Since body contouring procedures can involve liposuction and/or fat grafting, there are specific questions that surface for patients around qualifying for surgery, weight fluctuation and recovery. The guide below is a one-stop-shop to answer all your surgery questions: from booking your consultations, to figuring out how to pay for surgery, to arranging travel plans, to considering your unique medical history and more.
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What are the steps involved in getting a gender affirming body contouring surgery?
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Since several patients of body masculinization surgery (BMS) undergo top surgery as a part of the same procedure we refer them to the top surgery timeline guide. Though specific to top surgery, steps 1-7 that cover how to get surgery–from requesting a consultation, to obtaining insurance approval and completing all other preoperative requirements–are all the same for any type of body contouring procedure.
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Will my insurance cover this surgery?
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You can leave the insurance worries to us. The GCC provides a free insurance concierge service to interested patients. After soliciting any necessary documents from you, our insurance advocacy team will get to work to secure full or partial coverage for your medically necessary, gender affirming procedure(s). Our team has a 90% success rate in securing coverage for insured patients. Learn more about that process here.
That said, there are new insurance restrictions around body contouring procedures:
For Patients with Insurance Coverage:
If you have insurance coverage and we are a contracted provider, we are unable to offer you an out-of-pocket price. This is due to the service being reimbursed at a drastically reduced amount, limiting our ability to provide this service at a reasonable reimbursable rate.
Managed Medi-Cal plans, such as San Francisco Health Plan (SFHP), coverage has not changed for Liposuction, ensuring flexibility in Liposuction units.
Background Information:
In the past, GCC billed for multiple units, each representing different areas on the body, and the procedure was reimbursed based on the number of units. However, insurance companies are now reimbursing for only one (1) unit, regardless of the number billed.
Impact on GCC:
Since May 2023, GCC has experienced significant impacts due to reduced reimbursement for Liposuction.
Self-Pay Patients (Cash Patients):
All self-pay patients (cash patients) can still undergo the procedure in the same manner as before.
Message to Patients with Insurance Scheduled for Liposuction:
Unfortunately, currently insurance companies have decreased the reimbursement for liposuction, and starting from 1/1/2024, GCC cannot proceed with insurance-based liposuction procedures. We regret any inconvenience this may cause.
For comprehensive details on our fees and available patient financing resources — including reputable credit providers and scholarships for gender-affirming surgeries — please refer to this page: https://www.genderconfirmation.com/about-us/fees-and-financing/
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How can I finance my surgery if it’s not covered or only partially covered by insurance?
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We have compiled a list of scholarships for gender affirming surgeries alongside trusted, medical credit agencies you can use to help finance your surgery with us. You can also find estimated costs for each procedure we offer if you plan on paying entirely out of pocket. Click here for more.
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Do I need a letter of approval from a therapist, psychiatrist or primary care doctor to get surgery with GCC?
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Letters of support or clearance letters from certified, mental health professionals are welcome and valuable, but not a requirement for adults who seek surgery with the GCC. This is because we use the informed consent model, which means that a letter from a therapist is not required unless the patient is seeking insurance approval.
Insurance companies always require a letter of support from a mental health professional for approval. If our reconstructive surgeons are outside of your provider network, you will also need a reference letter from your primary care provider to request insurance coverage. For more information, click here.
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What about patients who are traveling from out of town to San Francisco for surgery?
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Many trans, non-binary and gender expansive patients need to travel to access a board-certified, highly experienced gender affirming surgeon. At the GCC, we are very accustomed to working with patients from out of town. For recommendations on travel and lodging, click here. We have also compiled a guide on preoperative consultations and post-operative follow-up protocols for patients who do not live in the San Francisco Bay Area
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Do I need to be taking testosterone or estrogen hormone replacement therapy to undergo Body Masculinization or Feminization Surgery?
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Though hormone replacement therapy (HRT) is not a requirement for surgery, it can have a positive effect on fat redistribution and changing someone’s gluteal shape. For patients whose transition process involves HRT, we recommend that you wait until at least a year has passed on hormones before undergoing a body contouring procedure. Still, many patients experience difficulty with reducing or increasing fat reserves around the hips, legs and buttocks with HRT, exercise and diet alone. This is why even with hormone usage, some find it necessary to undergo a body contouring procedure to feel aligned with the shape of their bodies.
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Can I undergo a body sculpting procedure with other operations like top surgery or a breast augmentation?
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Absolutely! It is very common for our patients to undergo liposuction during their top surgery. Though they can be combined, the recovery processes for a fat transfer, such as a BBL, and a breast augmentation when combined can be particularly complicated. If you would like to discuss your eligibility for surgery and create a plan to meet your unique gender goals, you can speak with one of our board-certified plastic surgeons in a free, virtual consultation.
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Will gaining weight before fat grafting–such as a Brazilian Butt Lift or hip dip fat transfer–enhance my results?
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When it comes to body feminization surgery, patients often ask how they can maximize their results. At the GCC, we caution patients against rapid weight gain before surgery for the two reasons listed below. You can learn more about our recommendations around preoperative weight gain and how to maximize your fat grafting results here.
First, it can be challenging to maintain a sustainable weight that is not natural for our lifestyle without significant continuous effort. Significant weight fluctuation post-op can affect your final results.
Second, the type of fat that is available for grafting is called “subcutaneous fat” which refers to fat that is stored just beneath the skin. Often, the fat that appears from short-term, unsustainable weight gain is called “mesenteric,” referring to the fat that accumulates around the intestines. “Mesenteric” fat cannot be accessed by a surgeon as a part of body contouring, and if present in significant quantities, it can significantly contribute to cardiovascular risk.
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How long will a fat transfer (a BBL or hip augmentation) last? What happens if I lose weight after my procedure?
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Generally speaking, if the host tissue accepts the fat that is transferred or grafted into it, the results are essentially permanent, meaning they can be life long. By the six month mark post-op, patients should be able to see their final results. However, even if the fat transfer is successful, if the patient undergoes weight loss and loses overall body fat naturally, the area that was grafted will also shrink in size.
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Where can I learn about recovery from body contouring?
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We have compiled these extensive guides on recovery from liposuction and recovery from fat grafting or BBL procedures.
