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Frank Agullo, MD En Español

Transgender Female to Male

The realization that your biological gender does not match the gender that you identify with can create considerable anxiety. Sexual reassignment surgery can help patients who are struggling with these stresses achieve the outer body that they belong in and deserve. The decision to undergo female to male transgender cosmetic procedures is a significant one that should not be taken lightly. Dr. Frank Agullo at Southwest Plastic Surgery in El Paso, Texas, understands how emotionally taxing this process can be on patients. He is here to make the cosmetic portion of your transition as smooth and comfortable as possible. Dr. Agullo can transform the breasts, face, buttocks, and hips to resemble a sculpted male physique, giving trans patients the ability to feel comfortable and confident in their outward appearance.

Do You...

  • Suffer from gender dysphoria?
  • Experience social dysphoria or discomfort in public settings?
  • Wish for your true self to show in your physical appearance?
  • Want to immerse yourself in your new male identity?

Transgender Female to Male Procedure

Unfortunately, your transgender procedures cannot be completed together. Your body needs time to heal between surgeries. Dr. Agullo will provide you with an expected timeframe for your treatment that is dependent on your cosmetic needs and desires.

Regardless of the procedures that you expect to undergo, female to male transgender surgery always begins with top surgery. All of your procedures will be performed under general anesthesia to assure your comfort and safety.

Transgender Female to Male Techniques

Female-to-Male Top Surgery

Top surgery is the primary FTM transgender procedure. During surgery, the breast tissue and fat will be removed using one of the following techniques:

  • Periareolar incision: Incisions are made along the outer edge of the areola through which the tissue is removed. The remaining skin is pulled together and reattached to the areola. The nipples can also be adjusted with this technique.
  • Double incision/Free nipple graft: A U-shaped or horizontal incision is made across the breast beneath the nipple. The fat, tissue, and excess skin are removed and tightened. This technique is ideal for patients with larger or sagging breasts.

Pectoral Implants or Fat Injections

Pectoral implants or fat injections allow Dr. Agullo to mold the chest for a more masculine contour.

  • Pectoral implants insert semi-solid silicone implants into the area where the breast once was to provide natural-looking, masculine definition. Patients must wait three months after their top surgery to get pectoral implants.
  • Fat grafting is available for patients who wish to add definition to the chest but do not want implants. Fat is taken from another region of the body and transplanted into the chest.

Body Masculinization

Liposuction of the body can reduce the look of feminine contours and highlight a straighter and more masculine physique. Liposuction can be used on the hips, buttocks, thighs, and other regions of the body to remove fat cells that are contributing to feminine curves. This procedure helps eliminate the natural voluptuousness of the female form and gives you a more masculine silhouette.


Facial Masculinization

Facial masculinization allows men to attain a more angular or rugged facial appearance. Due to hormones, women and men tend to have different facial shapes and characteristics. Masculinization procedures allow men to minimize feminine facial contours and create more masculine ones. Procedures can include forehead lengthening, cheek augmentation, rhinoplasty, jaw contouring, chin recontouring, and surgery to enhance the Adam’s Apple.


Hair Transplantation

Hair transplantation allows a female-to-male transgender patient to grow facial or body hair in the areas he desires. Facial hair transplant surgery gives trans men the ability to attain natural-looking beards, mustaches, or sideburns while improving confidence in their physical appearance.


Preparing for Your Surgery

Being emotionally and physically prepared for your surgery/surgeries will help to ensure that your recovery goes smoothly. Dr. Agullo will provide you with detailed instructions on how to prepare for your procedure and how to take care of yourself afterward. Typically, patients are expected to:
  • Stop smoking at least two weeks before the surgery.
  • Avoid eating or drinking anything after midnight on the morning of your procedure.
  • Refrain from using lotions, sunscreen, bath products, or scented soap on your chest, breasts, stomach, arms, and other regions close to the breasts.
  • Ask a friend to drive you to and from the surgery, as you will not be able to do so.
  • Bring your ID and paperwork.
  • Wear a loose-fitting, button-up shirt. You will not be able to stretch over your head after the procedure.

Transgender Female to Male FAQs

What do I need to be considered for this procedure?

Before patients are cleared for female-to-male procedures, they must prove that they are physically and emotionally ready for the transition. Potential candidates must present a written letter from a primary care doctor, psychologist, gender therapist, or psychiatrist, stating that the patient is ready for the next phase of their gender transition. Medical clearance is not negotiable.

Patients over the age of 40 must also present proof of a normal mammogram before undergoing female-to-male top surgery.

Do I need to be on hormone therapy to qualify?

Patients are not required to be on hormone therapy. However, many are, as this is often a requirement for insurance companies. If you are participating in hormone therapy, you may need to stop before and after your procedure.

What can I expect from recovery?

Patients’ recoveries will depend on the surgical procedure/s that they undergo. Patients can, however, expect to be sore, swollen, and bruised. Pain can be remedied with a prescription or over-the-counter pain medication. Top surgery patients will be wrapped in a compression garment that will reduce swelling, promote circulation, and aid in the overall healing process. Bandages and dressings will be applied to all incision sites, and you will be given instructions on how to care for these incisions during your consultation. Patients should refrain from taking aspirin or using any kind of tobacco product. Your results will gradually become apparent as the swelling decreases.

As with any surgical procedure, there is an element of risk. Contact your doctor immediately if you experience:

  • Dizziness
  • Shortness of breath
  • Increased heart rate
  • Chest pain
Is there a chance of getting breast cancer after top surgery?

After your female-to-male top surgery, the risk of developing breast cancer is significantly reduced; however, it is not completely eliminated. Although a mastectomy removes the breast tissue, there is no way to be sure that all potentially cancerous tissue is removed. Mammograms will no longer be required, but you should be mindful of your chest and any irregularities that you may find.

Why choose Dr. Frank Agullo?

Dr. Agullo is a board-certified, award-winning plastic surgeon practicing in Southwest, Texas. He is highly qualified and has spent years performing thousands of plastic surgery procedures, including many transgender procedures. He is enthusiastic, compassionate, and understands that the decision to undergo the transition process is one that is not taken lightly. During the consultation, Dr. Agullo offers patients a preview of their results with the VECTRA® XT 3D Imaging System.

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