In many cases the hormone treatment is not sufficient to achieve a totally feminine silhouette. So plastic surgery through body feminization operations allows us to redefine the body contour (through liposuction or lipoesculture, breast augmentation, the ambdominoplastia or buttock augmentation, for example) so that the patient can feel completely identified with their gender.
Body fat is not distributed in the same way in men and women and this means that their figures, as well as their genitals, are different.
Although hormone therapy does cause certain changes in body fat distribution in transsexual women, this is not always enough to produce a feminine figure.
Three-dimensional liposculpture allows for the modelling of fatty deposits in specific areas and thereby define feminine curves. This modelling is achieved by means of the proper combination of liposuction of excess fat from some areas and the lipoinjection of this in others which lack volume.
Breasts are one of the clearest signs of female identity and, although hormone therapy helps them to develop, it is often not enough or does not give patients the volume they seek. In such cases, breast augmentation (augmentation mammoplasty) is recommended. This can be carried out before or after vaginoplasty and can help transsexual women assume their female role.
Thanks to implants or prostheses, augmentation mammoplasty helps increase the size of the breasts whilst giving them a feminine appearance.
Transsexual women may have a tendency to accumulate fat in the area of the abdomen and this cannot be eliminated either by dieting or physical exercise.
Sometimes, combined with these fat deposits is a distension of the abdominal muscles which further accentuates the "droopy tummy” appearance.
Abdominoplasty (or "tummy tuck”) is a surgical technique to eliminate excess fat and improve the figure, particularly the waistline. It can also repair the muscles of the abdominal wall.
This should not be regarded as a substitute for dieting and is not therefore indicated for slimming.
Buttock augmentation is a technique that, via the placement of cohesive silicone implants, gives the area a rounder shape (for women) or boosts the buttock’s muscles (in the case of men).
The prosthesis, which is located under the gluteus maximus muscle, is put in place by means of an incision in the crack between the two buttocks. Recovery from the procedure, which is carried out under general anaesthetic, means following certain rules, such as sleeping face down for a couple of weeks. Physical exercise involving the area treated must be avoided for at least five or six weeks, as should injections to the area of the buttocks.
The thigh lift is a surgical technique that eliminates excess skin, sagging and wrinkling at the top and insides of both thighs.
Aimed especially at those who have lost a lot of weight, who do not have great quality skin or are genetically predisposed, the procedure can be combined with liposculpture if the thighs are joined by excess accumulated fat. Those planning to lose weight should be especially careful, and it is better for them to postpone this operation.
A thigh lift will take between two and three hours and requires, in addition to general or peridural anaesthetic, an stay in hospital for the first night. For the first 48 hours after the operation, patients should rest, although from the third day on they can stand and begin to walk. Even so, it is not advisable to walk too much for the first week.
To alleviate heaviness and reduce swelling, a lymphatic drainage can be carried out, although this should only be done when the surgeon indicates that it is time to do so. A return to physical activity can be carried out from the fifth week on, although without stressing the area.
It should be noted that, in the case of those with very lax skin who have never carried out physical exercise, it may be that after some years the flaccidity will return. Nevertheless, there will never be a return to the situation prior to the operation.