From requesting a consultation to obtaining insurance approval, we have you covered with our FFS timeline guide.

Dr. Ellie Zara Ley (she/her/they) is a board-certified plastic surgeon and 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. She also specializes transgender adolescent care. She is highly trained, having completing her general surgery residency at University of Arizona, a fellowship in plastic and reconstructive surgery at the University of Utah, a fellowships in craniofacial and pediatric plastic surgery at Primary Children’s Hospital in Salt Lake City and another in hand surgery and microsurgery at the University of Southern California. Prior to joining our team in 2022, she worked as an assistant clinical instructor …

The techniques used for a breast augmentation are the same regardless of a patient’s gender identity. That said, surgeons who are not experienced working with transgender patients may not have the expertise to determine how to best help a patient achieve their goals given their body’s proportions due to the puberties or puberty they have undergone. For more information, click here.

So far, there is little evidence linking saline or silicone breast implants to an increased risk for breast cancer. Otherwise, for patients who have developed breast tissue through hormone replacement therapy (HRT), there is some evidence to suggest that it can increase your breast cancer risk. As a result, it is recommended that if you are over the age of 50 and have been undergoing HRT for 5 or more years, you undergo screening mammography every 2 years. Additionally, there is a type of lymphoma that is associated with breast implants. Read more about risk evaluation and best practices for breast cancer detection in transgender patients here.

All of the breast implant options we offer involve a risk of sensation loss. While most patients report an overall loss in sensitivity of their breasts and nipples post-op, they tend to report higher levels of sexual satisfaction because of feelings of euphoria and alignment with their bodies. You can read more about this topic here.

We have prepared a guide specifically for breast augmentation patients on how they can prepare for surgery in the days leading up to it. Additionally, exercise and drug consumption are two of the most important factors to monitor before your surgery that can help you maximize your results and speed up your healing process. Learn more about our guidelines and recommendations around exercise and drug use here.

The most common procedure to accompany a breast augmentation is body feminization surgery or gender affirming body contouring. You can learn more about trunk and arm liposuction as well as fat grafting options like a Brazilian Butt Lift (BBL) and hip dip fat transfer here.

Generally, patients who are taking estrogen and/or progesterone HRT are recommended to let their breast tissue develop for at least a year under treatment. Doing so can maximize breast augmentation results. That said, we have no HRT requirements to undergo this surgery. Likewise, we have had successful results with patients who come in with no initial mammary tissue.

Absolutely not. At the GCC we are committed to serving patients of all gender identities. We only require HRT for patients undergoing certain bottom surgery procedures. We take an individualized approach with our patients to design a surgical plan that meets their unique goals.

Many trans, non-binary and gender expansive patients need to travel to access quality, reliable gender affirming surgical care. 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.