Gender-Affirming Body Contouring

The Gender Confirmation Center of San Francisco offers masculinising and feminising body contouring procedures for transgender and non-binary patients seeking to align their body shape with their gender identity. Masculinising body contouring typically involves liposuction to reduce hip and thigh volume and create a straighter, more angular silhouette. Feminising body contouring may include fat transfer to the hips and buttocks to enhance curves, combined with liposuction to the waist to create an hourglass proportion. Additional body procedures include brachioplasty, thigh lift, and lower body lift for patients who have undergone significant weight changes or require reshaping as part of a broader gender-affirming surgical plan.

Gender-affirming body contouring at the Gender Confirmation Center of San Francisco addresses the secondary sex characteristics of the body shape — hip-to-waist ratio, thigh volume, buttock projection, and abdominal contour — that contribute significantly to how patients are perceived and how they perceive themselves. Dr. Scott W. Mosser MD FACS approaches body contouring within the gender-affirming framework, designing procedures to achieve a body silhouette consistent with the patient's gender identity rather than simply removing fat or addressing skin laxity in isolation. For FTM and transmasculine patients, the typical goal is a reduction of the typically female fat distribution pattern — characterised by a pear-shaped silhouette with wider hips and thighs relative to the waist and shoulders. Liposuction of the lateral hips, outer thighs, and inner thighs reduces this characteristic feminine contour, creating a more cylindrical or android body shape. Where lower abdominal skin laxity is present after liposuction or significant weight loss, abdominoplasty may be incorporated. For MTF and transfeminine patients, feminising body contouring works toward the opposite goal: creating or enhancing the hourglass proportion characteristic of the feminine silhouette. This typically involves liposuction to reduce the waist and create definition, combined with autologous fat transfer — using the harvested adipose tissue — to augment the hips and buttocks. Fat is processed and reinjected into the lateral hip fat compartment and the upper buttock to increase projection and width, shifting the body's widest point from the shoulder plane toward the hip. The practice also performs brachioplasty (arm lift) to address excess inner upper arm skin and fat, thigh lift for inner thigh laxity, and lower body lift for circumferential skin excess following massive weight loss. All body contouring procedures are planned with the patient's aesthetic goals and anatomical starting point at the centre of the surgical design, with the gender-affirming objective guiding both the selection of procedures and the execution of each intervention.