The choice to undergo gender-confirmation surgery (GCS) is a defining moment in a person’s life. Gender-confirmation surgery is also incredibly complex and requires mastery of multiple surgical specialties. The goal of the procedure is to provide the patient with a physical appearance that truly matches who they are. That is why so much time, passion, and care is required.

Providing Personalized Results

There are many different aspects of gender-confirmation surgery. Dr. Ploplys performs top surgery as well as facial feminization. These procedures include:

  • Transfeminine Top Surgery – Enhancing the size of the breasts to create a more feminine appearance. Breast implants, fat grafting and breast lift are often used individually or in combination with the goal of creating more feminine contours.
  • Transmasculine Top Surgery – Creating a chest with a flatter and more masculine appearance by removing breast tissue and reshaping and repositioning the nipple areola complex. This can be done with a periareolar approach for smaller chested individuals. For most patients, subcutaneous mastectomy with free nipple grafting is required. Liposuction is often used as an adjunct to hone the result.

The other main aspect of gender-confirmation surgery is all the little details. Subtle changes to the face can create a softer, sharper, or more refined appearance that is more masculine or feminine. The procedures used to achieve this often include rhinoplasty, chin augmentation, and facial implants or fillers.

From the moment you come in for your consultation, our surgeon will work with you to understand your goals so that she can provide you with results that satisfy your needs. You input is vital to the entire process.

If you are interested in undergoing gender-confirmation surgery, contact our office to schedule a consultation. We can provide you with compassionate and comprehensive care throughout the entire process.

It was never about “becoming” another person – I already was who I wanted to be – I just wanted and needed my body to reflect that.
I can say I am a proud transgender man and I am so happy with my body transformation.


In many cases insurance companies will cover top surgery. We have an insurance specialist in office that can look into your plan and work toward insurance approval of surgery.
Ideal patients for top surgery have been living as their desired gender and taking hormonal replacement for a year. A letter from a psychologist is required by some insurance companies for coverage. We generally abide by WPATH standards of care for eligibility.Hormonal replacement therapy changes the chest appearance in itself and is an important tool to achieve the best surgical result. We also require that patients not use niccoteine for 6 weeks before and 3 months after surgery to allow healing.
Patients usually require 2 weeks off of work after surgery unless they have a physically demanding job. For female to male top surgery, the chest must be wrapped for 2-6 weeks postoperatively. There is no lifing over 10 pounds or soaking in a tub for 6 weeks. We use Exparel during surgery to provide enhanced pain relief for the first 3 days. Patients usually are able to travel home the same day as surgery.
Top surgery with free nipple grafting requires a large scar placed under the natural contour of the chest. This scar is permanent, but can be minimized. We start patients on silicone gel sheeting at 2 weeks and continue this for 3 months postoperatively. Patients also have the option of laser scar therapy to reduce appearance of scar. If nipple color is affected, we often replace color with in office tattooing.
Any type of chest surgery can affect nipple sensation. Breast augmentation can blunt sensation expecially initially, however it usually mostly recovers. Free nipple grafting cuts all of the nerves to the nipple. Some patients report eventual development of sensation, but this should not be expected.