Gender Affirming Surgery
At Associated Plastic Surgeons, we proudly offer gender affirmation (sex reassignment) procedures to help individuals align their physical appearance with their sense of self.
What Is Gender Affirming Surgery?
Gender-affirming surgery is performed to transition patients with gender dysphoria (gender identity disorder) to their desired gender. This surgery (or surgeries) transforms the patient’s physical appearance and, where possible, function, along with their existing sexual characteristics to resemble their identified gender.
This surgery is not a rushed decision. Patients are required to progress through a transition period to determine if they are truly ready to have this life-changing surgery. Once completed, however, these procedures, coupled with appropriate hormone therapy can allow a person to finally feel at home with his or her body and gender.
Gender-affirming procedures include top and bottom surgeries, as well as body contouring procedures and possible cosmetic procedures, such as rhinoplasty.
Dr. Duboys works with you through each step of this process.
What Is Female to Male Top Surgery?
In female to male (FTM) surgery, the breasts, uterus, and ovaries are removed in two separates procedures. FTM top surgery involves the removal of the breasts. The shape of the nipple-areolar complex is altered to more closely resemble the natural male configuration.
Patients who have smaller breasts can have FTM top surgery performed through an incision in the lower half of the areola, using a combination of liposuction and surgical removal. If we need to remove excess skin, this can usually be also done through an incision around the areola.
Patients with larger breasts will likely need to have some excess skin removed as it may be prone to sagging. This is usually done at the breast crease, although it will leave a scar.
What Is Male to Female Top Surgery?
In male to female (MTF) top surgery, Dr. Duboys places breast implants through an incision along the breast crease, in the armpit, or around the nipple. Since the male breast and chest have some inherent differences from the female chest, this may require a two-stage process. In some cases, a spacer may be needed to first make room for the implants.
What Is the Preparation for Gender-Affirming Surgery?
Dr. Duboys follows the standards of care adopted by the World Professional Association for Transgender Health (WPATH). These follow a series of steps to see if Dr. Duboys will consider surgery. The first step usually involves meeting with a mental health professional for diagnosis and psychotherapy. A diagnosis of gender dysphoria and a letter from the therapist is necessary before the patient can begin hormone therapy.
Hormone therapy involves androgens for FTM transitions, estrogen, and anti-androgens for MTF transition. These hormones help the patient develop characteristics of the identified sex, everything from hair growth to fat distribution.
Before we can consider surgery, the final step is for the patient to live for as long as one year in his or her preferred gender role. This includes work or school, changing the accepted name, and basically living in their identified gender. Once we successfully manage these steps, the patient can proceed to surgery.
Facial Feminization Surgery
Facial feminization for MTF surgery can involve certain cosmetic procedures such as plastic surgery to soften features such as the nose, brows, chin, and hairline. This can also include shaving down the patients Adam’s apple. Laser hair removal is a requirement for facial feminization.
Male to Female Bottom Surgery
MTF bottom surgery usually involves the removal of the testicles and most of the penis. During the procedure, the doctor also shortens the urethra. We use some of the skin to fashion a vagina. A “neoclitoris” can be created from parts of the penis.
Female to Male Bottom Surgery
FTM bottom surgery involves a “neophallus” being made from tissue from the forearm or other parts of the body that allows sexual sensation. We may extend the urethra, but this is a difficult procedure and isn’t always successful. Hormone treatments will help with hair growth and more masculine feature development. We may also involve the use of cosmetic surgery.
What Is the Age Requirement for Gender Affirming Surgery?
The patient should be at least 18 years of age.
Sex Reassignment Surgery Risks and Complications
Some common risks and complications associated with sex reassignment surgery are bleeding, infection, wound breakdown and scarring. Dr. Duboys will discuss additional risks and complications at the time of your consultation.
What Is Recovery Like After FTM Top Surgery?
This procedure has varying periods of recovery due to the different needs from liposuction to tissue excision. Patients will wear a binder following surgery for at least one month. If the patient had keyhole surgery, then they will have to wear a compression shirt.
Most patients can return to normal activities within two weeks after their top surgery, but strenuous exercise, especially involving the chest muscles, needs to wait at least one month. Patients can return to clerical types of jobs in one week in most cases.
What Is Recovery Like After MTF Top Surgery?
After your breast augmentation, you’ll be in compression bandages. Once we remove the bandages, Dr. Duboys will require that the patient wear a support bra for at least one month. Your chest will feel tight and the implants may seem to sit too high. This is normal, as the chest tissue needs to expand and the implants need to settle down into their final position. Recovery is not overly difficult, and most people can return to normal activity in a week or so. Strenuous exercise, especially impact exercise, will need to wait for one month.
Schedule a Consultation
If you are interested in sex reassignment surgery and would like more information, please contact our Huntington, NY office today. Call (631) 423-1000 to schedule a consultation with Long Island plastic surgeon Dr. Elliot Duboys.