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You Deserve Compassionate, Experienced Gender-Affirming Care

At SVIA® Plastic Surgery, gender-affirming surgery is led by Dr. Liu [confirm], a board-certified plastic surgeon with the American Board of Plastic Surgery and fellowship-trained in aesthetic plastic surgery. The American Society of Plastic Surgeons notes that selecting a board-certified plastic surgeon is the most important choice in gender-affirming surgery.

Care at SVIA® extends well beyond the operating room. Kelly, the practice's Patient Care Coordinator, has more than 20 years of experience in dermatology and plastic surgery and provides specialized guidance for the transgender community. The surgical team also includes registered nurses with backgrounds in gender-affirming care, so you are supported by people who understand your journey from consultation through recovery.

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What Is Gender Confirmation Surgery?

Gender confirmation surgery, also called gender-affirming surgery, is a group of procedures that change the body's physical characteristics to reflect a person's gender identity. There is no single path. Some patients choose one procedure, while others combine several over time.

SVIA® Plastic Surgery offers gender-affirming procedures in several categories:

Please note that Dr. Liu does not perform rhinoplasty or bone-shaving procedures, and SVIA® Plastic Surgery is not an in-network insurance provider.

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FTM Top Surgery

FTM top surgery, also called transmasculine top surgery or masculinizing chest surgery, removes breast tissue to create a flatter, masculine, or nonbinary chest. For many patients, it also means no longer needing to bind.

Top Surgery Techniques

  • Double incision with free nipple grafts: Best for medium-to-large chests. Tissue and excess skin are removed through incisions along the lower chest, and the nipples are resized and repositioned.
  • Periareolar: Suited to smaller chests with good skin elasticity. Tissue is removed through an incision around the areola, and the areola can be reduced.
  • Keyhole: Designed for very small chests with firm skin, using a small incision along the lower edge of the areola.
  • Liposuction: Often added to smooth the sides of the chest and underarms for a natural contour.

Recovery After FTM Top Surgery

Most patients return to desk work within 1 to 2 weeks and avoid lifting and strenuous upper-body exercise for about 6 weeks. You will wear a compression vest to reduce swelling. Scars soften and fade over the first year, and follow-up visits allow Dr. Liu to monitor healing.

MTF Breast Augmentation

MTF breast augmentation, also called transfeminine top surgery or feminizing chest surgery, enhances the size and shape of the breasts to create a more feminine chest. Many patients choose it because hormone therapy alone does not produce the fullness they want.

Implants vs. Fat Transfer

Two methods can be used for MTF breast augmentation, alone or together:

  • Breast implants: Silicone or saline implants provide the most predictable increase in size. Dr. Liu will select an implant width and profile that suits your chest, which is often broader than a cisgender woman's.
  • Fat transfer: Fat removed by liposuction from another area is injected into the breasts. It adds a more modest amount of volume and contours the donor area at the same time.

Hormone Therapy and Timing

Hormone therapy often stimulates some breast growth, which can affect implant sizing and results. The WPATH Standards of Care, Version 8, suggest that some procedures may be followed at least 6 months after hormone treatment, or for a longer period when needed to achieve the desired result, unless hormones are not desired or are not medically appropriate. Your surgeon will discuss the best timing for you.

Recovery After MTF Breast Augmentation

Most patients return to desk work within about one week and resume strenuous exercise after about six weeks. Swelling subsides over the first few months as the implants settle.

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Transgender Body Contouring

Transgender body contouring reshapes the waist, hips, abdomen, and buttocks to create a silhouette that feels aligned with your gender identity. These procedures can be feminizing, masculinizing, or tailored to a nonbinary look, and they are often combined with top surgery.

Liposuction

  • Liposuction removes stubborn fat through small incisions and can shape the body in either direction
  • For a feminine figure, it can define the waist and smooth the flanks and back
  • For a masculine physique, it can reduce fullness at the hips and thighs and create a straighter, more angular shape

Tummy Tuck

  • A tummy tuck (abdominoplasty) removes excess skin and tightens the abdominal muscles for a flatter, firmer midsection
  • It can benefit patients after weight loss or pregnancy, and it pairs well with liposuction for a more complete contour

Brazilian Butt Lift (BBL)

  • Using your own fat, removed by liposuction, a Brazilian butt lift adds volume and shape to the buttocks and hips, creating a curvier, hourglass figure
  • According to ASPS, research supports injecting fat only into the tissue just beneath the skin, never into the gluteal muscle, and choosing a board-certified plastic surgeon
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Facial Feminization Surgery

Facial feminization surgery (FFS) softens facial features for a more traditionally feminine appearance. At SVIA® Plastic Surgery, FFS focuses on soft-tissue procedures that can be customized to your goals:

  • Cheek feminization: Implants or fat transfer create fuller, rounder cheeks and a softer contour.
  • Eyelid surgery (blepharoplasty): Removing excess skin and fat from the upper and lower eyelids creates a brighter, more open look.
  • Facelift: Tightening the skin and underlying tissues addresses sagging, jowls, and refines the jawline.

Because Dr. Liu does not perform rhinoplasty or bone-shaving procedures, patients seeking those procedures can discuss coordinating care with other specialists.

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Nonbinary Surgery

For nonbinary individuals, surgery is not about fitting traditional gender norms but about creating an appearance that reflects a unique identity. Dr. Liu works closely with nonbinary patients to design a custom plan, which may combine feminizing and masculinizing techniques or focus on balance and neutrality. Common choices include:

  • Chest reduction or flattening
  • Liposuction
  • Targeted body contouring
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Are You a Candidate for Gender-Affirming Surgery?

You may be a candidate for gender-affirming surgery if you are in good overall health and feel ready to take this step in your transition. The WPATH Standards of Care, Version 8, outlines suggested criteria that many surgeons use, including:

  • Marked and sustained gender incongruence
  • The capacity to give informed consent
  • Any other physical or mental health concerns are reasonably well managed
  • A period of hormone therapy, when appropriate for the procedure and your goals

Good candidates are also nonsmokers or willing to stop before and after surgery, and they have realistic expectations about results. During your consultation, Dr. Liu will review your health, goals, and any documentation needed for your procedure.

Dr. Jerome H. Liu and Dr. Tom S. Liu preforming breast augmentation procedures

Why Los Gatos Trusts SVIA® Plastic Surgery for Gender Confirmation Surgery

Patients choose SVIA® Plastic Surgery for gender confirmation surgery in Los Gatos because they receive advanced surgical training alongside genuinely personal care. The practice's surgeons, Dr. Jerome Liu and Dr. Tom Liu, completed general and plastic surgery training at UCLA Medical Center, followed by selective aesthetic fellowships. Both are members of ASPS and The Aesthetic Society.

The practice's approach to gender-affirming care includes:

  • One-on-one, private consultations: You stay in a single consultation room for your entire visit.
  • Visual education: Touch screen displays and TouchMD software help you explore your options, and you can revisit them from home.
  • A dedicated surgical team: Registered nurses and surgical technologists support each case in the SVIA® Surgical Suite.
  • Coordinated, combined plans: Top surgery, body contouring, and facial procedures can be staged or combined based on your goals and safety.
  • Support for traveling patients: The staff helps out-of-town patients plan their stay and recovery.

What to Expect Before, During, and After

Consultation

Your consultation includes a review of your medical history, hormone therapy, and goals, followed by an examination and a discussion of your options. In-office and virtual consultations are available.

The cost of gender confirmation surgery in Los Gatos depends on several factors:

  • The procedure or combination of procedures you choose
  • Surgical technique and operating time
  • Anesthesia fees
  • Facility fees for the surgical suite, staff, and supplies

SVIA® Plastic Surgery is a non-contracted insurance provider. The practice charges a consultation fee that can be applied toward surgery, and patient financing is available for qualified applicants.

The Day of Surgery

Most gender-affirming procedures at SVIA® are performed on an outpatient basis under general anesthesia. The surgical team will review your plan with you, answer any last-minute questions, and ensure you feel comfortable before your procedure begins.

Recovery

Recovery depends on the procedure. Most patients return to desk work within 1 to 2 weeks and resume strenuous exercise after about 6 weeks.

Compression garments help reduce swelling after top surgery and body contouring, and BBL patients receive specific guidance on sitting during the early healing period.

Follow-up visits allow the team to monitor your progress closely.

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Schedule Your Gender-Affirming Surgery Consultation at SVIA® Plastic Surgery

Whether you're ready to stop binding, have been on hormones for a while and want more fullness, or are still weighing your options, you deserve elite surgical experience and an exceptional care team from the start.

Dr. Liu completed aesthetic fellowship training after plastic surgery residency at UCLA Medical Center, training that shapes his approach to chest contours, nipple placement, and implant sizing for each patient's frame. Kelly has spent years guiding transgender patients at SVIA®. Gráinne, our OR nurse and coordinator, brings a background in gender-affirming care and post-anesthesia recovery.

Together, they help with the practical details, from timing surgery around your hormone therapy to planning recovery if you're traveling from outside the Bay Area.

To book a private consultation at our Los Gatos office, or a virtual visit if you'd like to talk from home first, call SVIA® Plastic Surgery at (408) 317-4682.

Disclaimer: This information is provided for educational purposes only and does not replace a consultation with a board-certified plastic surgeon. Outcomes, risks, and suitability vary from patient to patient.

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Gender Confirmation Surgery FAQs

What are the risks of gender-affirming surgery?

Does insurance cover gender confirmation surgery?

Do I need a letter of support before surgery?

Can I combine procedures?

Do I need to be on hormones before surgery?

Will I still need to bind after top surgery?

What are the risks of gender-affirming surgery?

Risks vary by procedure and can include bleeding, infection, scarring, changes in sensation, asymmetry, and contour irregularities. Top surgery with nipple grafts carries a risk of changes in nipple appearance or sensation, and implants carry risks such as capsular contracture. Dr. Liu will review the risks of your specific plan during your consultation.

Does insurance cover gender confirmation surgery?

SVIA® Plastic Surgery is a non-contracted insurance provider, so the practice does not bill insurance directly. Some patients seek reimbursement from their plans on their own, and the team can discuss payment and financing options with you.

Do I need a letter of support before surgery?

Many surgeons and insurers follow WPATH guidance, which recommends an assessment by a qualified health professional before surgery. Patients should confirm the specific letter or documentation requirements for their procedure and insurance plan before scheduling surgery.

Can I combine procedures?

Yes. Top surgery is often combined with liposuction, and body contouring procedures are frequently performed together. Your surgeon will recommend combining or staging procedures based on your safety and goals.

Do I need to be on hormones before surgery?

Hormone therapy is not required for every procedure. For MTF breast augmentation, a period of hormone therapy is often recommended first, since hormones may produce some breast growth that affects implant sizing.

Will I still need to bind after top surgery?

Binders are no longer needed after FTM top surgery. During recovery, you will wear a medical compression vest instead.

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