Top Surgery and Gender-Affirming Breast Augmentation in Connecticut
Dr. Richard Agag is a board-certified plastic and reconstructive surgeon in Connecticut who performs Top Surgery and gender-affirming Breast Augmentation. His background includes extensive experience in breast reconstruction and microsurgery, providing a strong surgical foundation for his work in gender-affirming breast and chest surgery.
Dr. Agag completed his Plastic Surgery residency at Rutgers New Jersey Medical School followed by a Microsurgery Fellowship at the University of Pennsylvania. He is Professor of Surgery and Chief of the Division of Plastic and Reconstructive Surgery at Rutgers Robert Wood Johnson Medical School.
Why Patients Choose Dr. Agag
- Board-certified by the American Board of Plastic Surgery since 2012
- Fellowship-trained in microsurgery at the University of Pennsylvania
- Founder and Managing Partner of The DIEP Group CT
- Surgical Director of the PROUD Gender Center
- Extensive academic work in breast reconstruction and microsurgery
- Named a Castle Connolly Top Doctor since 2020
Academic & Professional Contributions
Dr. Agag’s academic career includes leadership, research and surgical education. Earlier in his career, he was an Assistant Professor of Surgery at Albany Medical College, where he served as Director of Microsurgery and Director of the Microsurgery Fellowship.
His research has appeared in Plastic and Reconstructive Surgery, Journal of Reconstructive Microsurgery, Annals of Plastic Surgery and other peer-reviewed publications. His published work includes research on breast reconstruction, microsurgical free-flap reconstruction and breast augmentation.
Dr. Agag has also been involved in international reconstructive surgery and surgical education. His work has taken him to countries including Vietnam, Nepal, Ecuador, Bolivia, Peru, Mali, Zambia and the Philippines. In 2019, he served as a breast and microsurgical visiting educator in Hue, Vietnam, where he performed the first DIEP flap procedures in Hue.
His professional memberships include the American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, American Council of Academic Plastic Surgeons and American Association of Plastic Surgeons.
Gender-Affirming Care
Dr. Agag has served as Surgical Director of the PROUD Gender Center at Robert Wood Johnson University Hospital since 2018 and is a member of its multidisciplinary team. His involvement in gender-affirming healthcare also includes the Babs Siperstein Gender Steering Committee and professional education on gender-affirming surgery.
Dr. Agag works alongside Dr. Shareef Jandali at the Top Surgery Group in Connecticut. Dr. Jandali also performs Top Surgery and gender-affirming Breast Augmentation.
Masculinizing Top Surgery
Dr. Agag performs gender-affirming Top Surgery for transgender and gender-diverse individuals seeking a more masculine chest.
The specific Top Surgery technique used is selected according to the individual’s anatomy and surgical needs. Top Surgery can be performed using approaches such as Double Incision, Periareolar and Keyhole Top Surgery. Double Incision Top Surgery uses incisions below the pectoral muscles and is generally suited to those with more chest tissue or excess skin. Periareolar Top Surgery uses incisions around the areola and can minimize visible scarring for those with smaller chests and good skin elasticity. Keyhole Top Surgery removes chest tissue through a small incision along the edge of the areola and results in minimal scarring. Nipple position, skin elasticity and the amount of tissue to be removed are among the factors considered when determining the appropriate surgical approach.
Gender-Affirming Breast Augmentation
Dr. Agag performs gender-affirming Breast Augmentation for transgender and gender-diverse individuals seeking increased breast volume and a more feminine chest contour.
Breast Augmentation is typically performed with breast implants, with implant size, shape and placement selected according to the individual’s anatomy and goals. In some transgender women, the existing chest anatomy may require particular consideration of breast width, nipple position and the inframammary fold beneath the breast when planning implant placement.
Depending on the amount of available breast tissue and skin, augmentation may be performed as a single-stage procedure or, in some cases, as a staged procedure. A staged approach uses tissue expanders that are gradually filled after surgery to stretch the skin and create space for the desired breast volume. The expanders are later removed and replaced with permanent breast implants.
Implants may be positioned either above or partially beneath the pectoral muscle. The appropriate approach depends on factors such as existing breast tissue, chest dimensions, implant size and the amount of soft-tissue coverage available over the implant.
Hospital Affiliations
Dr. Agag is affiliated with several hospitals in Connecticut:
- Bridgeport Hospital – Bridgeport, CT
- Norwalk Hospital – Norwalk, CT
- St. Mary’s Hospital – Waterbury, CT
- MidState Medical Center – Meriden, CT
Consultations
Dr. Agag offers in-person or virtual telehealth consultations. Contact the practice to schedule a consultation.
Costs, Financing & Insurance
Top Surgery Group is accepting new patients with Aetna, UHC, UHC Oxford, UMR, ConnectiCare, Anthem, BCBS, and Cigna.
Dr. Agag is an out-of-network provider. The Top Surgery Group insurance advocacy team will help you throughout the insurance approval process and will work with insurance companies to obtain approval and appeal denials.
If insurance does not cover gender-affirming surgery, the practice can provide a quote for the out-of-pocket cost. The Top Surgery Group accepts medical financing to make surgery more accessible.
Surgery Requirements
- Patients must be 19 years of age for surgery. Consultations are available before age 19.
- The practice follows WPATH Standards of Care guidelines for surgery. A letter from a mental health provider recommending surgery is required.
- Patients must stop smoking/vaping and recreational drug use before surgery.
Insurance companies may have additional requirements before approving coverage for gender-affirming surgery. Requirements vary by insurance plan and may include additional referral documentation or other prerequisites.
Meet With Dr. Agag
Have questions for Dr. Agag? Contact the practice by clicking the Send Inquiry button.
