To most people, the ideal female form is the shapely “hourglass”—think of the tiny waist and curvy hips of women like Marilyn Monroe, Scarlett Johansson, and Kim Kardashian. Body feminization surgery is an option for transwomen who would like to obtain this feminine ideal, and for those who would simply like to appear more traditionally feminine. Typically, body feminization surgery includes trunk liposuction combined with buttocks augmentation. These procedures offer a number of benefits, including an improved self-image and self-esteem, increased congruence between one’s appearance and one’s gender identity, and the ability to more effectively “blend in” in society as a woman.
While estrogen is produced by both males and females, females have higher levels of this hormone in their bodies. The effects of estrogen are responsible for the physical qualities that we typically think of as feminine, such as breasts, lack of body hair, and the characteristic distribution of fat. Thanks to estrogen, genetic women tend to store body fat in their hips, thighs, and buttocks. Similarly, testosterone causes genetic men to carry weight in the middle of the body, around the waist and abdomen. A waist-to-hip ratio of 0.7 is considered most attractive in women, while a ratio of 0.9 is preferred for men. For some transwomen, hormone therapy is effective in shifting body fat distribution to create a feminine body contour. This is particularly true for those who begin transitioning in their teens or early twenties, as these patients haven’t been exposed to as much testosterone over the years. Most older transwomen, as well as those seeking a very defined hourglass shape, will require body feminization surgery in addition to hormone therapy.
There are three defining characteristics of the female form—breasts, round buttocks, and a low waist-to-hip ratio. Buttocks augmentation, also known as the “Brazilian butt lift”, is the preferred procedure for achieving a shapely, feminine backside. Generally, the male buttocks lack projection and are fattier in the flank areas, resulting in a semi-flat presentation with minimal curve in the lower back. In contrast, the female buttocks tend to be rounder and fuller, with increased projection and an “s-curve” silhouette. The Brazilian butt lift procedure allows the transwoman to obtain a feminine backside and improve her waist-to-hip ratio via a less invasive, natural augmentation called fat transfer. Essentially, fat transfer involves using liposuction to move fat from an area of the body where it is unwanted, to an area of the body where it is more desirable.
The Brazilian butt lift is a very safe procedure with a low risk of complications. In fact, it is often performed using conscious sedation, which means that the patient is awake but relaxed. During the surgery, fat is first suctioned from the donor site. It is then purified and carefully injected into the buttocks. While any part of the body can serve as the donor site, transwomen typically undergo trunk liposuction, which means the fat is removed from the waist area to provide a more feminine contour. Because it is a natural element of the body, using the patient’s own fat to augment the buttocks offers a safe enhancement with beautiful, natural results.
Patients who undergo Brazilian butt lift should expect to experience some temporary swelling, bruising, and pain during their recovery. Your body may also reabsorb some of the fat that was injected, so your surgeon may opt to “overfill” a bit to counteract this effect. While the risk of more serious complications is low, these can include bleeding, fluid build-up, infection, or scarring. One caveat: Brazilian butt lift is not generally a good option for very thin patients, as there must be sufficient body fat available for transfer. For these patients, silicone implants may be a better option. Your surgeon can help you to decide which route is preferable for your unique anatomy.
Trunk liposuction is the preferred procedure for achieving an ideal waist-to-hip ratio, with a tapered waist and curved, feminine hips. Depending on the patient’s individual needs, areas targeted by trunk liposuction can include the waist, abdomen, “love handles” and mid/lower back. Removing unwanted fat from this region can result in a streamlined, more contoured silhouette. As with buttocks augmentation, this procedure is very safe. Trunk liposuction is usually completed in about an hour using only light sedation and local anesthesia. Tiny incisions are made in the target areas, and the unwanted fat is gently suctioned out. The fat can then be transferred to the buttocks region if the patient has opted for a Brazilian butt lift.
Recovery time for trunk liposuction is typically minimal. It is normal to experience some swelling, bruising, and pain at first, but most patients are able to resume light activity within a few days and return to work within one week. While serious complications are rare, these can include fluid build-up, infection, blood clots, or nerve damage. For this reason, it’s important to choose a highly skilled and experienced surgeon for your trunk liposuction procedure.
At ICTC, we know that each patient has her own unique needs and expectations, which is why we take an individualized, patient-centered approach to gender transition services. During the preoperative consultation, your surgeon will take the time to discuss and understand your goals for body feminization surgery. He will also perform a physical exam of the lower body, which will help to determine the best body feminization procedure for your unique anatomy. Additionally, he will thoroughly explain the procedure and answer any questions you might have.
Body feminization is a vital component of the transwoman transition, offering many physical and psychological benefits. Because this procedure is so important, it is paramount to choose a surgeon with specialized knowledge and skill. At the International Center for Transgender Care, our board-certified surgeons have more than 20 years of experience treating transgender patients. We are proud to offer all of our services in a respectful, welcoming environment at our world-class surgical center in Dallas, Texas. We look forward to assisting you in achieving the very best possible results for your buttocks augmentation and trunk liposuction. Contact us today to schedule a consultation at (972) 543-2477.