Transgender Surgery

Transgender surgery or gender affirmation surgery describes a group of procedures which help patients achieve their true gender identity.  Some patients are looking to transition from male to female, female to male or have no gender identity (non binary) and would like to remove or blunt certain secondary sex traits.

The process involves many health care professionals including internal medicine physicians, psychiatrists, endocrinologists and surgeons.

Surgery can divided up into facial or body procedures.  Facial procedures work to either feminize or masculinize the facial features.  This may include modification of the cheek bones, jaw, nose (rhinoplasty) and shaving the Adam’s apple.   Body surgeries are further split into “top” and “bottom” surgeries.  Top surgeries involve the creation of breasts (breast augmentation) and the removal of breasts (mastectomy).  Bottom surgeries involve the creation of a penis (phalloplasty) or vagina (vaginoplasty).

I perform both breast augmentation and mastectomy for transgender patients.  Breast augmentation is performed similarly to standard breast augmentation, although the technique varies slightly. Most often silicone implants are used and can provide a natural, feminine result. 

For patients looking to transition from female to male, I perform transgender mastectomies.  The technique I use most often is called the “double incision” with a free nipple graft.  This involves the removal and reduction of the nipple and areola.  The breast is then removed with an incision above and below.  The skin is then closed, placing the incision at the normal male pectoral crease. The nipple is then sutured in place, in a lower, more lateral male position. 

In very exciting news, my colleagues at the Lahey Hospital and Medical Center have started a Transgender Surgery Program which offers phalloplasty and vaginoplasty.

In the state of Massachusetts, coverage of these procedures by your health insurance company is mandated.  However, as with all surgery, patients must be appropriately selected and healthy enough to undergo surgery.  Medical problems such as obesity, smoking and other conditions are taken into account.  For more information, please make an appointment to meet in person.