Facial and body feminization is mainly achieved through the technique of liposculpture. Rhinoplasty and malar implants improve the aesthetic result. Breasts are augmented typically with silicone implants taking into consideration the special male thoracic dimensions. Genital reassignment is performed with orchiectomy and vaginal reconstruction reversing the penile skin.
The female-to-male transition includes a variety of surgical procedures that provide physical traits more appropriate to male identity. Facial masculinization is mainly performed using mandibular implants to create angular aesthetics. Liposuction is performed to alter the typical female fat distribution, while typical breast reduction mammoplasty creates a masculine thorax. Genital reassignment includes either phalloplasty with a free forearm flap and an erectile prosthetic device or use of the enlarged (because of the hormonotherapy) clitoris (metoidioplasty).