Gender affirming surgery is a term that encompasses any procedure that helps patients transition to their self-identified gender. At VPSI, our doctors are known for their long-standing advocacy for the transgender community and their depth of experience in offering a full range of gender affirming surgeries. We are pleased to be trusted partners to transgender patients across the nation.

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What Is Gender Surgery?

Gender surgeries are surgical procedures designed to alleviate gender dysphoria, allowing you to have a physical appearance that mirrors your gender identity.

Gender affirmation surgery may encompass several different procedures, including procedures to alter the appearance of the face for a more masculine or feminine appearance. Top surgeries can change the appearance of the chest, and bottom surgeries alter the genitalia. 

What Are the Benefits of Gender Affirmation Surgery?

For patients whose bodies do not reflect their self-identified gender, the benefits of gender affirmation surgery are profound. They can include:

  • Greater confidence and self-acceptance
  • Improved mental health
  • A decreased risk of depression

Meet Our Board-Certified Plastic Surgeons

At VPSI, our surgeons distinguish themselves by their excellent technical skills and artistic eye. Both Dr. Brosious and Dr. Goldman have the versatile experience that allows them to say “yes” to nearly every patient who walks through the door. 

Dr. John Brosious is a full-scope plastic and reconstructive surgeon offering head-to-toe surgeries. His background includes experience in Level I Trauma centers and academic institutions, equipping him to take on the most advanced reconstruction cases. Dr. Brosious performs over 200 chest surgeries a year for both transfeminine and transmasculine patients, and he is also the only surgeon in Nevada performing male to female genital gender affirmation surgery. 

Likewise, Dr. Joshua Goldman is a comprehensive plastic and reconstructive surgeon, well-known in the breast cancer community for his specialization in breast microsurgery. He single-handedly has the highest number of microsurgery cases in the State of Nevada and has been named by Vegas Inc’s Las Vegas Weekly as “Las Vegas 40 Under 40” and a “2021 Top Doctor.” 

To Dr. Brosious and Dr. Goldman, you are family, and they are here to help guide you through your journey to enhance your natural beauty.

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Josh Goldman, MD

John Brosious, MD

What Are the Different Types of Gender Surgery?

Gender affirming surgeries are individualized to meet your needs and may differ based on your desire to appear more masculine, feminine, or nonbinary.

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Facial Feminization Surgery

Our doctors offer facial feminization surgery for patients who wish to have a less typically masculine facial appearance. Facial feminization may encompass several specific procedures, including hairline reduction, brow reduction, eyelid surgery, rhinoplasty, jawline reduction, and chin reduction.

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Top Surgery 

Our doctors perform more than 200 chest surgeries each year, including procedures for transmasculine and transfeminine patients. We typically offer breast augmentation with implants or fat transfer and provide either a minimally invasive periareolar procedure or a double mastectomy with free nipple grafting for chest masculinization. Custom procedures are available for nonbinary patients, depending on their specific goals and expectations.

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Bottom Surgery (Vaginoplasty)

Dr. Brosious is the only surgeon in the State of Nevada, and one of the few in the country, performing vaginoplasty, which is male to female genital affirmation surgery. Another term for that is penile inversion vaginoplasty. This is a very elegant surgery involving the creation of a female vulva and vagina from a penis and testicles. The vagina is fully functional, and most patients can have sex and orgasm after surgery. The results are aesthetically-pleasing, meaning the scars are virtually imperceivable, and the results look very natural.

The Procedure Process Explained

The Consultation

During your first appointment, one of our doctors will perform a physical examination to ensure your eligibility for surgery. We also assess candidacy based on the well-respected WPATH guidelines, which require mental health screenings for patients seeking top or bottom surgeries. No mental health screenings are required for facial procedures.

The consultation process will also allow you to talk with your doctor about your goals and expectations for the procedure. This will allow our doctors to customize your head-to-toe care to align with your needs and your gender identity.

What Should I Do in Preparation?

Your doctor will let you know what steps you need to take to prepare for a safe and successful procedure. For top surgeries and bottom surgeries, this may mean consulting with a mental health professional. For all surgeries, it may entail pausing certain medications to ensure a healthy recovery.

How Long Does the Procedure Take?

Gender affirmation surgery looks different from one person to the next, simply depending on your specific expectations. The duration of the surgery can vary, but in many cases takes several hours.

What Is Surgery Like?

The specifics of the surgery will depend greatly on the specific unique care required for you to achieve your aesthetic goals. The most important thing we want you to know is that our practice is a place where everyone can feel safe and comfortable, no matter where you are in your transition process. 

Additionally, we are committed to providing our patients with results that give them real confidence in how they look, which means our gender affirming surgeries are often paired with body contouring, liposuction, and other aesthetic procedures.

What Should I Expect in Terms of Recovery?

Recovery can vary according to the procedures involved, but patients should expect to rest and heal for a week or more. Pain and swelling can be common during the recovery process, but medications and other management tools will always be available.

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Other Considerations

Nonbinary patients usually fall under the “gender nonconforming” umbrella, as they identify with a gender other than the one assigned to them at birth. The difference is that nonbinary patients identify neither as wholly masculine nor as feminine, but instead as features of both. 

Not everyone who has gender dysphoria feels the desire to have gender surgery. Additional treatment options can include hormone therapy, behavioral therapy, and more.

Gender affirming surgery is becoming more commonplace all the time. In a 2015 study of the transgender community, researchers noted that about 25 percent of 27,000 surveyed had undergone at least one gender affirming surgery.

The specific recovery timeline can vary by procedure but will usually require a week or more. Your doctor will provide a more specific timeline during your initial consultation.

While every surgery entails some level of risk, choosing a skilled and experienced plastic surgeon can minimize that risk.

Ultimately, only you can determine whether gender affirming surgery is right for you. Among patients who do have surgery, virtually all report life-changing benefits.

You’re in Good Hands With Vegas Plastic Surgery Institute

Vegas Plastic Surgery Institute is a full-scope plastic and reconstructive surgery practice, offering both head-to-toe reconstruction and cosmetic surgery. Our doctors and team abide by uncompromising standards to provide you with a high level of care and a positive experience in a judgment-free zone. Schedule a consultation at our Las Vegas office today at (702) 727-8500.