Be Who You Truly Are

Gender-affirming surgeries are an essential aspect of gender-affirming care for many individuals. These procedures can have a significant positive impact on a person's mental health and well-being by aligning their physical body with their gender identity.

As you consider undergoing gender-affirming surgery, it's crucial to find a highly skilled and experienced surgeon who specializes in such procedures. Dr. Trey Sands is a reputable and dedicated surgeon who has performed over 500 surgeries for transgender individuals. Known for his unique technique in creating a more masculine appearance, Dr. Sands' approach involves the formation of a pec and curves that resemble the natural male physique. Many patients, even those from far away locations like New York, travel to New Orleans for his expertise.

Types of Surgical Procedures

Gender-Affirming Chest Surgery

Chest surgeries transform the upper body region to achieve a more gender-aligned appearance. Options include the following:

FtM Top Surgery

Top surgery for female-to-male (FtM) individuals, commonly known as a double mastectomy, is a crucial component of gender-affirming care for those seeking to align their physical appearance with their male gender identity. Here’s what you need to know:

  • This procedure involves the removal of breast tissue and excess skin from the chest, resulting in a more masculine chest contour. In addition to the mastectomy, many FtM individuals opt for nipple resizing and repositioning to further enhance the appearance of their chest, creating a more typically male aesthetic.
  • The double mastectomy with nipple resizing and repositioning not only helps FtM individuals alleviate gender dysphoria but also plays a significant role in affirming their gender identity. By masculinizing the chest and repositioning the nipples to align with male anatomy, this procedure can have a profound impact on the individual's self-image and overall well-being.
  • Furthermore, the customization options available in nipple resizing and repositioning allow for a tailored outcome, enabling FtM individuals to achieve a chest appearance that reflects their unique identity and aesthetic preferences.

MtF Top Surgery

Top surgery for male-to-female (MtF) individuals often involves the insertion of breast implants to enhance the size and shape of the chest, contributing to a more feminine appearance. This procedure plays a crucial role in gender affirmation for many MtF individuals, as it helps align their physical characteristics with their female gender identity. Here’s what you need to know:

  • By undergoing top surgery with breast implants, MtF individuals can experience a significant reduction in gender dysphoria and a boost in self-confidence, enabling them to live more authentically and comfortably.
  • The insertion of breast implants as part of top surgery for MtF individuals allows for a personalized approach to chest feminization, as it offers the opportunity to achieve the desired breast size and contour. This customization is essential in catering to the diverse preferences and aesthetic goals of MtF individuals, empowering them to express their gender identity in a way that feels authentic and affirming.
  • Overall, top surgery with breast implants represents a vital aspect of gender-affirming care for MtF individuals, providing a means to align their physical appearance with their gender identity and supporting their overall well-being and sense of self.

Non-Binary Top Surgery

Non-binary top surgery using fat transfer, also known as autologous fat grafting, offers individuals a unique and customizable approach to chest reconstruction. Here’s what you need to know:

  • This procedure involves the removal of excess fat from one part of the body, such as the abdomen or thighs, through liposuction and then transferring it to the chest area to create a more masculine, feminine, or non-binary appearance. The use of fat transfer in non-binary top surgery allows for a more natural and nuanced outcome, as it enables the individual to sculpt their chest in a way that aligns with their gender identity.
  • One of the key benefits of non-binary top surgery using fat transfer is the ability to avoid the use of implants, which may not be desired by some non-binary individuals. Utilizing the patient's own tissue can result in a more organic look and feel and potentially reduce the risk of complications associated with foreign materials.
  • Additionally, fat transfer offers the advantage of simultaneously contouring other areas of the body through liposuction, providing a comprehensive and harmonious transformation for the individual seeking non-binary chest reconstruction.
  • Overall, non-binary top surgery using fat transfer represents a significant advancement in the realm of gender-affirming procedures, offering a personalized and natural option for individuals seeking to align their physical appearance with their gender identity. This innovative approach empowers non-binary individuals to express their gender in an authentic and affirming way while also providing a safe and effective means of achieving their desired chest aesthetics.

Body Contouring

Body contouring as gender-affirming surgery encompasses a range of procedures aimed at helping individuals achieve a physical appearance that aligns with their gender identity:

  • Buttock augmentation, often achieved through the use of implants or fat transfer, can help create a more feminine or curvaceous silhouette for individuals seeking a more feminine appearance or a rounder, fuller buttock contour.
  • Liposuction can be used to remove excess fat from areas such as the abdomen, thighs, or hips, helping to create a more masculine or feminine body shape.
  • Fat grafting, on the other hand, allows for the transfer of the patient's own fat to areas that may benefit from additional volume, such as the buttocks or hips, contributing to a more feminine or curvaceous figure.

These procedures offer transgender and non-binary individuals the opportunity to sculpt their bodies in a manner that supports their gender identity. By customizing their physical appearance through these procedures, individuals can experience a more congruent and affirming relationship with their bodies, contributing to their overall sense of well-being and self-confidence.

Pre-Surgical Considerations

Mental Health Assessment

Candidates for gender-affirming surgery typically need to demonstrate a commitment to living as their stated gender for a specified period, often around two years. This real-life experience allows individuals to integrate their gender identity into their daily lives fully and ensures that they have thoroughly considered the implications of surgical intervention.

Additionally, many healthcare providers require candidates to engage in counseling or therapy for at least one year before undergoing gender-affirming surgery. During this time, the mental health professional works with the individual to explore their gender identity, assess their readiness for surgery and provide the necessary support. Ultimately, the counselor or therapist's letter of recommendation serves as a crucial component of the surgical evaluation process, affirming the individual's readiness for top surgery and their capacity to make informed decisions about their gender transition.

Dr. Sands recommends that you engage in therapy for at least one year before pursuing gender-affirming surgery. This recommendation also applies to patients who have been taking testosterone for the same length of time. The one-year requirement reflects Dr. Sands' commitment to thoroughly preparing you for the life-changing journey.

Hormone Therapy Requirements

Candidates for gender-affirming surgery are not universally required to undergo hormone therapy as a prerequisite for top surgery. While hormone therapy is not a mandatory precursor to top surgery, individuals who have been on such a regimen may experience certain benefits that can enhance the outcomes of their surgical procedure.

Hormone therapy, particularly testosterone for transmasculine individuals and estrogen for transfeminine individuals, can influence the distribution of body fat, muscle mass, and breast tissue, potentially affecting the natural contours of the chest. As a result, individuals who have been on hormone therapy for an extended period may achieve more favorable aesthetic results from top surgery, as the hormonal changes can contribute to a more congruent and gender-affirming chest appearance.

Nonetheless, the decision to undergo hormone therapy and its duration are highly individualized and may vary based on the unique needs and preferences of each person seeking gender-affirming care.

Fertility Preservation

Fertility considerations are an important aspect of gender-affirming surgery, particularly for individuals who may wish to preserve their reproductive options in the future. While Dr. Sands' practice does not offer fertility treatments and services, we recognize the significance of this aspect of care and are committed to supporting our patients in making informed decisions about their fertility.

As part of our comprehensive approach to gender-affirming care, we collaborate with recommended doctors and fertility specialists who can provide guidance and assistance in navigating fertility preservation options. These trusted professionals work closely with our practice and can offer expertise in fertility preservation techniques, such as egg or sperm freezing, ensuring that individuals have access to the resources they need to address their fertility concerns in conjunction with their gender-affirming journey.

Consultation and Planning

Before embarking on your gender-affirming journey, it is essential to have a thorough consultation with a qualified surgeon such as Dr. Sands. This involves:

  • Discussing your goals, expectations, and medical history
  • Evaluating your overall health and any pre-existing medical conditions
  • Outlining the various available procedure techniques and what to expect during recovery
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Recovery and Aftercare

The recovery period and aftercare protocol vary depending on the surgical procedure. Below are some general guidelines Dr. Sands recommends for post-operative care:

  1. Rest: Prioritize rest and relaxation after surgery to support your body's healing process.
  2. Follow-up appointments: Attend all scheduled follow-up appointments with your surgeon to monitor your progress.
  3. Medication: Take prescribed medications, such as pain relievers and antibiotics, as directed.
  4. Hygiene: Keep incisions clean and dry at all times, and follow your surgeon's instructions for wound care.
  5. Activity restrictions: Avoid strenuous activities and heavy lifting for the prescribed time to prevent complication.

You may experience some discomfort, swelling, and bruising in the initial stages of recovery. It is essential to be patient and give yourself ample time to heal. Remember, your Sands Aesthetics + Plastic Surgery surgical team will support you throughout your journey and address any concerns or questions.

For Our Out-of-Town Patients

Dr. Sands is renowned for his gender-affirming surgeries, which is why our patients travel from around the US and the world to access his services. To make this more accessible, we offer virtual pre-and-post surgical appointments.

You’ll come in person on the day of surgery, stay overnight, and then are free to return home. You will need to return for a follow-up appointment in person one week later, then may attend remaining appointments virtually.

Insurance and Costs

Health Insurance Coverage

Navigating insurance coverage for transgender surgeries can be a complex process. Firstly, check your specific insurance plan for what procedures are covered. The benefits offered can differ significantly between providers and policy types. You may find that your plan covers some of the surgeries, like hormone therapy or specific gender-confirming procedures. It's essential to consult with our medical team, as we can help you understand the intricacies of your insurance policy.

Out-of-Pocket Expenses

Even if your health insurance covers transgender surgeries, you may still incur out-of-pocket expenses. These may include:

  • Deductibles: The amount you pay before your insurance starts to cover costs.
  • Co-payments: A fixed fee you are responsible for at the time of service.
  • Co-insurance: The percentage of the cost you are responsible for after meeting your deductible.

Financial Assistance Programs

If you encounter financial setbacks when trying to cover the costs of your transgender surgery, don't lose hope. Sands Aesthetics + Plastic Surgery offers various financing options to make gender-affirming surgery more accessible, recognizing the importance of inclusivity and personalized care.

Care Credit

Care Credit is a popular choice for patients seeking flexible payment plans. Care Credit allows individuals to cover their gender-affirming surgery expenses with convenient monthly payments, offering low-interest or interest-free financing options based on the patient's needs and credit history. This gives patients the financial flexibility to undergo gender-affirming procedures while managing their budget effectively.


Alphaeon caters specifically to the cosmetic and elective surgery market, providing tailored financing plans to meet the unique needs of patients seeking gender-affirming procedures, ensuring affordability and accessibility. With competitive interest rates and flexible repayment terms, Alphaeon enables individuals to pursue their desired surgeries with financial peace of mind.


PatientFi is a financing platform designed to empower patients in their healthcare journey. This option offers customizable financing plans, considering the specific requirements of gender-affirming surgery. Our partnership with PatientFi allows patients to navigate the financial aspects of their transformation confidently, making gender-affirming procedures at Sands Aesthetics + Plastic Surgery more achievable for a diverse range of individuals.

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Choose Dr. Trey Sands for Gender-Affirming Surgeries

Choosing the right surgeon for your gender-affirming surgery is a crucial decision. Dr. Trey Sands is an experienced and compassionate professional who deeply understands what’s required for these transformative experiences.

With over 15 years of experience performing top surgery, Dr. Sands’ expertise ensures you receive the highest standard of care and the best possible surgical outcomes. He will work closely with you to develop a customized surgical plan that reflects your goals and desired results while providing emotional support.

When choosing to work with Dr. Trey Sands for your gender-affirming surgery, you'll be partnering with a compassionate, professional, and highly skilled surgeon. You can feel confident and encouraged as you transition with the support and expertise of a surgeon who understands your unique needs and goals. Contact us today to learn more about how we can help you.

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