MTF | Plastic Surgeon McLean VA | Chevy Chase MD
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MTF

MTF Plastic Surgery

The MTF (male to female) transition is a process. Hormone therapy and other types of preparation may be required.

As always, our consultations are FREE.

Dr. Navin Singh carefully assesses your long-term goals and will accommodate your transitional timeline ideals as best as is possible. We would love to be a part of your Transition Journey.

Facial Restructuring

The Male to Female transitioning process can be a series of procedures all designed to meet the specific goals of the patient. Facial Restructuring is not a one-size-fits-all decision every individual body is unique.

Likewise every face requires a custom process to produce the best final results and ideal image.

Dr. Singh’s depth of reconstructive experience will help to guide the process to the healthy, and beautiful results that form the female physique.

Procedures to consider:

Trach Shave– While vastly improving the feminine neck angles, a trach shave is a surgery that has certain risks involved, and should be discussed with Dr. Singh in person. An incision of about 2 cm is placed under the chin, if possible inside a crease. From there a tunnel under the skin is made until the thyroid cartilage. With a bur it’s prominence and upper rim are trimmed. The muscles that run along and over the cartilage are united in the middle to cover the remaining prominence.  This results in a smoother appearance of the neck.

Laser Hair Removal– Removal of a beard and other unwanted facial hair is a process of stopping hair from growing out of the hair follicle through the use of a laser. Once the treatments begin it will depend on how the hair follicle reacts as to the amount of subsequent treatments needed for the desired end result. Also this option works best on dark haired patients and results may vary due to other skin requirements.

Rhinoplasty– Surgery of the nose can greatly affect the perception of male to female transitioning. The button nose that is usually seen on the supermodel has a narrow bridge and a button like tip. For a sexier lady like nose, a patient may choose to change the contour lines of the nose to show a more subtle bridge and upturned tip.

Fat Grafting to Lips and Forehead: If Liposuction is performed to the body fat grafting may be a softening option to produce a gentler rise of the forehead.

Fillers for the Lips– Everyone desires the Angelina Jolie sensuous pout. Finding the right amount of curvy enhancement filler ratio is crucial. If overdone can result in an un-feminine quality.  Dr. Singh will guide the process for the perfect kissable lips.

Latisse– Eyelashes reveal feminine eyes. Dr. Singh may prescribe a prescription for an eyelash growth product. This can help facilitate longer luscious lashes without any surgical needs.

Other options may be considered with an in person consultation. Our consultations are free and exploring options is the best way to evaluate if you are a good candidate for any procedure.

Top Surgery

Breasts are one of the most feminine features of a woman’s body. For many MTF patients, feminizing hormones produce mild to moderate breast development.

While some individuals are quite satisfied with their results, some do not feel that they have achieved the fullness that they desire. A breast augmentation can enhance breast size, playing an important role in the feminization process.

Before MTF Breast Augmentation Surgery

Prior to breast augmentation surgery, a thorough examination is taken to evaluate your general health. Your doctor will go over the type of anesthesia to be used, the procedure, what results might realistically be expected and the possible risks and complications.

Preoperative instructions are important and include avoiding certain drugs, like aspirin that can cause excess bleeding. Antibiotics will be prescribed to prevent infection.

Photographs are taken before and after surgery in order to evaluate the final results. Birth control and other estrogen containing hormones may also be discontinued temporarily for the same reason.

The MTF Breast Augmentation Procedure

Breast augmentation is usually performed under general anesthesia with the patient asleep. Your surgeon may choose from a variety of surgical procedures, depending upon what changes are desired. The type of incision used will be determined by the goals of the patient.

The traditional incisions are around the nipple or under the breast. The disadvantage of these incisions is leaving a scar on the anatomy we are trying to improve. Although these scars often fade with time, avoiding them is best.

If saline implants are used, a fantastic way to avoid breast scars is using the arm pit incision. A breast implant containing a silicone gel, a saline solution, or a combination of the two is inserted into the pocket which can be created above or below the chest muscle. In some cases, particularly those in which there is breast asymmetry, inflatable breast implants may be used. With this procedure, your surgeon can adjust the amount of inflation.

After the breast implants are securely in place, small sutures are used to close the incisions. A breast augmentation typically takes less than an hour, depending upon the procedure and extent of the surgery.

Following MTF Breast Augmentation Surgery

Following breast augmentation surgery, the patient wears a surgical bra which is worn for several weeks. Pain connected with breast augmentation is controlled with oral narcotic medication. Antibiotics are prescribed to prevent infection. Normal activities everyday activities are typically resumed in 1 week; however, strenuous exercises and overhead lifting must be avoided for one month.

The stitches that we use dissolve and do not need to be removed. Complications of infection and slow healing are rare; however there are certain inherent risks connected with every surgical procedure and will be thoroughly discussed with your doctor.

Patients can minimize complications by carefully following directions given. In some cases in which the breast becomes too firm due to the formation of scar tissue, called capsular contracture, a second breast augmentation procedure may be necessary.

Body Contouring

Body Contouring with SmartLipo 

All bodies, whether male or female, come in different shapes and sizes.  Genetic females store fat a lot easier than men. Women’s’ bodies store fat in different areas such as the hips, buttocks and thighs – but not usually around the waist. As a result, their bodies appear curvier and more voluptuous – which is something many transgender women worry about during their physical transformation.

Though it’s possible to achieve a feminine form through a variety of surgical and lifestyle choices, it’s important to recognize the natural differences in body types between men and women, and to form realistic expectations based on your natural physical form.

No two women’s bodies are the same. The female form comes in many different physical packages, all which are beautiful in their own way.

Liposuction, also known as lipoplasty or liposculpture, is a body-sculpting procedure to remove fat deposits that are unresponsive to dieting and exercising.  This procedure can be applied to many different areas of the body.  Liposuction results in a slimmer and better proportioned figure.

In the abdomen, liposuction can be used alone to decrease flank fullness (“love-handles”), and decrease the thickness of the abdominal wall.  Sometimes, it is used in conjunction with an abdominoplasty, or tummy tuck, to provide the patient with the best possible results.

This mainly depends on the amount of excess skin and the quality of the skin in the abdomen, which will be evaluated during your initial consultation. This procedure can also be done in conjunction with other procedures such as the tummy tuckfat grafting, breast augmentations in order to help contour the body to fit the desires of the patient.

Reasons for Considering Liposuction

-Create a more proportioned figure

-Contour the body

-Eliminate fat from any of the following areas:

-Chin and Neckline

-Back

-Upper Arms

-Stomach and Waistline

-Hips and Buttocks

-Thighs and Knees

    –Calves and Ankles

Liposuction versus Diet and Exercise

Liposuction is not a replacement for proper exercise and diet.  Patients that have excess weight will do better by starting with a professional diet regimen such as Weight Watchers® and with a regular exercise regimen.

Once natural weight loss is achieved, which takes a number of months, liposuction can be used to address stubborn areas to complete the transformation. 

How Many Areas Can I Have Done?

Several areas can be liposuctioned on the same day.  For your safety, we generally limit liposuction to approximately five liters of “aspirate”.

For some people, only one or two areas can be done before reaching this level, for others, four or five areas can be done.  This all depends on the amount of preexisting fat in the region. 

Who Is A Good Candidate For Liposuction?

Liposuction is a popular procedure for persons looking to improve their body contour by reshaping areas of excess fat.  The best candidates are people looking to remove fat deposits resistant to diet and exercise. 

Anesthesia

Liposuction is generally done under general anesthesia or under intravenous sedation.  When administered by a certified anesthesia provider, these techniques are very safe and provide patients with a comfortable experience.  Smaller areas can be performed under local anesthesia only where the area is numbed and the patient remains awake.

Make sure, however, that the provider offering to perform liposuction under local anesthesia in the office still has privileges to perform the procedure in a surgical facility under general or intravenous sedation.  This will assure that he or she is recognized as qualified to perform the procedure by his or her peers. 

General Procedure

Through tiny incisions in the skin, an infiltrating canula is inserted and “tumescent” fluid is infiltrated.  This fluid consists of a mixture composed of lactated ringer’s solution mixed with a local anesthetic (lidocaine), mixed with a constrictor of the blood vessels to decrease bleeding (epinephrine).

The solution is massaged and given time to work.  The amount of solution can differ between techniques ranging from a “super wet” technique where approximately the amount infiltrated is the same as the planned aspiration, to a “tumescent” technique where even more fluid is inserted.  The technique used will depend somewhat on the amount of total aspiration planned and your body habitus.

After the infiltrate is given time to work, a narrow tube or “canula” is inserted and used to vacuum out the fatty tissue beneath the skin.  Different sizes of canulas with different lengths and apertures will be used according to each patient’s fat location.  The surgeon determines the amount of fat to be removed by massaging the skin and squeezing the tissue.  After eliminating the excess fat, the incisions are closed. 

Compression

A compression dressing or bandage is applied to the area and will need to be worn for an extended period of time (approximately six weeks).

This will prevent bleeding, reduce swelling, and support the affected area.  There are a variety of specialty garments manufacturers that provide specialized wear for liposuction patients. 

Variations on Techniques

There are several different types of “newer” liposuction procedures, such as ultrasonic and power assisted liposuction, that has developed as a result of recent advancements in new technologies.  These are especially useful in targeting areas where the fat is more fibrous, such as in the back or breast.

Together, the patient and the surgeon can discuss which method(s) are best during the initial consultation visit.  Liposuction can last from thirty minutes to several hours depending upon the amount of fat to be removed.

Liposuction surgery is an excellent procedure that can benefit those who want to remove unattractive fatty deposits. Lasers may be used to enhance the lipolysis and skin tightening associated with liposuction 

Recovery Process

The length of the recovery will depend on how extensive of an operation the patient undergoes.

A support garment may need to be worn for several weeks after the surgery, depending upon which area(s) are selected to utilize the liposuction procedure.

Patients sometimes report minor pain associated with surgery which can be treated effectively with oral medication.