Gender Affirmation Surgery

Gender affirmation surgery describes a range of surgical procedures that modify a person’s physical characteristics to align with their gender identity. The term encompasses chest surgery, facial surgery, body contouring, and genital surgery — performed individually or in combination depending on the patient’s specific goals and areas of dysphoria.

At Centre for Surgery, gender-affirming chest surgery is performed by Dr Spiros Vlachos and Mr Andreas Shiatis, two consultant plastic surgeons on the GMC Specialist Register with subspecialist experience in gender-affirming surgery. Facial feminisation surgery (FFS) and tracheal shave are performed by Dr Shehab Jabir, Consultant Facial Plastic Surgeon. All procedures take place at our CQC-regulated Baker Street clinic, which holds an overall rating of "Good" from the Care Quality Commission.

A two-week mandatory cooling-off period applies after every consultation. No referral or gender clinic letter is required — adults aged 18+ can self-refer directly. 0% APR finance is available through Chrysalis Finance.

RELATED: Gender Surgery hub — all procedures | Evolution of Transgender Healthcare in the UK

Gender affirmation surgery vs sex reassignment surgery (SRS)

Language around transgender healthcare has evolved. The older term "sex reassignment surgery" (SRS) reflects a medical model that assumes a person is born with a sex which is then reassigned through surgical intervention. In current practice the preferred term is "gender affirmation surgery" — reflecting that the surgical procedures involved affirm an individual’s existing gender identity rather than reassign it.

Both terms refer to the same group of surgical procedures: chest surgery (top surgery and breast augmentation), facial surgery (FFS and tracheal shave), body contouring, and bottom surgery (vaginoplasty, phalloplasty, metoidioplasty). Centre for Surgery offers chest surgery, facial surgery, and body contouring; bottom surgery is not performed at our clinic.

Gender-affirming procedures available at Centre for Surgery

Centre for Surgery offers comprehensive gender-affirming surgical care under one roof for transgender men, transgender women, non-binary, and gender-diverse patients. The appropriate combination of procedures is determined at consultation based on each patient’s anatomy, areas of dysphoria, and specific goals.

For transgender men and non-binary individuals seeking a flatter, more masculine chest contour, all five FTM/N top surgery techniques are available at Centre for Surgery:

The technique is selected based on chest size, skin elasticity, and patient goals. Your surgeon will assess your anatomy at consultation and recommend the most appropriate approach. From £9,500.

For transgender women and non-binary individuals seeking a fuller, more feminine chest:

What does gender affirmation surgery involve?

The procedure depends entirely on which intervention is being performed. All surgical procedures at Centre for Surgery are performed under TIVA (Total Intravenous Anaesthesia) — the safest form of general anaesthesia for day-case surgery, using only intravenous agents with no inhaled gases. TIVA produces faster emergence, less post-operative nausea, and quicker discharge than traditional general anaesthesia.

Standalone tracheal shave can be performed under local anaesthetic with optional sedation. All other procedures are performed under TIVA.

All procedures are performed as day cases — you go home the same day once recovered from the anaesthetic. A small number of patients undergoing comprehensive combined FFS may stay overnight; this is discussed in advance.

Am I suitable for gender affirmation surgery?

Suitability for gender-affirming surgery depends on the specific procedure being considered and is confirmed at a face-to-face consultation with your surgeon. There is no single set of criteria that applies to all gender-affirming procedures — each is assessed on its own terms.

These differ from NHS gender pathways and from some private providers. Your surgeon will discuss your individual circumstances openly at consultation. A mandatory two-week cooling-off period applies from the date consent is given to all surgical procedures.

How to prepare for gender affirmation surgery

Pre-operative preparation depends on which procedure is being performed. Detailed procedure-specific guidance is provided at your pre-operative assessment. The general principles below apply to all gender-affirming surgery at Centre for Surgery.

Stop all nicotine products — cigarettes, vaping, patches, gum — at least four weeks before and four weeks after surgery for soft tissue procedures. For bone procedures (forehead contouring, jaw contouring, genioplasty), six weeks of cessation before and after surgery is required. Smoking impairs wound healing, increases infection risk, and is a particular concern for nipple graft viability and bone healing.

Stop blood-thinning medications and supplements — aspirin, ibuprofen, fish oil, vitamin E, ginkgo biloba — for one to two weeks before surgery unless otherwise directed. Discuss your full medication list at consultation. If you are on hormone therapy, do not stop without guidance from both your surgical team and prescribing clinician.

For TIVA procedures: no food for six hours before surgery; clear fluids only up to two hours before. For local anaesthetic procedures: eat normally.

Arrange a responsible adult to take you home and stay with you for the first 24 hours. Wear comfortable loose clothing on the day. Fill prescriptions in advance. Prepare a comfortable recovery area at home with everything within easy reach.

Recovery after gender affirmation surgery

Recovery varies significantly depending on the procedure performed. The general guidance below applies to chest surgery; FFS and body contouring follow procedure-specific recovery profiles.

Centre for Surgery is regulated by the Care Quality Commission, with an overall rating of "Good".

RELATED: Recovery after MTF Top Surgery | Recovery after FTM Top Surgery

How much does gender affirmation surgery cost in London?

Indicative pricing at Centre for Surgery:

All prices include:

0% APR finance is available through Chrysalis Finance, subject to status. Gender-affirming surgery is classified as cosmetic by most UK private insurers and is not typically covered, though exceptions exist for procedures deemed medically necessary for gender dysphoria treatment.

RELATED: How Much Does MTF & FTM Top Surgery Cost In London? | How Much Does FTM Top Surgery Cost in the UK?

Gender Affirmation Surgery FAQs

Gender dysphoria is the distress that arises from a mismatch between a person’s gender identity and their physical body. It can affect mental health, social functioning, and quality of life. Treatment options include social transition, hormone therapy, surgery — or any combination of these. Not everyone with gender dysphoria pursues surgery, and surgery is not a clinical requirement for any particular gender identity.

For those who do pursue surgery, gender-affirming procedures address the specific physical features that contribute to dysphoria. The choice of which procedures to undergo — and in what order — is highly individual.

No. Adults aged 18+ can self-refer for any gender-affirming procedure at Centre for Surgery — no GP referral, no gender clinic letter, and no diagnosis of gender dysphoria is required. You can book a consultation directly by calling or emailing

A mandatory two-week cooling-off period applies after every consultation before surgery is booked, regardless of how certain you are about proceeding.

We operate on adults aged 18 or over only. Centre for Surgery does not perform gender-affirming surgery on minors under any circumstances.

This depends on the specific hormone therapy and the procedure planned. Standard feminising or masculinising hormone therapy at typical doses does not usually require cessation before surgery. Some hormone treatments — particularly those with thrombotic risk — may require a pause before surgery under TIVA, in line with standard pre-operative guidelines.

Your surgeon and anaesthetist will review your specific hormone regimen at pre-operative assessment. Do not stop any prescribed medications without consulting your prescribing doctor and your surgical team.

All chest surgery, FFS, and body contouring procedures are performed under TIVA (Total Intravenous Anaesthesia). Standalone tracheal shave can be performed under local anaesthetic with optional sedation. TIVA is the safest form of general anaesthesia for day-case surgery — using only intravenous agents with no inhaled gases.

Yes — all surgical procedures involving an incision result in scarring. Scar location, length, and visibility depend entirely on the procedure performed. For top surgery, scar position varies by technique: keyhole produces the least visible scars (confined to the areola border); double incision and inverted T produce horizontal lower-pectoral scars; periareolar scars are confined to the areola margin.

Final scar appearance is not assessable until at least 12 months post-operatively. Silicone gel from six weeks post-operatively, sun protection on healing scars, and non-smoking throughout recovery all support optimal scar quality.

All surgical procedures carry risks. The specific risk profile depends on which procedure is performed. General risks include bleeding, infection, wound healing complications, asymmetry, and unsatisfactory aesthetic outcome requiring revision. Procedure-specific risks are discussed in full at consultation. See our individual procedure pages for detailed risk information.

RELATED: Risks and complications of cosmetic surgery | Risk of nipple loss in FTM top surgery

This depends on which procedures you have. Top surgery and body contouring do not affect reproductive organs and do not, on their own, prevent biological parenthood. Hormone therapy can affect fertility while taken; this should be discussed with your prescribing clinician. Bottom surgery (not performed at Centre for Surgery) typically does affect future biological parenthood — sperm banking or egg/embryo preservation should be considered before bottom surgery if biological parenthood is a goal.

Most UK private insurers classify gender-affirming surgery as cosmetic and do not cover it. Some policies cover specific procedures deemed medically necessary for gender dysphoria treatment — check directly with your insurer. The NHS provides gender-affirming surgery via specialist gender pathways with significant waits (typically 12–18 months or longer). Self-funded private surgery at Centre for Surgery is typically schedulable within weeks of consultation.

Centre for Surgery welcomes transgender, non-binary, and gender-diverse patients. We use inclusive language throughout, ask about and use your affirmed name and pronouns, and approach gender-affirming care with respect for each patient’s individual identity and goals. Our clinical team is experienced in gender-affirming procedures and the specific medical considerations relevant to transgender and non-binary patients.

Why choose Centre for Surgery for gender-affirming care?

Chest surgery is performed by Dr Spiros Vlachos and Mr Andreas Shiatis. FFS and tracheal shave are performed by Dr Shehab Jabir. All three are consultant plastic / facial plastic surgeons on the GMC Specialist Register. You can verify their registration directly on the GMC website.

Our Baker Street clinic is regulated by the Care Quality Commission, with an overall rating of "Good". The CQC inspection report is publicly available, and we encourage patients to read it before booking.

Adults aged 18+ self-refer directly. No GP letter, no gender clinic referral, no mandatory diagnosis of gender dysphoria, no mandatory psychological assessment, no mandatory hormone therapy.

All procedures are performed under TIVA — the safest form of general anaesthesia for day-case surgery.

Standard practice for all surgical procedures. No surgery is scheduled before this period has elapsed.

Available through Chrysalis Finance, subject to status.

Chest surgery, facial surgery, and body contouring all performed at the same Baker Street facility. Patients requiring multiple procedures can plan a sequenced approach with the same surgical team.

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Centre for Surgery is a CQC-regulated private hospital on London’s Baker Street, delivering plastic and cosmetic surgery through GMC-registered specialist surgeons. Our expertise spans facial procedures including rhinoplasty and facelift surgery, breast surgery, gynaecomastia surgery for men, and body contouring procedures such as liposuction and tummy tuck surgery. Patient safety, surgical excellence and natural-looking results sit at the heart of everything we do.

Centre for Surgery is a CQC-regulated private hospital on London’s iconic Baker Street, offering plastic and cosmetic surgery led by GMC-registered consultant surgeons.

95-97 Baker Street

Marylebone

London

W1U 6RN

Mon Mesotherapy – WOW Fusion® Sat, 9am – 6pm

Saturday consultations available

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