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The Best Top Surgeons for Gender Affirmation: Finding Expert Care for Your Journey

Medically reviewed by Jennifer Richman on May 10th, 2025.

Top surgery is a life-changing procedure that can help transgender, non-binary, and gender diverse patients who need it significantly reduce their gender dysphoria. Top surgery is an umbrella term for surgical procedures that permanently alter the chest contour: flattening it, significantly reducing chest volume, or augmenting the breasts. 

Finding the right surgeon is one of the most important steps of the process for trans men (FTM), trans women (MTF), non-binary folks, and gender non-conforming patients who are interested in this surgery. The best way to find which top surgeon is best for you is to explore their credentials, review their before-and-after and results, and request a consultation with them to see if they can meet your unique goals for surgery.

Dr. Scott Mosser (he/him), Dr. Alexander Facque (he/him), Dr. Zara Ley (she/her/they), and Dr. Daniel Jacobs (he/him) are some of the most sensitive and best top surgeons in the US and throughout the world. As a surgical practice, the Gender Confirmation Center (GCC) of San Francisco has been a trailblazer in the US for developing cutting-edge techniques for non-binary patients, tailoring results to every patient’s unique anatomy and goals, and abandoning discriminatory practices in top surgery against patients with high BMIs. 

Frequently Asked Questions About Finding the Best Top Surgeons

Who are the best surgeons for FTM top surgery and non-binary top surgery in the US and the world?

There is no one best surgeon for top surgery in the US or the world. Several providers are certified by the American Board of Plastic Surgeons, members of the World Professional Association for Transgender Health (WPATH), and have years of training and experience in gender-affirming chest surgeries.

Dr. Scott Mosser (he/him), Dr. Zara Ley (she/her/they), Dr. Alexander Facque (he/him), and Dr. Daniel Jacobs (he/him) are some of the most renowned top surgeons for MTF top surgery, non-binary top surgery, and FTM top surgery. They are incredibly sensitized in working with gender-diverse patients, offer the widest array of surgical techniques, produce some of the best results in the US, and offer consultations free of cost to interested patients.

How far in advance should I schedule consultations with top surgeons?

Every surgeon has a different waitlist time for top surgery and scheduling a consultation. Patients should expect to get a date for top surgery 3-6 months after meeting with their surgeon for an initial consultation. Generally speaking, your surgeon’s office will schedule you for a consultation faster if you can present the requirements for surgery. If you would like to have your insurance plan cover top surgery, this would include presenting a support letter from a licensed mental health professional.

What is the average recovery time after top surgery with experienced surgeons?

After top surgery, patients will be more or less fully recovered after 6 weeks: this is when they can return to rigorous physical activity. As long as your job does not require heavy lifting, you will likely be able to return to work 1-2 weeks after surgery. For more information on recovering shoulder mobility and reducing pain after top surgery, click here for our free physical therapy recovery guide. 

How do I know if I’m a good candidate for top surgery?

Most top surgeons will use an informed consent approach to determine a patient’s eligibility for this type of gender-affirming surgical care. What sets Dr. Mosser, Dr. Ley, Dr. Facque, and Dr. Jacobs apart from other top surgeons is that they accept patients regardless of BMI, gender identity, or hormone usage. If you have questions about whether you are a good candidate for top surgery based on your medical history, you can request a free top surgery consultation here. 

Will my insurance cover top surgery with the best surgeons?

Yes, many insurance plans cover gender-affirming medical care. Insurance providers that cover top surgery require patients to present a support letter from a licensed mental health professional. 

If the surgeon you would like to undergo gender-affirming chest reconstruction with is out-of-network, meaning they are not on the provider list for your insurance plan, you will need a referral from your primary care provider to petition to get coverage. You can refer to the “What if I have insurance that covers gender confirming surgery but they don’t have qualified surgeons in their network?” section of this page for further information.

What’s the difference between going to a general plastic surgeon versus a top surgeon specializing in transgender care?

Particularly in the case of top surgery, there are several key common differences between mastectomies, breast reductions, and breast implant surgery for cisgender and gender diverse patients. 

In the case of mastectomies, there are a variety of chest reconstruction techniques for trans masculine and non-binary patients that are not practiced by surgeons who only treat cisgender female breast cancer patients. Even in the case of a breast augmentation, there are common anatomical differences between most cisgender females and trans feminine patients that a surgeon would need to take into consideration to give a patient optimal results.

How many top surgeries should a surgeon have performed for me to consider them experienced?

There is no single number of surgeries that makes a surgeon “qualified” or “good.” Rather, we recommend that you look into their before-and-after and after photo gallery to get a sense of the quality of their results and read reviews from their patients online. We especially encourage you to look out for after images that resemble the results you want from surgery. If you like what you see, the next step would be to schedule a surgical consultation with them.

What are the most important factors in achieving the best possible top surgery results?

Setting realistic expectations for surgery, quitting tobacco use, and optimizing any underlying health conditions are three of the most important things patients can do to be satisfied with their results. 

For every patient, the “best” top surgery result is different. We encourage you to come into your top surgery consultation with images of former top surgery patients or even cisgender men, that align with what you would like your chest to look like post-op. From there, your surgeon should be able to determine whether or not they could reasonably help you achieve that chest contour. 

Top 3 Tips for Finding the Best Gender-Affirming Top Surgeon for You

Several highly experienced top surgeons haveThere are severala number of highly experienced top surgeons who have extensive careers working to give transgender, non-binary, and gender expansive patients satisfactory results. The following are our top three tips to help you find the best top surgeon for your unique goals and anatomy.  

1. Search in Trusted Databases and Provider Lists for Surgeons with Proper Qualifications

A good place to start looking for trusted providers is in vetted databases like TopSurgery.net’s top surgery provider list and the World Professional Association for Transgender Health’s (WPATH) provider database.

As a bare minimum, a surgeon whothat provides gender-affirming top surgery should be certified by the American Board of Plastic Surgeons, be a registered member of WPATH, and have hospital privileges. Even though most top surgery procedures are performed in an ambulatoryambulant surgical center, surgeons should have agreements with nearby hospitals in case an urgent medical issue arises that needs to be managed in the context of a hospital.

2. Check Patient Reviews and the Before and After Photo Gallery

Surgeons should be transparent on their websites about the type of results they are able to produce. When looking through a surgeon’s before and after photo gallery, look for top surgery results that resemble what you want to look like after surgery, such as a chest with some volume or a double incision technique on a plus-sized patient with or without nipples.

Additionally, you can gain a lot of insight about a surgeon’s expertise and bedside manner by reading patient reviews on Reddit, YouTube, and other online forums. Generally speaking, you can expect even the best surgeons to have a few negative reviews; while they are rare, surgical complications do happen with some patients, and those negative experiences are bound to be a cause for complaints. 

3. Request a Consultation to Meet the Surgeon

What sets the GCC apart from other providers is that we offer our surgical consultations, whether virtual or in-person, free of charge to all patients. The consultation is your space to get to know the surgeon. You can tell that a surgeon is a good fit for you if you feel like they listened to your preferences and took your questions and concerns seriously. Ideally, by the end of the consultation, they should be able to give you a sense of what a realistic result will look like and feel like for your top surgery procedure. Besides taking your goals into account, proper expectation setting is one of the most important components of developing the surgical plan. 

The Gender Confirmation Center’s Top Surgeons: Our Expert Team

Our Surgical Philosophy and Approach to Individualized Care

Many patients ask what sets us apart at the GCC from other top surgeons:

• Innovative, inclusive approach to surgery: Dr. Mosser (he/him) has been at the forefront of working with non-binary patients to develop surgical techniques that meet this population’s unique needs. Dr. Ley (she/her/they) is the only trans woman of color to offer a full spectrum of gender-affirming surgeries. Dr. Facque (he/him) and Dr. Jacobs (he/him) are also renowned for their surgical results, friendly bedside manner, and commitment to patient inclusivity (esp. around gender diversity and BMI)
• Free virtual and in-person consultations: Regardless of whether or not you have insurance, consultations with our board-certified surgeons are always free of costfree-of-cost to patients. You can request a consultation with more than one surgeon. Please note that all bottom surgery consultations must be in-person (cannot be remote/virtual).
• Highly successful insurance concierge/insurance advocacy team: Our insurance advocacy team offers free services to all patients. They have a 90% success rate of securing coverage for interested patients.

No discrimination based on BMI: our surgeons do not place arbitrary BMI limits on who is eligible for top surgery.

Dr. Ellie Zara Ley, MD (she/her)

Dr. Ellie Zara Ley (she/her/they) is a board-certified plastic surgeon who is a recognized expert with vast experience and knowledge in all aspects of transgender and gender diverse surgical care. She is the only transgender woman of color to offer a full-spectrum specialization in gender-affirming surgery: top surgery, bottom surgery, facial surgery and body contouring. Before joining our team in 2022, she worked as an assistant clinical instructor of plastic surgery at the University of Utah and had her own private practice in Arizona.

Dr. Alexander Facque, MD (he/him)

Dr. Alexander Facque is a board-certified plastic surgeon with over 5 years of experience in gender-affirming care and is proud to bring his skills in gender-affirming facial surgery, top surgery, and gender-focused body contouring. He is a member of the queer community devoted to improving the quality of care for trans, nonbinary, and gender diverse communities.

Dr. Scott Mosser, MD, FACS (he/him)

Dr. Scott Mosser is a board-certified plastic surgeon with a deep and long-lasting commitment to gender confirmation surgery. He has over 13 years of experience and has been exclusively devoted to gender-affirming care since he opened the GCC (Gender Confirmation Center) in 2013. He works to educate himself on the needs of the transgender community and collaborates with fellow medical professionals to ensure transgender healthcare receives the attention and knowledge-sharing it needs to properly serve all transgender people.

Dr. Daniel Jacobs, MD (he/him)

Dr. Daniel Jacobs is a board-certified plastic surgeon who brings over 30 years of experience in reconstructive plastic surgery and research. He is proud to bring his skills in top surgery and provide outstanding surgical care for transmasculine, transfeminine, non-binary, and gender-expansive patients.

Patient Journeys: Experiences with the Best Top Surgeons

Reading patient testimonials from the top surgeon will give you a good sense of the kinds of results they consistently produce and the patient care experience they and their team offer. 

Top Surgery Patient Care Experience

Patient testimonials for gender-affirming top surgery should speak to the surgeon’s bedsidebeside manner and the patient’s experience working with the surgical team. However, your surgeon doesn’t necessarily need to have the best bedside manner to be an excellent provider. The quality of their results and their ability to take your goals and concerns into account when designing your unique surgical plan are the most important factors.

Below is a testimonial from Grey, one of Dr. Facque’s former top surgery patients:

“In total, I have had three surgeries with Dr. Facque, and I could not be happier with my results! He performed a double incision with nipple grafts, body contouring (flank, abdomen, thighs), and facial masculinization surgery (chin lipo). In every case, the process was smooth and straightforward (despite some of my surgeries taking place during the height of COVID). I scheduled consults, communicated with the insurance team, and got on the surgery schedule – each time with ease. The process really helped calm my nerves around this pivotal moment in my life., The team was respectful and answered all my questions, and Dr. Facque made me feel seen and heard. I think it speaks volumes that each time I’ve decided to proceed with a gender affirming surgery, I’ve always returned to GCC. I am now a more confident, joyous, and excited version of myself, and running around with my shirt off never gets old!”

Top Surgery Patient Satisfaction 

Oftentimes, one of the greatest determinants of patient satisfaction is the surgeon’s ability to listen carefully to an individual’s unique needs and goals. From there, they can make a precise assessment of what is possible given their unique skill set and the patient’s autonomy.

The testimonial from Ace, a former Dr. Mosser patient, speaks to this skill:

“Surgery with Dr. Mosser has truly been a transformative, life-changing experience. Today, I am comfortable and confident to say I am trans: a conclusion that took years to reach.

Navigating through the US healthcare system has been an ongoing challenge, especially as a foreign-born, non-binary person. Growing up between two cultures and juggling with differently defined gender roles, I have struggled with the idea that I wasn’t “trans enough” to deserve or qualify for treatment (which is, of course, not true at all!) The moment I walked into Dr. Mosser’s office, I knew I was welcomed, listened to, and taken seriously. Thank you so much for holding a safe, respectful, and liberating space for all folks on the spectrum.

I am fortunate and privileged to have made it this far with the help of such a great support system. Without the weight of dysphoria, my mind and body feel so much lighter; even breathing seems a lot easier now. I am finally at peace with the person in the mirror staring back at me, and I remind them how proud I am of who we are, the choices we’ve made, and for surviving the little everyday struggles.”