Gender Surgery

Gender-affirming surgery, historically called gender reassignment surgery, changes physical characteristics so that your body better reflects your gender. For many people it eases gender dysphoria; for others it is about feeling at home in their body. There is no required order and no single pathway. Some people have one procedure, others combine or stage several:

• A flatter, masculine chest: FTM top surgery, using a double incision, nipple-sparing double incision, keyhole or periareolar technique, chosen by chest size and skin quality.
• An outcome outside the binary: non-binary surgery, with chest, facial or body procedures tailored to your identity rather than a masculine or feminine template.
• A fuller chest: MTF top surgery with implants, fat transfer or both, planned around any breast growth from hormones.
• Softer facial features: facial feminisation surgery on the forehead and brow, nose, jaw, chin, lips and hairline, in one operation or staged, with 3D planning for bone work where it helps.
• A prominent Adam’s apple: a tracheal shave, alone or alongside FFS.
• A more masculine or feminine silhouette: body masculinisation or body feminisation, using liposuction and fat transfer to change where fat sits on the chest, waist, hips and buttocks.

We do not offer genital gender-affirming surgery, such as feminising vaginoplasty, phalloplasty or metoidioplasty. These operations are carried out by specialist genital surgery units, usually after referral from a gender identity clinic.

No. Adults aged 18 and over can self-refer directly, with no GP letter or gender clinic referral. A psychological assessment letter is not a mandatory precondition for top surgery here, although we recommend one if you are in the earlier stages of gender-affirming care. Our guide to the WPATH letter for top surgery explains what one covers, and our comparison of NHS vs private FTM top surgery sets out routes and waiting times if you are weighing up the NHS pathway.

Not for every procedure, and the answer differs by operation. Testosterone does not usually need to be paused for top surgery, while oestrogen is reviewed case by case because of its effect on blood clotting. For MTF top surgery, implant size is usually planned once breast growth on hormones has settled. Our guides to hormone therapy before FFS and MTF breast augmentation without hormones cover the detail. Never stop prescribed hormones without advice from your surgical team and prescriber.

Top surgery, non-binary surgery and body masculinisation are performed by Dr Spyridon Vlachos and Dr Gino Vissers. Facial feminisation surgery and tracheal shave are performed by Mr Shehab Jabir, Consultant Facial Plastic Surgeon. The surgeon who assesses you at consultation is the surgeon who operates, under TIVA or local anaesthetic with sedation depending on the procedure, at our Baker Street hospital, rated Good overall by the Care Quality Commission.

You can see real patient results in our FTM top surgery before and after photos, and prices in our FTM top surgery cost guide. The clinical team uses inclusive language and welcomes all gender identities, and we recommend a two-week cooling-off period after every consultation.