Gender Affirming Surgery for Transgender and Nonbinary People in Savannah, GA

What Is Gender Affirming Surgery?

Not everyone has a body that accurately reflects their gender. For some people, there’s a disparity between the gender they are and the gender they appear to be to other people. This disparity can cause significant distress, partly because it affects a person’s perception of themselves and partly because it affects how they’re perceived and treated by others.

Gender affirming surgeries are procedures that alter the body so it better represents a person’s gender. These can include procedures that alter the:

• Face
• Chest (sometimes called “top surgery”)
• Genitalia (sometimes called “bottom surgery”)

Although gender affirming surgeries are most often associated with transgender men or women, nonbinary people sometimes choose to have these procedures as well. It’s a highly personal choice that ultimately depends on the individual and how they want to represent themselves.

Why Have Gender Affirming Surgery?

Transgender and nonbinary people have gender confirming surgery for highly personal reasons. These typically relate to how they feel about their body and their gender presentation.

Perhaps you have specific body goals you want to achieve; perhaps not. Ultimately, having these procedures helps relieve dysphoria (feeling unhappy, dissatisfied, or uneasy) and improves confidence and self-image.

Are There Any Non-Surgical Alternatives to Gender Confirmation Surgery?

There are lots of non-surgical options that can help reduce feelings of gender dysphoria, and help you feel more like the person you know you are.

Some non-surgical options include:

• Breast binding or padding to alter the appearance of the chest
• Tucking or packing to alter the appearance of the genital region
• Hormone therapy to alter what are called secondary sex characteristics. For instance, estrogen enlarges the breasts, alters body fat distribution, and reduces facial and body hair. Testosterone alters body fat distribution, increases facial and body hair, and adds muscle mass.
• Voice therapy to help change speaking pitch and resonance so your voice better matches your gender
• Hair removal via electrolysis or laser therapy to permanently remove face and body hair

Many people find that these options help reduce dysphoria, but they aren’t really considered alternatives to surgery. This is because surgery is the only way to permanently make significant changes to the body. For this reason, many transgender people consider transgender surgery a vital step in their transition.

Of course, this isn’t the case for everyone. Not all transgender people have surgery as a goal or consider it the “final step” of a finite transition process. It’s up to every individual to decide what transition looks like for them and what procedures are best for them. For some people, that means having both top surgery and bottom surgery. For others, it might mean top surgery only. Some people choose not to have surgery at all, in favor of non-surgical options.

What Is Gender Affirming Surgery Like?

Gender confirmation procedures are typically carried out under general anesthesia, either in a clinic or hospital setting, but the specifics depend on the surgery you’re having.

Facial surgery and top surgery may be performed in a clinic and doesn’t always require an overnight stay. These decisions are made by your plastic surgeon, who considers your preferences as well as what is safest and gives the best chance of good results.

Transfeminine Surgery

Facial Surgery/Neck Reconstruction Surgery

This category includes different options for facial feminization surgery. In this surgery, certain facial features are altered to appear more feminine, such as the:

• Cheekbones
• Jaw
• Chin
• Nose

It also includes surgery to reduce the Adam’s apple by removing thyroid cartilage.

Chest Surgery (Top Surgery)

Top surgery for transgender women is breast augmentation to enhance the size and/or shape of natural breasts. It’s recommended that a woman be on HRT for a year or longer prior to surgery because it provides more options for breast implants and helps improve surgical outcomes. In addition, some insurers may require that a woman have been on HRT for a minimum period of time to qualify for top surgery insurance coverage.

Transmasculine Surgery

Facia Surgeryl/Neck Reconstruction Surgery

This category includes options for facial masculinization surgery. In this procedure, certain facial features are altered to appear more masculine, such as the:

• Cheekbones
• Jaw
• Chin
• Nose

There’s also a procedure to construct an Adam’s apple by augmenting existing thyroid cartilage.

Chest Surgery (Top Surgery)

For trans men, top surgery typically means removal of the breasts. Some trans men may also choose to enhance their chest with pectoral implants. Being on HRT doesn’t affect possible surgical options or outcomes but may affect insurance eligibility.

Who Is a Good Candidate for Gender Affirming Surgery?

A good surgical candidate is someone who is in good general health and has realistic expectations for surgery. If you have any chronic health conditions, such as diabetes, it’s important these are well-managed and stable.

To qualify for surgery, you must be able to meet the World Professional Association of Transgender Health (WPATH) standards of care criteria. This may be required by your surgeon. It’s also typically required by insurance companies that cover gender affirming surgeries.

According to WPATH recommendations, to be eligible for surgery, you must meet the following criteria:

• Be of legal age to make your own healthcare decisions
• Be capable of giving informed consent
• Have documented gender dysphoria
• Be managing any significant medial health problems
• Have one referral letter from a behavioral healthcare provider (for top surgery)
• Be able to commit to a minimum of one year on hormone therapy that some procedures require

Gender Affirming Surgery Consultation

Your surgical consultation will involve talking to your plastic surgeon about your history. This includes discussing your medical history and health status, as well as your transition process.

You’ll also have a physical exam and speak with your surgeon about the results you’re hoping to achieve with surgery. Your surgeon uses this information to develop a plan for your procedure. This will include deciding what surgical techniques they’ll use to achieve your desired results.

Your consultation is also a good time to ask any questions you have about the surgery or recovery period. It can help to write down your questions before your appointment to make sure you and your surgeon cover everything you want to.

How to Prepare for Gender Confirmation Surgery

The preparations you need to make for surgery depend mostly on your own personal health and medical status. Your surgeon will give you specific instructions on what to do prior to surgery.

In general, preparing for surgery may involve:

Medication changes. Certain medications should be avoided before surgery because they affect your level of surgical risk. This includes prescription blood thinners, as well as over-the-counter drugs that have a similar effect. Make sure to let your surgeon know about all medications or supplements you take.

Smoking cessation. If you’re a smoker, you’ll be asked to stop smoking for two weeks or more prior to surgery. It’s also important to avoid smoking for as long as possible afterwards. This is important because smoking reduces blood oxygen levels, which adds to surgical risk and can slow the healing process.

Gender Affirming Surgery Recovery and Aftercare

The recovery period for gender confirming surgeries depends greatly on the kind of surgery you have. In general, you can expect a recovery period of at least a couple weeks for facial and top surgery.

Gender Affirming Surgery Risks and Complications

Surgical Risks

All surgical procedures carry a certain amount of risk. Most of these surgical risks happen only rarely, but it’s still important to understand them so you can give informed consent for your procedure.

General anesthesia. Between 1 in 5,000 and 1 in 10,000 people are allergic or sensitive to anesthesia. If you’ve had general anesthesia before without any problems, you’re unlikely to have a dangerous reaction to subsequent anesthesia. However, if you’ve never had general anesthesia before, there’s no way of knowing in advance if you’ll have this kind of reaction.

Blood clot. Your risk of blood clot or deep vein thrombosis (DVT) increases temporarily after having surgery. Prolonged inactivity also increases the risk, so it’s important to resume light activities according to your surgeon’s recommendation. Smoking also increases the risk of a clot or DVT.

Poor results. There’s a risk that even if your surgery goes well, you don’t get the results you were hoping for. To reduce this risk, choose a skilled, experienced surgeon with a good reputation. Make sure to talk with them extensively about what you want from surgery. This helps ensure your expectations are realistic and in line with the results your surgeon thinks they can achieve.

Complications

Complications are unexpected issues that sometimes arise after surgery. Most surgical complications are minor and will resolve themselves as you heal. If you experience excessive pain, signs of infection, or any other symptoms that worry you, contact your doctor or surgeon for advice.

Seroma/hematoma. These minor complications can occur during the recovery process. Seroma is an accumulation of fluid at an incision site. Hematoma is severe bruising. Most of the time these issues don’t need any special treatment and clear up on their own as your body heals.

Excessive pain. Pain that doesn’t respond to prescribed medication may indicate an issue with the healing process. Make sure to contact your doctor or surgeon if you have excessive pain during recovery.

Infection. Signs of infection include fever and wound discharge. Infection can affect your recovery time and may affect scarring too. It’s important to follow your surgeon’s aftercare instructions to reduce the risk of infection.

Scarring. The degree of scarring you can expect varies depending on the procedure you have and the techniques your surgeon uses. With breast augmentation, for instance, scarring is minimal if the surgeon uses techniques that conceal incision sites. Mastectomy scars, on the other hand, extend further across the chest, making them more noticeable.

Loss of nipple sensation. Some people may experience loss or alteration of nipple sensation after having top surgery. This can happen after breast augmentation or masculinizing chest surgery to remove breast tissue and excess skin. For most people these changes are temporary, but sometimes nipple sensation is permanently altered or lost.

Note that some top surgery techniques, such as periaereolar surgery and keyhole surgery, are better able to preserve nipple sensation than others. If this is important to you, bring it up at your surgical consultation.

What Results Can I Expect from Gender Affirming Surgery?

The specific results of your surgery depend on the type of surgery you have and the kinds of changes you’ve chosen for your body. For many people, the most significant result of their surgery is the positive impact on their self-image, confidence, and dysphoria.

Overall, gender confirmation surgeries have a very high satisfaction rate. One study reported an average satisfaction rate of 94% to 100% for gender confirming surgeries, with very few people expressing major or minor regrets. People who have gender confirming surgeries report having:

• Reduced dysphoria
• Improved quality of life
• Higher levels of happiness

However, having gender affirming surgery doesn’t necessarily mean that gender dysphoria goes away completely, forever. Some people experience dysphoric feelings from time to time, even after surgery. Everyone’s post-surgery experience is different, and there’s no single “right” way to feel.

How Much Does Gender Affirming Surgery Cost?

The cost of transgender surgical procedures ranges widely depending on the specific procedure and how that procedure is performed. There are lots of different factors that go into determining your costs for any surgery. Your surgeon will discuss these factors with you at your surgical consultation and give you a quote for each specific procedure you want to have.

Does Insurance Cover My Surgical Costs for Gender Affirming Procedures?

There’s no quick answer to this question, as it depends on:

• Your employer
• Insurance carrier
• The procedure(s)
• What state you live in

While few employers fully cover gender affirming surgeries, increasing numbers of employers provide partial coverage.

It’s also important to know that currently for all transgender people who want to have gender confirming surgery, a medical diagnosis of gender dysphoria is needed in order for any health insurance coverage to apply. For some procedures, insurers may also require that an individual has been on HRT for a minimum period before they’re eligible for coverage.

If you’re eligible for partial or full coverage for any given procedure, make sure to have your insurer confirm your coverage in writing before going ahead with surgery.

Financing Options for Gender Affirming Surgery at SPS

Savannah Plastic Surgery offers several payment options, including checks and cash and all credit cards. We also offer Alpheon®, Care Credit® and PatientFI® financing. To learn more about your payment options and get insurance information, please visit our financing and insurance page.

Gender confirmation surgeries have the potential to change and enhance your life in a range of ways. It’s important to choose a plastic surgeon you feel comfortable with and who you can trust with these important procedures. Learn about our experienced, compassionate surgeons here.

Contact us today to schedule a consultation and talk with one of our doctors. We welcome residents of Savannah and the surrounding areas of Chatham County, including those in Brunswick and Hinesville, Georgia and Bluffton, South Carolina.