Gender-Affirmation Surgery

Facial feminization includes combined procedures to give the face a softer, more traditionally feminine appearance. This can include surgeries for both bony and soft tissues of the face, neck and thyroid cartilage. FFS is often complemented by laser hair removal.

Mastectomy and chest contouring

Masculinizing surgery, sometimes referenced as female-to-male top surgery or FTM top surgery, removes unwanted breast tissue to create a more masculine chest appearance. There are several surgical techniques that may be used based on your physique and amount of chest tissue present. The most common technique is bilateral mastectomy with free nipple grafts. Some people may be eligible for a periareolar, or keyhole, technique that minimizes scarring. These procedures are offered as a drainless technique.

Breast augmentation

Breast augmentation enhances the size, shape or fullness of the breasts. Ideally you will have taken hormone therapy for at least 12 months before getting breast augmentation. Hormone therapy results in nipple growth and development of some breast tissue, which means surgery is likely to be more successful with better cosmetic results.

Vaginoplasty

Vaginoplasty is a feminizing genital surgery that includes several procedures performed at once. We use a penile inversion technique in which the penis is turned inside out to form the inner walls of the vagina. The head of the penis is then used to create a clitoris. Outer and inner labia are formed, and the urethra is shortened and repositioned. The surgery results in fully functioning external female genitalia that allow for urination, sexual penetration and orgasm. Preoperative electrolysis or laser hair removal from the scrotal sac is recommended. Follicles will be scraped and electrolyzed during surgery, but hair growth cycles prevent removing all dormant hair.

Vulvoplasty

Vulvoplasty is a feminizing surgery that creates a vulva and removes the penis, scrotum and testes. The vulva is created using scrotal and urethral tissue, and the urethra is shortened.

Metoidioplasty

Metoidioplasty is a masculinizing surgery where the clitoris is "released" to give the appearance of more length to the phallus. The final result is a normal appearing, but very small, penis. This surgery can be performed in conjunction with a vaginectomy and a hysterectomy with bilateral salpingo-oophorectomy. Urethral lengthening can also be done at the same time, or at a later time, to allow the patient to stand to urinate. The labia majora becomes the scrotal sac and customized solid silicone testicular implants can be placed. The surgery is minimally invasive, and sensation to the clitoris remains intact.

Phalloplasty

Phalloplasty, a masculinizing surgery, is the formation of a phallus using skin taken from another spot on the body: sometimes the flank, lower abdomen or forearm. The principal advantage to this procedure is that it creates a penis of significant enough size and bulk to accommodate an erectile device that allows for penetrative sexual intercourse. Urethral lengthening can also be done at the same time, or at a later time, to allow the patient to stand to urinate.

Body feminization can be done to achieve an hourglass figure. Typically, this procedure involves trunk liposuction and buttocks augmentation. Fat is removed from the waist, abdomen, hips and mid/lower back. This fat can then be transferred to the buttocks area to form a shapely, feminine backside – a procedure known as the "Brazilian butt lift."

Body masculinization can help a person attain the classic V-shaped figure. Certain areas of fat storage, such as the hips, legs and buttocks, can be difficult to change through diet and exercise alone. Body contouring can help achieve a broad and defined upper torso, trim waist and minimal fat in the lower body area.

Yes. Our gender-affirming surgery team includes 3 surgeons who are board-certified in their respective fields. Satish Ponnuru, MD, is certified by the American Board of Plastic Surgery. Joshua Broghammer, MD, is certified by the American Board of Urology and has specialty training in reconstructive urology. Meredith Gray, MD, is certified by the American Board of Obstetrics and Gynecology.

Yes. Dr. Ponnuru completed residencies in general surgery and specialty training in plastic surgery. He became a doctor in 1999 and has been performing surgery ever since.

Yes. Dr. Gray has been a member of WPATH since 2014. She presented research at the WPATH symposium in Amsterdam in 2016 and has attended several other training sessions and symposiums.

All 3 surgeons have privileges at The University of Kansas Health System. Our hospital has been continuously accredited by The Joint Commission since 2008. Your surgery will be done in a hospital with access to emergency services and specialty care. Our health system has earned Magnet designation by the American Nurses Credentialing Center's Magnet Recognition Program for 4 terms. This recognition indicates high-quality patient care and nursing excellence.

During your initial surgery consultation, a physician will thoroughly review your medical and surgical history. Our team will identify possible medical conditions that may need to be at their best prior to surgery. For example, if you have diabetes or high blood pressure, we will work with your primary care provider to make sure these conditions are well controlled. We also have a list of medical requirements for surgical candidates that includes no nicotine use and having a BMI of 30 or less. Gender-affirmation surgical procedures are only offered to adults aged 18 and over.