I have a mild thing about prosthetics. To me they are not at all affirming as they are just not really me. So I simply never considered the idea of breast enhancement. After 5 years on HRT I had a B cup and an A+ cup development, and both were Tanner Stage 3. I tried a year of progesterone with little other than nipple development.
I did occasionally get misgendered, but it never really upset me. One thing that did annoy me was finding a comfortable bra which worked with my asymmetric breasts. A friend of mine was delighted with her breast surgery, and urged me to do the same, but it wasn't a dysphoria trigger for me, and at nearly AUD$15000 out of my pocket, I decided against it. But my friend kept bugging me, and I weighed up the practical advantages and relented.
It was much more painful than bottom surgery, and I couldn't drive for a month, but aesthetically, the results were pleasing. I now have symmetric D cups, bras are easy to find in my size, and my clothes fit better. I no longer get misgendered, and I realised that breasts are way more important for others perceptions of women than I had imagined.
4 weeks after my surgery, I had a heart attack. The cardiologist exonerated both the surgery and my hormone levels as contributors, but during my trip in the ambulance I had 2 cardiac arrests, which involved CPR and Defib. My ribs were fractured, so we were concerned about the integrity of the implants. Once I had recovered from the attack, we had scans of the implants to confirm they are intact!
All up, I am glad I had the implants as my life has now improved.Previously, I was not comfortable going to the pool or beach, but now I don't give it a second thought. I use the women's change rooms and never get a second look from other women including mothers with small children. Even though I don't feel I pass well, I have had a number of men flirt with me, and one who was persistent!
This is a very personal decision, and may be driven by dysphoria, or practicalities, but as others have said, it must be your decision for you! You have to live with this decision for a very long time.
Hugs,
Allie