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 …

Dr. Alexander Facque (he/him) is a board-certified plastic surgeon and proud member of the LGBTQ+ community. Dr. Facque got his start in gender-affirming care as a resident at the Icahn School of Medicine at the Mount Sinai Medical Center in New York, where he first recognized the importance of providing safe and accessible surgeries to trans and non-binary patients. He then spent a year training and expanding his knowledge under Dr. Loren Schechter, one of the world’s foremost gender-affirming surgeons, as a fellow at Weiss Memorial Hospital’s Gender Confirmation Surgery and Practice Leadership in Chicago. Dr. Facque officially joined our team in 2020 and brought with him over 5 years …

We have compiled these extensive guides on recovery from liposuction and recovery from fat grafting or BBL procedures.

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.

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 …

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.

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.

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

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.

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.