked Questions
Does insurance cover gender-affirming top surgery?
Many insurance plans cover MTF top surgery when medical necessity is properly documented. Coverage typically requires documentation of persistent gender dysphoria, a WPATH Support Letter from a licensed mental health professional or primary care physician, and prior authorization submitted by our office after your surgical consultation. Contact us at (425) 818-8991 to begin.
Do I need a WPATH letter to have top surgery?
Many insurance carriers require documentation of persistent gender dysphoria from a licensed mental health provider — aligned with WPATH Standards of Care. For self-pay patients, requirements vary. During your consultation, Dr. Day’s team will clarify exactly what documentation you need and help coordinate timing if letters are pending.
How long does top surgery recovery take?
Most patients return to desk work around Week 1. Light activity resumes at Weeks 2–4, with full activity cleared at Weeks 4–6. Arm and chest-specific restrictions (no overhead reaching) may persist longer depending on your technique. Swelling takes 3–6 months to fully resolve. Dr. Day will give you specific milestones at your post-op visits.
Will I have nipple sensation after surgery?
Sensation changes after breast augmentation depend on implant size, placement, and individual anatomy. Most MTF patients retain nipple sensation, though temporary changes during the healing phase are common. With fat grafting, sensation is typically less affected because incisions are smaller. Dr. Day reviews realistic expectations for your specific case during consultation.
Can top surgery be covered and performed at the same time as other gender-affirming procedures?
In some cases, yes — combining procedures may be possible depending on surgical time, anesthesia safety, and insurance authorization. This is a consultation-specific discussion. Dr. Day will advise based on your overall health, goals, and what insurers will authorize together.
What is the scarring like after a double incision mastectomy?
Double incision leaves a horizontal scar below each pec. Scars are pink and raised initially, then gradually flatten and fade over 12–18 months. Scar outcome depends on technique, healing, and scar care compliance. Dr. Day discusses realistic scar expectations during your consultation — no surgeon can guarantee scar-free results.
How soon can I schedule surgery after my consultation?
Many patients at Pacific Sound have surgery scheduled within 4–6 weeks of their consultation, depending on insurance authorization timelines. Self-pay patients may schedule more quickly. The team moves as fast as documentation and scheduling allow.
Is Dr. Day performing surgery at a hospital or surgical center?
Dr. Day performs MTF top surgery at accredited surgical facilities including Swedish Medical Center, Virginia Mason Franciscan Health, Carillon Point Surgery Center, and Sound Plastic Surgery Center. The appropriate facility is determined based on your case, technique selected, and insurance.
How do I get started?
Call (425) 818-8991 or use the online scheduling form to request a consultation. Our patient care coordinator will guide you through the process — from your first appointment to insurance authorization to surgery date.
What is the scarring like after MTF top surgery?
Scar location and visibility depend on the technique selected. Implant-based augmentation typically uses a small incision in the breast crease (inframammary), around the areola (periareolar), or in the armpit (transaxillary). Fat grafting uses very small entry points for the cannula. Scars are pink and raised initially, then gradually flatten and fade over 12–18 months. Outcome depends on technique, healing, and scar care compliance. Dr. Day reviews realistic scar expectations during your consultation — no surgeon can guarantee scar-free results.
Schedule Your Top Surgery Consultation
You deserve a chest that aligns with your identity. Dr. Day and the Pacific Sound team create personalized surgical plans tailored to your unique goals.