There is a high frequency of reoperation in breast augmentation surgery in cases of male-to-female gender dysphoria, not only due to the high extrusion rates of breast implants due to the scarce skin tissue but also because of the high rates of patient dissatisfaction secondary to breast size and size of the nipple-areola complex.1–3 In this article, we present a case report of a patient with male-to-female gender dysphoria who underwent augmentation mammaplasty with the use of tissue expanders in the first stage and implant change in the second surgical stage. Changes in anthropometric measurements, degree of satisfaction, and quality of life were recorded using the BREAST-Q questionnaire,4 which has a maximum score of 100 percent, and the Diener scale,5 which assesses patient satisfaction with life over different domains. A 36-year-old patient diagnosed with male-to-female gender dysphoria presented with a surgical history of body liposuction and facial feminization and no other relevant history; the patient had been receiving endocrinology controlled hormone therapy since 2016. The patient was considered a candidate for augmentation mammaplasty in two surgical stages using breast expanders, following earlier evaluation by the gender dysphoria board of the Hospital de San José, in Bogotá, Colombia (Fig. 1).Fig. 1.: Preoperative view of the patient.Informed consent was obtained and the BREAST-Q presurgical questionnaire was completed. During the first surgery, the Natrelle 133 FV12 400-cc breast expanders (Allergan, Irvine, Calif.) were inserted and their proper positioning was verified. Subsequently, the breast augmentation began after a period of 3 weeks. The patient was evaluated weekly, and augmentation was performed by infiltration with saline solution, reaching a total of 550 cc infiltrated in each breast, until the patient was satisfied with the size. The results of the four subitems of the BREAST-Q postoperative questionnaire, completed 14 days after the first procedure, were as follows: Satisfaction with their breasts, 100 percent; Psychosocial well-being, 100 percent; Sexual well-being, 100 percent; and Physical well-being, 100 percent. The second intervention was scheduled after a period of 3 months to allow time for the mammary capsule to form. In the second procedure, the breast expanders were removed, capsulotomy was performed, and Mentor smooth, round, high-profile 550-cc breast implants (Mentor Worldwide LLC, Santa Barbara, Calif.) were placed. Through the Diener’s life satisfaction questionnaire, which the patient completed 1 month after surgery, it was possible to determine the cognitive component of well-being from a global perspective. When verifying the answers in the self-reported questionnaire of the Satisfaction with Life Scale in this patient, we found a score of 31 points out of 37 possible, with a higher score indicating greater satisfaction with life (Fig. 2).Fig. 2.: Postoperative view of the patient.Two-stage augmentation mammaplasty with the use of tissue expanders in patients with gender dysphoria is an ingenious and valuable alternative that allows for solving the problems that plastic surgeons face. The patient described augmentation mammaplasty through the use of breast expanders as a positive effect that strengthened the gender change process and improved self-esteem. DISCLOSURE The authors have no financial interests to declare in relation to the content of this article.