By plastic surgeon Dr Dirk Kremer. 

Plastic surgery plays a significant role in the process of gender affirmation for many as it provides individuals with an opportunity to align their physical appearance with their gender identity.

In this article, I hope I can provide an objective overview of the various plastic surgery options available to transgender individuals, including facial feminisation, chest surgery, and body contouring.

My goal is to present a factual account of these procedures and their impact on the journey of gender affirmation so that you can gain a better understanding of the types of specialised procedures that are commonly requested or performed.

Due to the specialist nature of these procedures it’s vital that you seek the honest opinion and expertise of a plastic surgeon who is well-versed in the specific procedures that interest you.

Facial feminisation surgery (FFS)

Facial feminisation surgery (FFS) encompasses a range of procedures designed to create a more traditionally feminine facial appearance.

For many transgender women, FFS is a crucial component of their transition, helping to align their facial features with their gender identity.

Key procedures within FFS include:

Forehead contouring: This involves reshaping the forehead to reduce the prominence of the brow ridge, often achieved through bone contouring.

Rhinoplasty: This procedure alters the shape and size of the nose to achieve a more refined, feminine appearance.

Cheek augmentation: Enhancing the cheeks with implants or fat grafting can create a fuller, more feminine facial contour.

Chin and jawline recontouring: Adjusting the chin and jawline helps to soften the lower face and achieve a more delicate profile.

FFS can significantly impact a person's self-esteem and confidence by providing a facial appearance that reflects their gender identity. The decision to undergo FFS is deeply personal and varies based on individual needs and preferences.

Chest surgery

Chest surgery, commonly known as chest reconstruction or top surgery, is a critical procedure for many transgender men and non-binary individuals seeking to achieve a more masculine chest appearance. This procedure involves the removal of breast tissue and the re-sculpting of the chest to create a flatter, more masculine contour.

Key considerations for chest surgery include:

Double incision method: This technique involves making two horizontal incisions across the chest to remove excess tissue and reposition the areolas.

Periareolar technique: This approach involves a circular incision around the areola, often used for individuals with smaller breasts and minimal excess tissue.

For transgender women, breast augmentation may be sought to achieve a more traditionally feminine chest appearance.

This involves the placement of implants to enhance breast volume and shape.

Body contouring

Body contouring procedures help transgender individuals achieve a body shape that aligns with their gender identity. These procedures are particularly relevant for those undergoing hormone therapy and seeking to further refine their body contours.

Common body contouring procedures include:

Liposuction: This procedure removes excess fat from specific areas of the body to create a more sculpted and proportionate figure.

Body lift: A body lift involves the removal of excess skin and fat to improve body contours, particularly after significant weight loss or changes due to hormone therapy.

Body contouring can enhance body symmetry and proportions, contributing to a more balanced and gender-affirming appearance.

Impact on gender affirmation

Plastic surgery procedures for gender affirmation can have a profound impact on an individual's quality of life. For many, these surgeries are an essential part of their transition, offering not only physical changes but also emotional and psychological benefits.

Aligning physical appearance with gender identity can lead to increased self-confidence, reduced gender dysphoria, and improved overall well-being.