Gender Affirming Surgery



Gender Affirming Surgery

Transgender Surgery Overview

Gender affirmation surgery, also referred to as gender reassignment surgery or sex reassignment surgery, are procedures by which a transgender person’s physical appearance and function of their existing sexual characteristics are altered to resemble those socially associated with their identified gender. The goal of these procedures are to give you the physical appearance and functional abilities of the gender you strongly identify with.

Dr. Ruston works individually with each one of his patients to find a treatment plan that will produce the desired outcome. Many of his LA patients report a re-affirmed sense of identity and improved quality of life after this procedure.

What is gender affirming surgery?

Gender affirming surgery refers to plastic surgery procedures that are performed on individuals with gender identity disorder (dysphoria) to help them transition to their desired gender. During this treatment, the plastic surgeon will transform the patient’s primary and/or secondary sex characteristics (e.g., breasts/chest, external and/or internal genitalia, facial features, body contouring) to match the identified gender.

Who is a candidate?

During your initial consultation with Dr. Ruston Sanchez, the surgeon will listen to your goals and desires, ask questions, and discuss options for particular procedures. Your surgeon follows WPATH standards of care for all procedures he offers. Please visit the following website for more information.

Types of Gender Affirming Surgery

Dr. Ruston offers several types of gender affirming surgeries to his patients in Louisiana and other parts of the country.

Transmasculine Top Surgery
(Gender Mastectomy)

During female to male top surgery, or gender mastectomy, the patient’s breasts are surgically removed and the chest may be contoured with liposuction. The surgeon will also alter the shape of the nipple-areolar complex in order to give it a natural male appearance. Patients who have smaller breasts can have this procedure performed via an incision in the lower half of their areola, or around the areola. More often, for patients with larger breasts, a double incision mastectomy is performed with the resulting scar placed under the chest muscle (pectoralis major) crease along with a free nipple graft.

Facial Masculinization Surgery

The majority of female to male patients achieve male facial features after hormone therapy is administered (before surgery). However, some patients who are looking to achieve a higher degree of masculinity may benefit from facial masculinization surgery. This procedure may incorporate forehead augmentation (lengthening), cheek augmentation to create a more angular shape, rhinoplasty to create a larger or wider nose projection, jaw contouring, chin recontouring, and thyroid cartilage (Adam’s Apple) enhancement.

Transfeminine Top Surgery
(Breast Augmentation)

In this type of feminization surgery (breast augmentation), Dr. Ruston will use an incision within the breast crease to insert breast implants, typically over the chest muscles.

Facial Feminization Surgery

This is another type of male to female surgery that incorporates cosmetic procedures that address the appearance of the chin, hairline, brows, and nose. The surgeon may also reduce the patient’s thyroid cartilage (Adam’s apple). Typically, the main goal of facial feminization surgery is to ensure that the patient’s facial appearance has distinct female characteristics.

Keep in mind that the specific treatment approach to be used will be determined by the patient’s individual needs. Each gender affirming procedure is a highly complex and specialized procedure that also aims to ensure neurological sensitivity and proper blood flow.


How do I get ready for Gender Affirming Surgery?

WPATH (The World Professional Association for Transgender Health) has published standards of care guidelines that Dr. Sanchez and gender affirming surgeons adhere to. For any top surgery, patients should have lived in their congruent gender role for over 1 year, present with one referral (letter of readiness) from a mental health provider, and otherwise be in good health for optimal candidacy. For breast augmentation, although not an explicit criterion, it is recommended that patients undergo feminizing hormone therapy. The purpose is to maximize breast growth in order to obtain better surgical (aesthetic) results.

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