Gender Confirmation Surgery enhances three major areas of the body bring out the female form within. This process oversees a number of procedures that will shape the face, chest, and genitalia to correspond with your gender identity.


Complete Gender Confirmation Surgery can take any number of years once Hormone Replacement Therapy has begun. This process varies from person to person and largely depends on the recovery time between surgeries, their schedule and desires and essentially many other factors of daily life. While some procedures may be performed in unison with others, it is still advisable to take your time and allow your body to adapt to the changes.

FACETotal: 1-10 hours
Depending on
Total: 4-6 weeks, estimated.
CHEST1-3 hours
for one day
2 weeks w/ 1-month post-op care
GENITALIATotal: 4-9 hours
Inpatient for 3-5 days
Total: 3 months w/ 12 months +
regular dilation treatment


The first step in your journey involves the consultation of a qualified therapist who specializes in gender transition. While this may be very difficult for some, Gender Confirmation Surgery in some cases is not reversible and your emotional and mental well-being is very important to reduce the risk of any complications you may have in the future.

Consultation with a specialized therapist is required before you can begin Hormone Replacement Therapy. However, surgeons will require one letter for top surgery, two letters for bottom surgery and none for facial feminization procedures.


The effects of Hormone Replacement Therapy (HRT) can have a profound effect on your emotional and physical well-being. Patient will be referred to an endocrinologist who can provide you with an informed understanding of the potential risks and benefits from HRT and is guided by the World Professional Association for Transgender Health.

  • Estrogen Therapy
    The main form of Estrogen is Estradiol, which embellishes feminine physical traits during HRT. It indirectly suppresses the production of testosterone and works directly on your tissues. Estradiol can be applied orally (tablet), transdermally (skin patch/gel), subdermal application (implant), and through a sub-muscular injection. Our recommendation is to avoid oral estrogens due to their increased venous thrombogenic effects.
  • Anti-Androgen Therapy
    In order to suppress the production of testosterone, Androgen blockers will be administered. This treatment slows male-pattern baldness and reduces the growth of facial hair. Anti-Androgen is usually prescribed with estrogen since the two treatments complement one another.


Because of the differences in male and female skulls, facial surgery can leave a more profound impact than a vaginoplasty and may very well be the most important decision of your journey. This combination of procedures alters the face to create a softer, more feminine appearance.

  • Thyroid cartilage reduction (Adam’s Apple) Shave
  • Forehead Reduction/Contouring
  • Jawline/Chin Contouring
  • Rhinoplasty
  • Voice Surgery (By our University of Miami ENT surgeon)

It is worth remembering that the differences between male and female features differ with age, ethnicity, genetics, and the age hormone replacement therapy began.


The breasts are the central part of the female form. While it comes in various shapes and sizes, it provides the body with a definition that is unique to the gender. For many transwomen, estrogen therapy allows the breasts to develop. The breasts begin to bud during the sixth month of treatment. While some patients are happy with the natural development, many undergo breast enhancement to attain a figure that is definitively feminine.


This series of surgical procedures is what allows your body to align with your gender identity. Gender Confirmation Surgery of the genitalia oversees a number of procedures, including:

  • Orchiectomy
  • Vaginoplasty
  • Clitoroplasty
  • Labiaplasty


A series of surgical procedures that enhance the newly-feminized shape of your body. Procedures include:

  • Liposuction/Liposculpture
  • Gluteal Enhancement
  • Silicone Removal