Medically reviewed by Jennifer Richman on June 13, 2025.
Body masculinization surgery (BMS) refers to the use of targeted liposuction, skin excision, and/or pectoral implants to help trans men and transmasculine non-binary patients feel more aligned with their bodies. These procedures are sometimes called “FTM body contouring” or “gender-affirming body sculpting.” We recognize that there is no one way to look masculine, and therefore, there exists no one-size-fits-all approach to body masculinization. If you are interested in creating an individualized plan for your surgery or have questions about your specific case, you can request a free consultation with one of our surgeons here.
There are three options of procedures that can be combined or performed alone: liposuction, skin excision, and body implants (pectoral). Let’s go through a few of them:
Liposuction can help eliminate stubborn, unwanted fat from areas that have not been reduced by consistent diet and exercise. This procedure is not a weight-loss strategy, but rather something that can be used to help alter the shape of the body. Liposuction can target the following areas:
These procedures involve removing undesired overhanging skin in any area of the body. For example, when liposuction alone is not sufficient for a patient, an abdominoplasty or “tummy tuck” can help them reduce their body dysphoria by eliminating unwanted skin and tightening abdominal muscles. To excise and tighten overhanging skin and tighten, a scar will be created. You can speak with one of our surgeons in a free consultation to discuss how to conceal the scars and otherwise reduce their visibility through scar care.
Chest reconstruction top surgery is not a body contouring procedure, but often a part of body masculinization surgery. Depending on the patient’s unique anatomy, a variety of techniques can be used to give the chest as flat an appearance as the patient would like.
Silicone pectoral implants can be inserted to enhance the chest and create a more defined, muscular pectoral appearance. For trans men and non-binary folks that have undergone top surgery, pectoral implants can help patients experience greater feelings of gender euphoria with the contour of their chest.
While an abdominoplasty targets loose skin and fat in the abdominal area, a mons lift, mons resection, and panniculectomy target the loose skin and fat in the upper groin area, below the abdomen. These procedures can help trans men and transmasculine non-binary patients who have undergone bottom surgery give the penis a more forward, apparent position on the body.
For some patients, it is helpful to think about what specific areas they want to target. For example, patients who experience hip dysphoria or dysphoria from having a “pear-shaped” body frame may want to target those zones through liposuction and/or an abdominoplasty. This may include taking fat out and/or tightening skin around the hips, abdomen, buttocks, thighs, under arms, and other zones upon request.
Approaches to body contouring to obtain a conventionally “masculine” body shape often aim to obtain a waist-to-hip ratio (WHR) range that is close to the WHR of those who went through a first, testosterone-dominant puberty. Specifically, the WHR most commonly associated with a masculine figure falls within the 0.85-0.95 range. If you are curious, you can measure your own WHR by dividing your waist measurement by your hip measurement.
Liposuction of the buttocks, hips, and trunk, alongside an abdominoplasty, can help create this effect.
<span class=”yoast-text-mark” style=”font-weight: 400;”>>In addition to gender-affirming body contouring surgery, it’s recommended that transmasculine people who want more muscular upper bodies should focus on upper-body weight training. Concentrating on building muscle in the back, neck, and shoulders can broaden and define the upper body, further enhancing waist-to-chest measurements.
The waistline of people who went through an androgenic puberty is significantly higher than those who went through an estrogenic puberty. This is largely because of bone structure. An estrogenic puberty widens or expands the pelvis, bringing the waistline further down on the body. Below, figure A shows the pelvis of an adult who went through an androgenic (testosterone-dominant) development, whereas figure B shows a widened pelvis resulting from an estrogenic development.
Liposuction is one of the most viable options for lifting the appearance of the waistline. Hormone replacement therapy (HRT), such as testosterone, cannot change the bone structure of the body, and the currently available options to change the pelvis have risks significant enough as to make them untenable. Lifting the waistline through liposuction of the abdomen, hips, and lower back can have a significant positive impact on the fit of male clothing. When done appropriately, contouring will decrease the hourglass silhouette featured in figure B below so that the body looks more like figure A. Thus, liposuction and possibly fat grafting can be powerful tools for androgenizing the body’s frame.
Abdominoplasty and/or lifting the waistline through liposuction of the abdomen, hips, and lower back can have a significant positive impact on the fit of male clothing. When done appropriately, contouring will decrease the hourglass silhouette featured in figure B below so that the body looks more like figure A. Thus, liposuction and possibly fat grafting can be powerful tools for masculinizing the body’s frame.
Below, you’ll see that the androgenic body form featured in figure C has a concave/flat appearance. Body contouring of the gluteal region would aim to remove the fullness of figure D so that they have an appearance more like figure C. Overall, buttock as well as thigh liposuction can help de-feminize the appearance of the lower body by eliminating or reducing curves so that a more squared-off body shape prevails.
The following before and after photos come from two of Dr. Mosser’s BMS patients.
The following factors are taken into account when determining an ideal candidate for body masculinization surgery:</span>
Selecting the right surgeon is crucial for achieving optimal results and ensuring a safe and successful body masculinization surgery. Our surgeons at the GCC (Gender Confirmation Center) are board-certified with extensive experience with gender-affirming surgeries and gender-affirmative care.
When researching potential surgeons, consider the following factors:
Some insurance plans that cover gender-affirming surgery may offer coverage for body masculinization surgery when patients provide the proper support documentation.
If you have insurance coverage and we are a contracted provider, we are unable to offer you an out-of-pocket price for your medically necessary body contouring (liposuction and/or fat grafting procedure). 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.
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.
Please note that managed Medi-Cal plans, such as San Francisco Health Plan (SFHP), coverage has not changed for Liposuction, ensuring flexibility in Liposuction units.
For information about prices and financing options, we invite you to consult this page.
The results of liposuction and skin excision procedures can be permanent. However, significant fluctuations in overall body weight will change and potentially diminish surgical results.
Conventionally masculine body frames tend to have shoulders that are wider than or the same width as the hips. Abdominoplasty and liposuction that targets the hips, buttocks, flanks, abdomen, lower back, and even thighs can help create a more masculine body contour.
The recovery process after body masculinization surgery can vary depending on the specific procedures performed and the individual’s healing rate. However, most patients can expect the following:
Initial/Short-Term Recovery: Most patients see a reduction in swelling and discomfort within 3 weeks, with daily activities being able to be resumed in 4-6 weeks.
Long-term Recovery: At ten weeks or more, you will enter the long-term recovery stage, with most visible scaring and swelling greatly reduced by the 3rd month.
Since FMS involves various procedures, including rhinoplasty, jaw contouring, and Brow bone augmentation & hairline repositioning, recovery times may vary*
Initial/Short-Term Recovery: Improvement in swelling and bruising (which is common) is typically seen within 2 to 3 weeks; the resolution and settling of features can take 3 to 6 months.
Long-term Recovery: It can take up to a year or more for the final results of facial bone contouring and rhinoplasty to become fully apparent.
Liposuction and fat grafting procedures may be able to be performed on an outpatient basis, but consult with your surgical team first*
Initial/Short-Term Recovery: Depending on the depth of the procedures and removal, it can take 2-4 weeks for initial recovery.
Long-term Recovery: Within 8-10 weeks, you should be able to resume your light/normal daily activities.
Initial/Short-Term Recovery: A hospital stay of 1 to 3 days is a typical requirement, followed by an initial recovery period of about 2 to 4 weeks. Pain, bruising, and swelling are common, with the ability to return to normal activities occurring after 6 to 8 weeks.
Long-term Recovery: Full recovery and reduction of residual swelling can take up to 8 to 12 weeks, with some residual discomfort subsiding within a few months.
Since this is a multi-stage procedure, recovery timeframes will vary depending on the specific surgical techniques used and the need for additional surgeries*
Initial/Short-Term Recovery: Patients are usually required to stay in the hospital for 5 to 10 days post-surgery. Then the first 4 to 8 weeks are focused on healing, with patients not performing ANY strenuous activities or heavy lifting.
Long-term Recovery: It can take up to 8 to 12 weeks to return to light/normal levels of activity, with full healing taking up to a year or more.
It’s important to follow the surgeon’s post-operative instructions carefully and attend all scheduled follow-up appointments to ensure a smooth and successful recovery. As you plan for your surgery, remember to consider taking the time to request accommodations from your employer, develop a care plan with family and friends, and build a financial cushion to rely on during your recovery period.
Like any surgical procedure, body masculinization surgery carries potential risks and complications that you should consider carefully..
Despite these potential risks, body masculinization surgery can offer numerous benefits. Especially for individuals seeking to align their physical appearance with their gender identity. Some of the benefits we have heard from our patients include:
It is essential to carefully weigh the potential risks and benefits with the guidance of a qualified surgeon. This will help you make an informed decision that aligns with your personal goals and priorities. If you would like to discuss these factors and more, you can meet with one of our board-certified surgeons in a free consultation.
All virtual and in-person consultations with our board-certified surgeons are free. Once you fill out this form, our patient care team will reach out and guide you through every step to get to surgery.