Gender Affirmation

Gender Affirmation Surgery

At West End Plastic Surgery, Dr. Ruff and our team are happy to offer the most advanced, personal care in your transition process. Dr. Ruff is a member of the World Professional Association for Transgender Health (WPATH). At West End Plastic Surgery, our surgeons and team are well versed in making your experience as comfortable and informative as possible. Our AAAASF accredited Class C Operating Suite affords our patients one on one care with maximum discretion.

portrait half woman half man, androgyny concept

Female to Male Top Surgery

We offer all types of procedures for the reduction of breast tissue to allow you to lead life without having to bind anymore. Most patients are well versed in the more common techniques of mastectomy including a standard incision with free nipple grafting and keyhole technique.  We also offer liposuction with J-Plasma skin tightening to provide a virtually scarless technique for select patients.

Mastectomy with Free Nipple Grafting

This is the most common technique we use at West End Plastic Surgery. The surgeon makes an incision in the inframammary fold and carries it to the side (usually along the border of the “pec” muscle shadow) for the best contour. Your surgeon removes and resizes the nipple to create a typical cis-male position, shape, and size (2X2.5 cm oval).

The pros of this technique is that it creates a great contour, excellent areolar shape/position and removes excess skin. With this technique, there is loss of nipple sensation and loss of pigment. The loss of pigment can be tattooed back on. This technique also leaves a larger scar and sometimes “dog ears” that may need revision under local anesthesia.

Keyhole Incision

For this technique, your surgeon removes the breast through an incision in the areolar border. The nipple can be resized and moved. This technique is best for patients with minimal excess skin.

The keyhole incision involves smaller incisions and faster healing. There is a possibility to retain some nipple sensation and patients are less likely to lose pigment. Unfortunately, this procedure is not possible in all patients. There is still a chance of some excess skin that may need to be removed in the future. Areolar spread is also a possibility.

Liposuction + Renuvion (J-Plasma)

In the past, we have successfully used tiny incisions with VASER liposuction to remove breast tissue and obtain some tightening of the skin. This has worked well in patients with minimal breast tissue and excellent skin tone. The issue was that most patients did not fit into this category.

Renuvion (J-Plasma) is the newest cutting-edge technology that uses radiofrequency and plasma energy to contract skin much more effectively than any other device used in the past. This allows us to combine VASER liposuction with the Renuvion (J-Plasma) to tighten skin and remove breast tissue on patients with even larger breasts and whose skin tone is not perfect.

With this technique there is virtually no scarring, no nipple loss, Patients are likely to keep nipple sensation and results are permanent. For patients choosing this technique, insurance will not cover this procedure. They may also need touch-up surgery to shrink and reposition the nipple/areola.

Male To Female Top Surgery

At West End Plastic Surgery, we strive to give patients the perfect breasts. At your consultation, we have an extensive discussion about your goals and how you want your breast to look. We offer small incision augmentation with silicone implants and can give you the breasts you’ve always wanted in about an hour. We modify the techniques to make the breasts as feminine as possible and frequently perform revisions for surgery performed elsewhere in the United States or internationally.

Facial Feminization

Facial feminization is a particular focus of expertise for the surgeons at West End Plastic Surgery.  We perform both facial feminization and masculinization procedures to have your face match your identity. We offer the full range of procedures including:

  • Rhinoplasty – In the center of your face, your nose is likely one of the first things that people see when you are in public. Whether it’s a more delicate nasal tip, a large hump that needs to be reduced, or a nose that’s too wide for your face, we can help you achieve your ideal aesthetic with rhinoplasty. We also have Vectra 3D imaging that can help you visualize what your nose will look like after surgery.
  • Jaw Surgery – Whether it’s a chin augmentation with an implant, filler or fat, a chin reduction, mandibular angle implants for a square jaw, or fat grafting and angle shaving for a smooth contour, we at West End Plastic Surgery can work with you to define how you want your lower face to appear. We perform bone remodeling, implants, and fat and filler injections.
  • Cheek Surgery – We can perform cheek augmentation with deep fillers, cheek implants placed through the mouth, or facial fat grafting. This can give you the prominent/high cheekbones that you’ve always wanted.
  • Forehead Reduction – Through small incisions in the hairline, we can reduce your brow bone. We can do this with burring/shaving or in some cases a bone setback to reduce the prominent brow ridge. Your hairline can also be advanced to round out and feminize your hairline and shorten your forehead.
  • Other Procedures – Facial aging procedures, Botox, fillers, J-Plasma, and eyelid surgery are for everyone.

Body Contouring

Your general body shape, muscle structure, and fat distribution can certainly masculinize or feminize your body. The use of liposuction, fat grafting and body implants can help achieve your goals of transitioning. We offer “manscaping” liposuction to masculinize your body by removing fat deposits from areas that are typically feminine areas – inner and outer thighs, lateral chest, etc. Similarly, fat grafting to the buttock area (Brazilian butt lift), hips and thighs can feminize your figure. Body implants such as pec implants, buttock implants, bicep/tricep, and calf implants can also be used to contour your figure.

Schedule a Consultation

To learn more about any of these gender affirmation procedures, contact West End Plastic Surgery. Call us at 202-785-4187 to schedule a consultation with Dr. Ruff. Our practice serves Washington D.C. and surrounding areas.

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