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Frank Agullo, MD En Español

Transgender Male to Female

Transgender Procedure: Male to Female

If you know deep in your heart that you were meant to be born of the opposite gender, and are ready to take the next steps and undergo plastic surgery for sexual reassignment, Agullo Plastic Surgery in El Paso is here for you. We handle all of the less invasive gender-confirming surgery, except removal of “the goods”. To transition from male to female, you may wish to have a breast augmentation, Brazilian Butt Lift, and feminizing rhinoplasty, as well as lipo in the areas you wish to create a more voluptuous appearance.

Most men who come to us and wish to transition to the female gender have already decided that yes, they would be happier in a female physique. Perhaps you are at this stage, and whether or not you have been taking hormone treatments, this is the right time to talk to our world-class plastic surgeon.

Our board-certified, award-winning plastic surgeon in El Paso, TX takes a compassionate approach with his clients. Dr. Frank Agullo is a very skilled, reputable, plastic surgeon in Southwest Texas. He has nearly two decades of experience in performing procedures, and with an extremely high success rate.

The first stage in changing from male-to-female is to schedule a consultation and see what you will look like after the procedure is done. Dr. Agullo will show you the after pictures, using a remarkably accurate, 3D Vectra Imaging system. How cool is that? This system can help you determine whether male to female transgender surgery in El Paso is a good solution for you.

Requirements and Expectations for M to F Transgender Surgery

We are enthusiastic about your life transforming decision and will make every best step to ensure your ultimate success. Agullo Plastic Surgery does require medical permission due to the seriousness of the surgery. All patients seeking Male to Female transformation must get the okay from either a family doctor, gender therapist, psychiatrist or psychologist. It must state that you are ready for the next step in your journey of transformation or something to that effect.

If you desire, Dr. Agullo can do your entire body, from face to breasts, abs, hips and butt augmentation. We offer head-to-toe enhancement, except for removal of the male genitalia. However, we can recommend a doctor who can do this for you, if you truly want to go that extra step.

After Dr. Agullo gets you prepared mentally and physically, you will truly look like a feminine version of yourself. Your physical appearance will match your authentic self and your new identity will reflect accordingly. You do not have to be doing hormone treatments in order to undergo transgender operations, although sometimes our patients are already past that phase on their path to becoming a female.

The reasons you wish to change from male to female are entirely personal, but some of our patients suffer from social dysphoria or physical dysphoria, both of which are anxiety disorders that surgery can overcome. The surgery will likely give you a renewed sense of self and more confidence. At the very least, it will help you to feel more comfortable with your own body.

Procedures for Male to Female Transgender Surgery

Women have beautiful, shapely curves. To achieve that hourglass figure, a breast augmentation will be performed. The first procedure for MTF (Male-to-Female) patients will require installation of implants, also known as breast augmentation. This works better than hormone therapy and also better than “pumpers” which are dangerous and offer risky results.

In case you are unfamiliar with the term, “Pumpers” is a term that describes non-medical personnel who offer services to inject loose silicone into desired areas of augmentation, but the result can appear very lumpy and surreal, as well as potentially getting infected. Some patients become disfigured, severely scarred or worse.

It is best to choose a board certified, reputable plastic surgeon such as Dr. Agullo, who has performed hundreds of breast augmentations with very successful results. Although the male and female breast tissue only varies marginally, there are other differences which require the hands of a skilled surgeon.

Not to worry, the procedure is very straightforward and can be done right at the office as an outpatient visit. General anesthesia will be used to ensure you do not experience any pain during the procedure, but it only takes approximately an hour to do.

Types of breast implants

The type of breast implant you have will depend on your build, the desired breast size and your skin elasticity. These two are the most common type of implants:

  • Silicone Implants: Silicone implants like natural breasts, and they move and sway as such. That is because of the elastic gel used in silicone. Beware that silicone implants may be more prone to leakage if the gel seeps back into the breast pocket or if the shell collapses. Discuss any concerns with your doctor. Overall, most patients are highly satisfied with the natural feel and look of silicone breast implants.
  • Saline Implants: Saline implants are a bit more firm and filled with sterile saltwater. They are durable, but if they do happen to leak, then the saline water can be safely absorbed by your body. Again, these scenarios are rare.
  • Gummy Bear: New implants that have a more concentrated silicone gel, which reduces the potential for leaking or rupture. These saline implants are crafted with a silicone shell and saltwater formula that has been sterilized, so that in case it does break, the body absorbs the water safely and without doing any damage to your interior makeup.

Male to Female Breast Augmentation Techniques

Thanks to the ease of technology, patients now see what their breasts will look post-surgery through a marvelous Vectra 3D imaging system. Dr. Agullo will explain the specific techniques used for the transgender operation, most specifically for the breast portion of the surgery. An incision will be made just underneath the pectoral muscle, around the areolas and nipples, and under the armpits.

Rest assured that your doctor will perform these with as few visible incisions and scarring as possible, thereby positioning the implants in a way they will heal quickly and be less noticeable. You will be wearing bikinis and sexy dresses before you know it!

A combination of one or more of these three incisions is likely:

  • Periareolar: just above or below the chest muscles
  • Axillary: within the deepest point of the armpit and least noticeable incision mark
  • Inframammary: directly below the breast

Once the chest is open, the plastic surgeon will position the breast implant directly over or under the pectoral muscle, depending on your body shape and form. Implants can help you achieve any size breasts you want. B, C, D, DD cup sizes will require a judgment call on the side of the doctor as to your body type and proportion, but it is recommended not to get implants that are too heavy due to the strain on your skin and loss of elasticity. Women’s skin is already built to adjust to breasts, but a man will need to be “trained” or positioned by Dr. Agullo, depending upon your skin condition and overall health.

Then, the plastic surgeon will seal up the incisions with layered sutures around the tissue and skin. With proper care, the lines may fade.

WARNING: If you have any loose silicone from “pumpers” Dr. Agullo may need to remove this prior to any breast augmentation/implants. These pose too much of a risk to keep in your body and with unknown results. He will have to evaluate your physique prior to determining whether or not to go through with a professional breast augmentation.

Feminine Rhinoplasty and Facial Surgery

As a separate surgery, Dr. Agullo can schedule and perform a feminizing rhinoplasty, which is a common Male-to-Female technique used to obtain a more feminine face. Your nose will be narrowed and more refined, as well as decreasing the nostril size and nose to look more womanly. He can also address other areas of your face that you may wish to enhance, such as cheek implants, refining the jaw line, etc. to give your appearance a feminine tone.

Brazilian Butt Lift / Lipo for MTF Surgery

El Paso Butt Implants are available for men who wish to enhance their backside to create a more voluptuous and feminine shape. Men often have flatter or smaller rear ends than women, so the Brazilian Butt Lift is a great solution. Buttock implants will not only increase the size of your butt, but it will also help to reshape and “lift” it up higher, which looks great in form-fitting dresses, pants, jeans and more revealing clothing.

A transgender male to female buttock surgery:

  • Gives your booty a more robust, plump appearance
  • When combined with breast augmentation, gives you the hourglass figure
  • Creates a better shape for those with a flat, small or sagging derriere.
  • Makes a more voluptuous and proportioned physique

Fat transfers are one technique used by Dr. Agullo to improve the appearance and proportion of a male butt. Liposuction removes fat from one part of the body; and the surgeon then repositions it to the backside to dramatically improve the volume and lift. Using a person’s own fat stores can help you naturally achieve a shapelier and more feminine butt. Fat can be removed from other areas of the body, such as the abdominal region, back, upper legs, arms and other places where cellulite deposits exist. If the patient does not have enough fat to perform the lipo, then Dr. Agullo will work together to find another solution.

Preparing for Transgender Male to Female Surgery

Transitioning from a male to female is exhilarating for patients who decide to go through with this big step in their lives, but you are in good hands with the El Paso area’s top plastic surgeon. Dr. Agullo attracts patients throughout the entire Southwest region for his skills and aptitudes as one of the nations’ “Superdoctors”, among the many awards he has achieved.

Here are some tips to help you prepare for this MTF surgery:

  • Quit smoking at least two weeks before surgery and after. Tobacco smoking greatly increases the risk of delayed healing and/or blood clots, or more serious things.
  • Ask a friend or relative to bring you to and from the procedure. Even though it can be done as an outpatient procedure, you will need assistance driving after anesthesia.  You may feel sore and groggy.
  • Bring a physician’s note, any requested paperwork and your photo ID.
  • Wear a loose-fitting clothing; preferably a button up shirt.
  • Do not drink or eat from the night before your surgery before your scheduled procedure, as it can make you very nauseous and interfere with the anesthesia. You must arrive on an empty stomach! Even water is excluded!
  • Never use aftershave or lotions of any kind on the body parts that you will be having surgery performed.

Male to Female Transgender surgery can be done right at Agullo Plastic Surgery. If you require a more extensive transfer, such as the removal of genitalia, then Dr. Agullo can refer you to a doctor who specializes in this procedure. He can perform all of the rest of your requirements to help you on your journey to becoming a woman.

Recovering From Male to Female Surgery

For a few days, you will likely feel very sore, swollen and bruised. This is normal. Be sure to get plenty of ice packs and rest often, but don’t lie down the whole time. You want to get up and walk around some to make sure the circulation is moving through your body, otherwise you run the risk of getting blood clots. Be aware of how you feel. If you notice any shortness of breath, feelings of dizziness, rapid heart rate, or chest pain, these are warning signs for blood clots. Call your doctor right away if you experience any of these things.

Do not smoke cigarettes or take any aspirin while you are healing. After a few weeks, you will begin noticing changes and start feeling better. You can finally be who you were meant to be, and your physical appearance will reflect that!

What are the Risks in Transgender Male to Female Surgery?

As with any type of surgery, there are always some risks involved. However, most patients go through the male-to-female transgender operations with smooth sailing. Every individual heals differently; hence some people take longer than others. Factors that help you heal faster include a healthy body, mind, physical strength and simply your genetics.

Whenever you get implants – either breast or buttocks – there is always a potential risk of rupture or leakage. This is most often attributed to some type of accident or strenuous activity, which you should not be doing for a good few months following surgery. Also you should know that both saline and silicone implants are not built to last a lifetime. Although they are FDA approved and safe enough to wear, there will at some point become a time in your life when updates are needed. Keep this in mind as you go through the male to female transitioning process.

Other risks include:

  • Possibility of prolonged healing or infection
  • Hemorrhaging, blood clots or other anesthesia-related problems
  • May have some scars from incisions
  • May experience pain, bruises, bleeding, swelling or soreness
  • Possibility of leakage/rupture of butt or breast implants
  • Pulmonary or vein problems
  • Most likely will have decreased nipple sensation
  • In rare cases, some people may have to have modification surgery

Cost of M2F Transgender Surgery in El Paso

There is an expense in transitioning from male to female, but you already know this. For you, this is not about how much it costs; this is about you wanting to become your real, genuine self! We are happy to help you achieve this.

There is no “set amount” that you can be quoted until you see Dr. Agullo for a consultation. Everyone has different desires, body shape and size, and desired outcome projections. If you want to do a little bit at a time, that is fine. We can take things slowly with you, or do it all at once, depending on your needs and wants.

One exciting thing we can do for you is show you “before and after” pictures of your post-surgery outcome. Using the innovative 3D Vectra Imaging System, patients can see exactly what their surgeries will look like after they fully heal, which can help you make the smartest and best decisions for your personal circumstances and desired outcome.

If you go through the entire male to female process, from the breast implants, lipo, butt augmentation and facial surgeries, the entire package will be most likely in the neighborhood of $20,000 to $??,000. However, if you do these things just a little bit at a time, Dr. Agullo will give you accurate estimates that are based on your body type, proportion and desired outcomes. Agullo Plastic Surgery is a top quality, board certified plastic surgery facility to achieve Male-to-Female Transgender Surgery in El Paso, TX or Las Cruces, NM. We serve patients throughout the Southwest region with exceptional customer service. Our compassionate team is dedicated to helping your dreams of becoming a woman come true!

Come, talk to us today. Schedule an appointment. Call 915-590-7900 or contact us to set up your no-obligation visit.


Schedule a risk-free evaluation with Dr. Frank Agullo today.