Gender-Affirmation Surgery at Stanford

Compassionate, Patient-Centered Care

At Stanford, we recognize that the journey of gender affirmation is deeply personal and profoundly impactful. Our Gender Affirmation Surgery Program within the Division of Plastic & Reconstructive Surgery is dedicated to providing compassionate, patient-centered care that is tailored specifically to the unique needs of the gender diverse community. We understand that each individual's experience is distinct, and our mission is to support that journey with respect, empathy, and expertise.

At Stanford, we are committed to being a leader in gender-affirming care, and our Gender Affirmation Plastic Surgery Program embodies that commitment. We invite you to explore the transformative possibilities available through our compassionate and comprehensive approach, where every detail is considered with the utmost care and respect for your unique journey. Your health, well-being, and authenticity are at the forefront of everything we do.

Our Multidisciplinary Approach

Our Gender Affirmation Plastic Surgery Program is an integral part of Stanford's larger LGBTQ+ health program.

We believe that effective care involves collaboration across multiple specialties, including but not limited to:

Mental health
Endocrinology
Primary care
Urology
Voice therapy
Surgery

We are proud to collaborate with other departments and services to promote inclusivity and provide comprehensive support to our LGBTQ+ patients. Through this collaboration, we aim to create an environment where all individuals feel seen, heard, and valued.

Gender Affirming Services

This comprehensive program encompasses a wide range of procedures, including face, chest, body contouring, and genital surgeries. We are particularly focused on improving sensation and sexual function by using innovative techniques that optimize nerve regeneration. Each procedure is performed by our team of highly skilled plastic surgeons who specialize in gender-affirming techniques, ensuring that our patients receive the highest standard of care in an affirming environment.

Facial Affirming Surgery

Facial Affirming Surgery comprises procedures that modify facial bone and soft tissue structures to align one’s facial appearance with their lived gender identity. These procedures can be masculinizing or feminizing and can include the following:

Upper Third of Face

Frontal sinus setback
Forehead and orbital contouring
Brow lift
Hairline advancement

Middle Third

Rhinoplasty
Fat grafting
Cheek implant

Lower Third

Jawline contouring
Genioplasty (chin)
Chin or jaw implants
Lip lift
Tracheal shave

Gender-Affirming Chest Surgery

Gender-Affirming Chest Surgery involves procedures to feminize or masculinize the chest.

Masculinizing chest surgery typically involves the removal of breast tissue and reconstruction of the nipple-areolar complex. We offer the following techniques, as well as Targeted Nipple Reinnervation—a new surgical technique wherein the intercostal nerves are preserved and directly innervate the newly reconstructed nipple-areolar complex, improving postoperative sensory outcomes.

Double incision mastectomy with or without free nipple grafts
Peri-areolar “Keyhole” mastectomy
Buttonhole mastectomy

Feminizing chest surgery involves the augmentation of breast tissue to achieve a feminine chest contour. This can be achieved using breast implants or fat grafting.

Gender-Affirming Body Contouring

Gender-Affirming Body Contouring refers to surgical procedures that contour the body to align with a person’s lived gender identity. This involves a combination of liposuction and fat grafting of various areas such as the abdomen, waist, hips, buttocks, and lateral thighs. We offer both masculinizing and feminizing body contouring.

Masculinizing Genital Surgery Phalloplasty, Metoidioplasty

Masculinizing Genital Surgery includes procedures such as phalloplasty and metoidioplasty, which are designed to reconstruct male genital anatomy.

Metoidioplasty involves the lengthening of the clitoris to produce a small phallus.
Phalloplasty is a complex operation to reconstruct a neophallus. Common donor sites include the radial forearm and anterolateral thigh. This can involve urethral lengthening to allow for standing urination or a perineal urethrostomy, which allows for sitting urination. At Stanford, we are particularly focused on sensation and sexual function. During consultation, we assess your priorities and goals to determine the best individualized surgical plan.

Feminizing Genital Surgery Vulvoplasty, Vaginoplasty, Orchiectomy

Feminizing Genital Surgery encompasses procedures like orchiectomy, vulvoplasty, and vaginoplasty.

Orchiectomy involves the removal of the testes.
Vulvoplasty involves the creation of the external vulva without a vaginal canal.
Vaginoplasty involves the creation of the external vulva and a vaginal canal. This can be achieved via traditional penile-inversion vaginoplasty or robotic peritoneal flap vaginoplasty.

At Stanford, we emphasize sensation, sexual function, and vulvar aesthetics.

Our Surgeons

Director of Gender Affirmation Surgery, Plastic & Reconstructive Surgery (2024 - Present)

Director of Breast Reconstruction, Stanford Women's Cancer Center (2012 - Present) Director of Adult Plastics Clinic, Stanford Healthcare (2016 - Present)

Instructor in Surgery, Mayo Clinic, Rochester, MN (2022 - 2022) Clinical Instructor, Stanford University (2022 - 2023) Clinical Assistant Professor, Stanford School of Medicine (2023 - Present)