A Comprehensive Guide To Male-To-Female Body Feminization Surgery

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Body feminization surgery (BFS) is a series of operations that add feminine features to your body. Estrogen therapy alone is usually not enough to feminize your aesthetic appearance. BFS is often combined with facial feminization and breast augmentation surgery.

The surgeries involved in male-to-female (MTF) body contouring are liposuction and fat grafting to enhance the hips and buttocks. Your waist will need slimming and the fat harvested from your waist will be grafted to the buttocks and hips.

What is male to female body contouring?

Men and women have different body shapes. The male body is boxier and less curvaceous compared to females. The goal of the surgery is to provide a feminine physique through a combination of liposuction and fat grafting. The overall result will depend on the number of body tissue that survives, and the amount of body tissue that is grafted.

Fatty Tissue is removed from any part of the body and is injected in those zones where it is needed. Buttocks and hips are two of the most common areas targeted during the process of body contouring and feminization.

Not all transgender women are ideal candidates for this procedure. If you do not have enough body fats, implants can be a good option. Ideally, it is for trans-women who are close to their ideal weight, are healthy, have good muscle tone, no excess skin, no saggy skin and has enough body fat that has not responded to other weight loss strategies.

What is the ideal female body shape?

There is no single definition for the female body shape. However, women have four types of body shape:

  1. Pear Shape
  2. Rectangle Shape
  3. Apple Shape
  4. Hourglass Shape

Women, in general, carry more fat than men around the hips, thighs, and buttocks which create the curves associated with the female body. Since the distribution of fat and muscles in men are mostly on the upper torso, trans-women carry the same features, and that is why body contouring is essential to get the full woman features.

Areas Treated For Body Contouring

  • Breasts (Breasts augmentation)
  • Waist (to achieve feminine waist-to-hip ratio)
  • Hips
  • Buttocks
  • Abdomen (Abdominoplasty or tummy tuck)

Ideal Candidates For Boby Feminization Surgery

Firstly keep in mind that body contouring is not a weight loss program, it is only to contour your body. Not all trans-women are suited for body feminization surgery. Make sure your body weight is ideal for your body frame.

Things To Consider

Surgeries, in general, carry potential risks that are either permanent or temporary. Fat removal for contouring is permanent, but you will need to maintain a healthy diet. If your surgery results in loose skin, lumps, or uneven colors you will require revision treatment after the operation.

It is essential to be prepared for results that may or may not satisfy you and keep a realistic outlook.

body feminization surgery

Procedures Involved In Body Feminization Surgery


Liposculpture is a derivative from liposuction. The procedure removes fat to contour the body to a desirable shape. BFS uses this approach to sculpt the waistline.

Liposuction is usually done on an outpatient setting under local or general anesthesia. Body feminization surgery uses liposuction for its safety procedures. Small incisions are made in the area you want to contour through which a thin suction tube is inserted to remove excess fat. After the suction is done, the cuts are sutured if necessary. The procedure will take about an hour for completion.

Breast Augmentation

Breasts are the typical outer features of the female body. Due to estrogen hormones, women have larger breasts than men. You should be at least 18 years and above to undergo breast augmentation.

Since MTF patients have broader shoulders and wider ribcage, breast implants are also taken as options. Because of the wide breastbone, most breast augmentation results may not give you the desired cleavage, which is why fat grafting is used to tighten up the cleavage area.

Butt Augmentation

Butt augmentation will give you a rounder and fuller buttocks that are in line with the female body. There are two categories of butt augmenting – Gluteal implants and Brazilian butt lift (Fat graft).

Gluteal or butt implants are solid silicone prosthesis that comes in oval, and round shapes and sizes may range. Two curvilinear incisions are made in the natal cleft. Making two incisions lowers the risk of wound dehiscence. After inserting the desired shape and size of the implants, the wound is sutured with a vacuum drain. You can expect full results in three to six months.

The Brazilian butt lift is a more invasive procedure which is used to add girth and projection to the buttocks. This is not only common among trans-women but women. Here, the fat is harvested from the tummy, lower back, and flanks and injected to the buttock. With this procedure, you will gain a bigger butt while removing excess fats from other parts of your body. It is important for the patient to have sufficient body fat.

Hip Augmentation

The most desired female body is the hourglass shape that has a low waist-to-hip ratio of 0.7. There are two approaches to have hip augmentation – implants and fat grafts.

Fat grafting is the more common procedure to enhance one’s hips. Fat is grafted from areas where there are excess fats, usually the abdomen and injected in the hips to create feminine curves. The inserted fats will remain in the hips permanently, while your body will absorb 30% of the fat grafting.

Pre-Operative Care

  • Quit smoking 2 weeks before and 6 weeks after surgery
  • Have a healthy diet and plenty of rest
  • If under daily medication, consult your doctor
  • A Blood test is required before the surgery
  • Do not eat, drink (even water) or chew anything at least 6 hours before the surgery
  • Avoid alcohol completely before and after surgery
  • Aspirin and anti-inflammatory medications or herbal medicines are to be avoided two weeks prior to surgery
  • Arnica tablets are recommended one week before and two weeks after surgery. It will help reduce bruising
  • If you have a gastric band, only a fluid diet is to be taken before surgery and fasting for at least 8 hours on the day of procedure
  • It is recommended to wear loose and comfortable clothes on the day of surgery
  • Additional restrictions by your surgeon are to be strictly followed

Risks And Complications

Some temporary nausea and fatigue are expected and not uncommon as a result of anesthesia

  • Temporary or permanent scarring may occur requiring future revisions
  • Hematoma or Seroma may also occur as large cavities and spaces are produced through body contouring
  • Skin Ischemia and resultant necrosis can result due to delayed healing
  • Infections, though uncommon, may also arise. Antibiotics can help
  • Bleeding, in the form of blood collection or through skin incision may also result
  • Asymmetry and contour irregularities
  • Numbness around the scars. This is temporary and tolerable
  • Deep Venous Thrombosis (DVT), blood clot or fat emboli to the lung may result in serious consequences
  • Mild to moderate swelling, bruising and discomfort are to be expected and are mostly temporary. It will subside with time.

Post-Operative Measures

After your surgery, your body will be fitted with a compression garment which you should wear for at least four weeks. The operation may leave you feeling uncomfortable, and you may experience mild pain and swelling. Take self-care measures while you recover.

  • Limit your physical activities for the first few weeks
  • You can take brisk walks
  • Antibiotics and medications can be taken as prescribed by your doctor
  • After a week you can undertake light activities

Results And What To Expect

Liposuction is generally considered safe, but as with every surgery, it carries potential risks. This can be eliminated by a qualified doctor and by religiously following the pre and post-op recommendations.

Results are permanent and lifelong. Some patients may require revision to treat loose skin, lumpy results or uneven contours. Some implants may require replacement after 10 years. These procedures do not replace a healthy diet and exercise. A good diet and exercise must be continued to maintain optimal results.

While the procedure can provide a feminine appearance, results may not be perfect. It is best to have realistic expectations.

What are the costs of surgery?

Surgery costs may vary, depending on many factors like location, type of procedure, number of procedures, charges of the surgeon/clinic, etc. In the United States, it generally ranges from 3000 USD up to 15000 USD. Some clinics may offer a discount if it is carried out with facial feminization and breast augmentation. In Thailand, it generally starts from 1500 USD. Prices may vary.


How long does the procedure take?

A: It depends on the number of procedures to be undertaken. For one area, it will take 30-45 minutes.

Is the result permanent?

A: Results will be life-long. Good diet and exercise are recommended. Weight gain and body changes may reverse the results.

Is a retouch possible in liposuction?

A: Yes. After the swelling is completely down and the liposuction hasn’t produced desired results, a retouch is possible.

Are implants life long?

A: Implants last for 10 to 25 years.

Can anyone get liposuction?

A: Everyone is not an ideal candidate. Sufficient fat should be available for transfer.

Which is more invasive – liposuction or abdominoplasty?

A: Abdominoplasty. It may leave a scar and needs a longer recovery period.

Can multiple procedures be carried out at once?

A: Very much possible. But the procedure will last longer.




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