Male to Female Surgery | Jaw-dropping results
Author: Babak Moein, MD FACSBoard-certified,
Fellowship trained in Cosmetic Surgery

Male To Female Surgery

Introduction to Male to female surgery

Male to female surgery is predicated on transforming the physical state of a transgender female from her male birth appearance to one that is more feminine. Surgical procedures have been developed by modifying traditional surgeries. At SurgiSculpt, we strive to help our transexual female patients achieve their dreams. Transgender patients consulted at SurgiSculpt have typically completed mental health professional assessments and been under the care of endocrinologists. Although hormone therapy helps transsexual females feminize their features, gender reassignment surgery is often essential to completing their male-to-female transformation. A combination of procedures is needed to achieve the postoperative outcomes that our transsexual patients desire. Surgical techniques have been adopted from conventional surgeries to create gender-affirming surgeries.

Sex reassignment surgeries have focused on transforming the breasts, abdomen, back, and buttocks. Genital surgeries are not performed at our center, but referrals can be provided to you upon request. Transgender females who undergo surgical procedures intended to provide gender confirmation surgeries will be well educated on the specifics of their surgery, the risk of complications, and a realistic appreciation of the expected outcomes.

Male to female surgery of the breasts

Male to female breast surgery involves transforming a masculine-appearing breast to a more feminine shape. A flatter chest mound characterizes the male breast. Transformation of a male breast requires multiple features, including a fuller breast mound with a rounded perimeter and borders and enlarged areolas. These prerequisites can only be achieved by expanding the breast mound fullness. Transexual females desiring feminized breasts fall into two categories, those that desire a modest increase in their breast size and those that wish to have drastic enlargement of their chest.

The former requires patients to be conservative with implant selection such that the nipple-to-inframammary crease distance matches the radius of their chosen implant. This ensures harmony of the chest appearance with a nipple centered on the newly created implant. A final modification of male breast augmentation also involves the placement of the implant over the muscle rather than under the muscles, as done in female patients. This is because the male pectoralis muscle is much bulkier than the female pectoralis muscle and can result in dynamic deformities if the muscle is lifted to accommodate the more utilized subpectoral pocket.

One year following augmentation, patients who desire more volume may have their implant replaced for a larger one once the skin between the nipple and inframammary crease has lengthened. The latter involves the placement of a lower-profile expander which can be used to stretch out the skin over three months, followed by expander removal and final implant placement. Stretching the lower breast pole skin allows for an increase in the nipple to inframammary crease distance, which will accommodate the desired implant size. If patients have been on hormones for extended periods, they may have developed some glandular tissue and lower breast pole lengthening, thus avoiding the need for a staged procedure. A breast sizing consultation is required to determine whether you can undergo a single-stage male-to-female transformation.

Male to female surgery of the abdomen

Male-to-female sex reassignment surgery of the abdomen requires the transformation of a lean and square torso to an exaggerated curvy figure. This plastic surgery requires aggressive elimination of the waistline fullness while adding prominence to the lateral hips. the abdominal area must be contoured to create a more feminine and less etched-out appearance. The creation of natural shadows consistent with a feminine abdomen includes delineating vertical natural shadows of the lateral and central vertical gulleys termed the semilunar lines and linea alba. Utilizing high definition liposuction principles is critical to achieving male-to-female surgical outcomes. High definition liposuction outcomes are predicated on being able to achieve the following:

  • 360-degree body contouring
  • Unveiling of natural shadows
  • Honoring feminine aesthetic guidelines

Male to female surgery of the back

Male to female surgery of the back is predicated on converting a fuller upper and middle back and narrowed lower back and flank to a lean back spanning from the upper to the lower back and flanks. Interestingly, in contrast to the male lower back and flanks, the female lower back and flanks should be contoured conservatively to provide a smooth transition zone between a fuller lateral hip and buttock and the maximally narrowed middle back waistline.  Achieving smooth contour lines is paramount to achieving an hourglass shape that establishes a feminine silhouette.

Male to female surgery of the buttock

Male to female surgery of the buttocks transformation is reserved for transexual females who desire a more feminine buttock. Their desires require transforming square buttocks into rounder and fuller buttocks with prominent hips. The feminized buttock appearance is classically called the bubble butt, which describes a buttock with maximum width and projection. The Brazilian Butt Lift describes the transfer of fat grafting throughout the male buttock cheeks to create a feminized buttock appearance. Creating a generous buttock and lateral hip is predicated on establishing the hourglass figure desired by transgender females.

Male to female Surgery Procedure

Gender confirmation surgery is focused on transforming the breasts, abdomen, back, and buttocks. Transgender females desire to appear more feminine from all viewed angles. This desire can only be achieved by utilizing circular techniques employed in high definition body contouring principles.

Patients seeking a transformation from a male to a female are typically treated with breast augmentation surgery. Male patients desiring breast feminization are limited by the tightness of their skin and their short inframammary crease to nipple distance. This means that patients will have two options for surgery: 1)modest implant augmentation or 2)staged expander placement and implant augmentation.

Breast confirmation surgery has become a mainstay of gender reassignment surgery and is often the initial gender change surgery. Breast gender confirmation surgery refers to changing the appearance of the patient's breasts to align with their gender preference. The length of hormone therapy and any breast changes resulting from being on hormones and your desired breast size will determine your ultimate surgical design.

Abdominal feminization is the second most frequent request of our transgender patients. To achieve this transformation, the lateral abdominal waist is contoured to narrow the waistline creating the hourglass figure. Abdominal feminization transforms the linear contours of a male body into exaggerated curves desired by females.

Back feminization is a continuum of abdominal conversion surgery and requires transforming a "V" shaped masculine back into a sleek and lean upper, middle, and lower back. The "V" shape of a male back is created by a prominent latissimus dorsi muscle. Back feminization aims to remove a "V" shaped back. The "V" shaped masculine back is predicated on a fuller upper and middle back, conveying a strong latissimus muscle that tapers into a truncated lower back and flank region. The lower back and flanks are reduced to create a smooth transition from the maximally narrowed waist to a general buttock and lateral hip.

Buttock feminization is predicated on transforming a square-shaped buttock that is firm and bold to a full-figured buttock.

Male to female Surgery Length

Male-to-female surgery may last between 1 to 5 hours, depending on the scope of surgery.

Male to Female Anethsia Type

Male to female surgery requires general anesthesia.

Male to female surgery Place of Treatment

Male to female surgery must be performed in an outpatient surgical suite or hospital operating room.

Male To Female Surgery Frequently Asked Questions:

Gender breast alteration may involve transformation from a male to a female breast. The goals of a male to female breast transformation involve increasing overall breast mound fullness and roundedness; moderate increases in size may be achieved with a single surgery, but more notable increases in breast size require a staged procedure.

Any and all patients who desire gender reidentification may be excellent candidates for gender abdomen confirmation surgery. Most patients seeking gender abdominal alteration surgery typically couple it with other gender reidentification procedures such as change of breast gender appearance. Patients desiring abdominal confirmation surgery have typically undergone extensive counseling and are well on their way to gender reassignment. 

Gender abdomen confirmation surgery requires a commitment to postoperative recovery. Since general anesthesia is required, 1 to 2 days of assistance by a responsible adult to ensure that the effects of anesthesia resolve are mandatory. Patients should also get generalized help around the house if heavy lifting, pushing, or pulling is expected. Remember that Vaser liposuction does also require a 10-day postoperative regimen where daily lymphatic messages are provided at the office.

Whether you are undergoing male to female or female to male abdomen transformation, this is major surgery and requires optimization of your healing potential.  Patients are asked to maximize their daily protein intake by consuming 150grams of protein daily. Patients are also advised to avoid any blood thinners. Finally, ALL smoking must be stopped at least one month prior to surgery to optimize healing of skin incisions and minimize the risk of infection

Gender abdominal confirmation surgery involves the creation of dramatic changes in contour that portray the change of a female to a male abdomen or male to female abdomen. Female to male abdominal changes will demonstrate a transformation from a more feminized rounder appearance to a more square and chiseled appearance.  in contrast, male to female breast changes will demonstrate a transformation of their square abdominal contour to a more curvy, narrowed waistline, and softer appearance. 

Your gender abdominal confirmation surgery will be performed at one of our accredited surgery centers. Due to the invasive nature of the surgery, patients require general anesthesia

Your gender abdominal confirmation surgery will be performed while under general anesthesia. General anesthesia is recommended to you since abdominal surgery involving Vaser liposuction and potential tucking procedures involves surgical incisions.

When you wake up from surgery, you will find your abdomen wrapped with a customized compression garment lined with foam in-lay. This specialized dressing and compression will help prevent swelling and bruising in the early postoperative period. After two weeks, you will be allowed to remove your compression dressings which may result in some rebound swelling. However, you will also be urged to return to physical activity that should counter your swelling.

Patients who undergo gender abdominal confirmation surgery will require 1 week to return to routine daily activities. Patients are allowed to participate in below the waist workouts at 2 weeks but will have to wait a full month before being allowed to perform all physical activities without any limitations.

Male To Female Surgery Patient-Specific Questions:

Gender abdominal reassignment surgery cost depends on gender conversion desired. For a male to female conversion, waistline narrowing is required which takes approximately 1.5 hours to complete. The cost of male to female gender abdominal confirmation surgery is approximately 10,000$. For a female to male conversions, abdominal etching is required which takes approximately 2.5 hours to perform. The cost of female to male gender abdominal confirmation surgery is approximately 14,000$.

Traditionally, we used to remove the lowest floating rib in an attempt to maximize waistline narrowing. With the advent of Vaser liposuction, waistline narrowing is maximized with comprehensive removal of fat from the lower back and flank region as well as the abdominal waist region, avoiding the need for rib removal.

Whether you are converting from a male to female or female to male, you will have comprehensive removal of fat using Vaser technology. As such, the results are permanent since minimal fat is left behind. This means that even if you gain weight, you will not gain it in the areas treated. As such, the results of this surgery are permanent.



I came into SurgiSculpt office for botox and Juvederm with my best friend.The Dr was very knowledgeable and made me feel comfortable. Both procedures were pain free and the results were amazing and subtle. I have been getting lots of compliments about how refreshed I look. Will definitely be recommending him to all my friends!!

Breast Reconstruction Following Mastectomy

I've had several procedures with SurgiSculpt following my mastectomy. The entire staff is great, especially both massage therapists (Theresa and Polly) as well as James. I am going to do nipple tattooing with them as well and then I will finally be all done! I couldn't be happier to have found SurgiSculpt and close this chapter of my life.

Awesome experience

Awesome experience! SurgiSculpt knew exactly what I wanted and everything I asked for was perfect! Easy to work with, great results. With this type of procedure you need a good listener, SurgiSculpt was a great listener.

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