Gender Affirming Surgery in San Francisco & Sonoma County

Gender affirming surgery involves reconstruction of the face, chest, or lower body for transgender patients. At Bay Area Esthetics Plastic Surgery our goal is to optimize both peace of mind and esthetics for our transgender community.

An ideal esthetic outcome provides you with a face and figure that is not only congruent with your gender but also attractive for your gender. Being comfortable in a t-shirt and being identified for the correct gender help contribute to peace of mind, while optimizing esthetics can provide added self-confidence.

• Our philosophy is that great results frame your face and body in line with your gender, while making it difficult for others to tell that you had surgery. We also customize your results to match your overall ethnicity and maintain safety by operating within the constraints of your anatomy.
• We have adopted the latest technologies and techniques that make face and body gender affirming surgery outcomes better and safer. From adding chest liposuction to blend areas after top surgery, or using your own tissues for facial feminizing or masculinizing surgery, we want your results to be safe and last a long time.
• We perform extensive photography to analyze your body from every angle and develop a plan specific to your body and goals.
• We are adept at combining a full-range of techniques to help you get the face and body you want in one surgery. This may include facial feminization at the same time as top surgery, or other cosmetic procedures like facial rejuvenation or a tummy tuck to give you the look you always wanted from top to bottom.

It’s time to take the next step and experience the difference gender affirming surgery by Bay Area Esthetics can make for you. Please contact us through our confidential online form or call / text 415-523-5235 to schedule a consultation with us.

Gender affirming surgery can be performed at various stages of a patient’s life. Procedures performed on the face and body are best performed once you have reached maturity and are done growing, after 17 years of age. There may be reasons to perform surgery sooner. If you have questions about the ideal timing for a procedure, please request a consultation or call / text 415-523-5235 to schedule an appointment with us.

Common reasons why patients pursue gender affirming surgery include having:

• Facial features that are too masculine or feminine for one’s gender
• Breasts in a male, or lack of breasts in a female
• Hips that are too narrow or indented in a female
• Buttocks that are too flat in a female
• Hips that are too wide or full in a male
• Thighs that are too full in a male

If you are a transgender patient, health insurance may likely help cover the cost of certain procedures like top surgery. We are happy to help you navigate this process. If you have questions about your eligibility for a procedure, please contact us online using our confidential online form or call / text 415-523-5235 to schedule a consultation.

Before your first visit, you will be asked to complete an intake form to document your personal and medical history, prior surgeries, dental work, medications, and allergies.

At your visit we will review your concerns and goals. We will also want to learn more specifically about any prior gender affirming procedures you received. We will examine your overall face, chest, and lower body from various angles. The examination will not be uncomfortable. A CT (computed tomography) scan may be used to evaluate and help plan surgery for forehead reshaping.

If you are interested in bottom surgery as well to reconstruct your genitalia, we may refer you to some of our trusted colleagues as we currently do not yet offer these particular procedures. We will also take photographs that will be used to plan your surgery and track your changes after. You will have a chance to discuss the plan with us prior to surgery.

We are meticulous and scientific when it comes to planning and performing gender affirming surgery. We will spend time before surgery making numerous measurements and, for facial transformative procedures we may perform 3-D virtual surgical planning to make the surgery safer, quicker, and more accurate. The procedure time can vary depending on the approach, number, and complexity of necessary changes.

Dr. Pourtaheri offers facial feminization to trans-women seeking to feminize their facial appearance. These procedures may include a feminizing rhinoplasty, frontal setback to reduce the forehead / brow prominence, hairline advancement, reshaping of the jaw (mandibuloplasties, genioplasty, or orthognathic surgery), tracheal shave (reduction of the thyroid cartilage), cheek augmentation,, and lip augmentation. If you have undergone gender affirming facial surgery elsewhere and are unhappy with your results, Dr. Pourtaheri offers revision facial feminization. This requires careful planning to correct the area of concern and maximize esthetics, while minimizing the risk of complications.

Dr. Pourtaheri offers facial masculinization to trans-men seeking to sharpen their facial appearance. These procedures may include a masculinizing rhinoplasty brow augmentation, jaw line / chin enhancement or orthognathic surgery, and buccal fat removal. If you have undergone gender affirming facial surgery and are unhappy with your results, Dr. Pourtaheri offers revision facial masculinization. This requires careful planning to correct the area of concern and maximize esthetics, while minimizing the risk of complications.

Top surgery for trans-men is not a simple mastectomy to remove all of the breast tissue. Careful planning and an artful eye is required to perform total recontouring of the chest. This will include a careful mastectomy either periareolar (through incisions around the areola) or transverse incisions (incisions across each breast that will end up at the bottom of your new chest; followed by chest liposuction to round out the chest contour. Depending on the size of your breasts and areolas we may also perform a nipple-areola reduction or free nipple grafting to create a smaller, more masculine nipple and areola, placed as symmetrically as possible in their location.

Top surgery for trans-women is not just about placing breast implants. Careful planning and an artful eye is required to perform total recontouring of the chest. This will include a careful breast augmentation with implants; followed by fat grafting to the chest as needed to optimize the breast and chest shape. Depending on the size of your breasts and nipples / areolae we may adjust your nipples and areolas at a second surgery to make them more feminine and located as centrally and symmetrically as possible.

The lower body, not just the genitalia, is important for displaying gender. Careful planning and an artful eye is required to perform recontouring of the lower body. This may include liposuction of the hips and thighs and high-definition etching of the abdomen to create a more masculine appearance. We can perform these procedures before or after bottom surgery, if that is something you plan to undergo as well.

The lower body, not just the genitalia, is critical for displaying gender in trans-women as well. Careful planning and an artful eye is required to perform recontouring of the lower body. This may include fat grafting of the hips and thighs or buttock augmentation with fat grafting to create a fuller more feminine appearance. In some cases, a tummy tuck may help narrow the waistline for added effect. We can perform these procedures before or after bottom surgery, if that is something you plan to undergo as well.

We can perform your gender-affirming surgery in San Francisco or Sonoma County based on your preference. Immediately following surgery we will take you to a recovery area to be cared for. Depending on the procedure, patients may go home the same day or stay in the hospital for one night.

Patients are given antibiotics on the day of surgery and may also need to take them after surgery. We also prescribe pain medications to limit discomfort. We may recommend a modified diet or feeding instructions to help with healing for several weeks if you underwent jaw surgery. After surgery, your face and body may be bruised, swollen, and sore for a week or two. It is best to not strain yourself to minimize the risk of wound healing problems. Compression garments are commonly recommended and regular walking is encouraged, starting the day after surgery. You will receive care instructions before and after surgery and have plenty of time to ask questions.

We will examine and check on you while you are in the hospital or call you the day after surgery to see how you are doing. We will plan to see you again in 10-14 days after surgery. We will schedule additional visits to check on healing progress; some of these can be done virtually if you live out of town. The bulk of the swelling resolves within several weeks and you should be able to appreciate your final results around 3 months after surgery. If you are ready to take the next step and learn more about gender affirming surgery to improve your appearance and well-being, please contact us online using our confidential form or call / text 415-523-5235 to schedule a consultation with us.