Dr. de Clermont-TonnerrePlastic Surgeon

Paris 16th — Gender-Affirming Surgery & ALD 31

Chest Feminisation (MtF)

Trans breast augmentation — Paris 16th & Pontoise

Chest feminisation is one of the most significant steps in the MtF transition. It involves developing the chest through silicone breast implants and/or fat transfer, to achieve a feminine silhouette in harmony with gender identity.

Dr. de Clermont-Tonnerre is one of the most experienced plastic surgeons in Paris for gender-affirming surgery. He supports his patients under the ALD 31 pathway or outside it, with compassion and expertise.

Book an appointmentGender surgery — all procedures

Techniques

Implants, fat transfer — or both?

Breast implants

Primary technique

The latest-generation cohesive silicone implants deliver precise and natural volume even in the absence of native glandular tissue. Placed submuscularly or in dual-plane depending on morphology. Immediate and lasting result.

  • Precise, immediate volume
  • Adapted to MtF morphology
  • Lifespan 15 to 20 years
  • ALD 31 coverage possible

Fat transfer (lipofilling)

Natural complement

Autologous fat transfer reshapes the contours and improves the natural appearance of the décolletage. Can be performed alone (moderate augmentation) or combined with implants for an optimal result.

  • 100% natural tissue (your own fat)
  • Reshaping of contours and décolletage
  • Combinable with implants
  • Slimming of the donor area

Implant selection

Anatomical implants — ultra-natural results

Dr. de Clermont-Tonnerre preferentially uses anatomical (teardrop-shaped) implants for patients with a slender morphology. Unlike round implants, which can appear overly prominent on a narrow chest, the anatomical shape faithfully reproduces the natural breast profile — flat at the top, with maximum projection in the lower third — for a result indistinguishable from a natural chest.

This choice is particularly suited to slender patients: it offers a gentle, harmonious feminisation without an artificial appearance, respecting body proportions. Volume is selected on a case-by-case basis during the consultation, with simulation trials to visualise the result.

  • Teardrop shape — 100% natural profile
  • Ideal for slim and slender morphologies
  • Discreet, harmonious and proportionate result
  • Latest-generation cohesive silicone
  • Personalised volume selection at consultation

Round vs anatomical

Round implant

Uniformly distributed volume. Can suit patients with more native tissue. Risk of an overly prominent appearance on a narrow chest.

Anatomical implant (teardrop)

Progressive projection from top to bottom. Very natural result even on a flat chest. Recommended for slender morphologies.

Step by step

How it works

01

Consultation and planning

Morphological assessment, volume and technique selection. ALD 31 file preparation if desired. Photographic simulation.

02

Pre-operative assessment

Blood tests, mammography or ultrasound, anaesthetist consultation. Mandatory 15-day reflection period.

03

Surgery

General anaesthetic. Duration 1h30 to 2h30. Submuscular or dual-plane implant placement. Fat transfer if indicated.

04

Hospital stay

Day case or 1 night. Support bra to be worn for 6 weeks.

05

Follow-up

Consultations at D+7, M+1, M+3, M+6. Final result at 6–12 months.

Practical information

Duration
1h30 to 2h30
Anaesthetic
General
Hospital stay
Day case or 1 night
Time off work
7 to 10 days
Final result
6 to 12 months
Aesthetic fee (from)
€6,000
ALD 31 fee (from)
€3,500

A specialist in gender-affirming surgery in Paris

Dr. de Clermont-Tonnerre has been practising gender-affirming surgery in Paris 16th for several years. He is one of the leading practitioners in Île-de-France for the surgical care of transgender and non-binary patients.

His practice covers all feminisation procedures (MtF): chest feminisation, facial feminisation surgery (FFS), genital surgery — as well as masculinisation (FtM): top surgery, phalloplasty. He supports patients under ALD 31 or outside it, according to individual wishes.

Every consultation is conducted with compassion, respect for gender identity and absolute confidentiality.

Frequently asked questions

Is chest feminisation covered by French national health insurance?+
Yes, under ALD 31 (Affection Longue Durée No. 31 — gender dysphoria), breast augmentation for MtF patients can be covered by the Assurance Maladie (French national health insurance). A period of hormone therapy is generally required (in practice, at least 2 years without sufficient breast development). Dr. de Clermont-Tonnerre assists you in compiling the coverage file.
Which technique — implants or fat transfer?+
Both techniques can be used, alone or in combination. Silicone implants are most often chosen as they guarantee a precise and immediate volume, ideal when native tissue is underdeveloped (common in the absence of glandular tissue). Fat transfer (lipofilling) can complement the result by reshaping the contours for a more natural appearance. The technique is discussed during the consultation according to your morphology.
Is a multidisciplinary team required?+
For patients seeking coverage under ALD 31, a multidisciplinary follow-up (specialist psychiatrist or psychologist, endocrinologist) is recommended. Dr. de Clermont-Tonnerre liaises with specialist teams in gender dysphoria. For patients seeking aesthetic treatment outside ALD 31, the surgical consultation alone is sufficient.
What results can I expect?+
The result is a naturally feminine chest, tailored to your morphology. Implants provide a precise and lasting volume. The final result is assessed at 6–12 months, once swelling has fully subsided and the implants have settled. The vast majority of patients report a profoundly positive impact on their quality of life and wellbeing.
When can chest feminisation be performed during a transition?+
Breast augmentation can be considered at any point in the transition pathway. Under ALD 31, the health insurance typically requires at least 2 years of hormone therapy without sufficient breast development. Outside ALD 31, the procedure can be performed as soon as you wish, following a consultation.
Are there risks associated with breast implants?+
The latest generation of silicone implants are very safe. Specific risks include: capsular contracture (hardening around the implant), implant displacement, and late-stage rupture. Implants have an estimated lifespan of 15–20 years. Radiological monitoring (ultrasound) every 2–3 years is recommended.

Patient testimonials

★★★★★

“After two years of hormone therapy, my chest had not developed sufficiently. The augmentation with Dr. de Clermont-Tonnerre changed everything. He understood my expectations and the result is magnificent and natural. My transition finally feels complete.”

Camille

★★★★★

“Dr. de Clermont-Tonnerre is the surgeon I recommend to all trans women in Paris. Compassionate and highly skilled, he understands perfectly the specificities of our bodies. The ALD 31 process was straightforward with his guidance.”

Lea

★★★★★

“I had consulted several surgeons before him. None seemed as comfortable and expert in trans surgery. Perfect result, impeccable follow-up.”

Ines

⭐ View all Google reviews

See also:

Facial feminisation (FFS) →Vaginoplasty (MtF) →
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