FTM Body Masculinization Surgery Explained

What Is Body Masculinization Surgery?

Body Masculinization Surgery (BMS) is a group of procedures that masculinize body contours, particularly for trans men who feel they didn't get enough masculinization from Testosterone and Top Surgery. Though less common than Top Surgery, these procedures are regularly performed, sometimes in tandem with Top Surgery.

While many trans men are satisfied with the body shape changes that are acquired through hormone therapy, others don't achieve the level of masculinization desired, which can negatively affect body image, self-esteem and confidence. Body Masculinization Surgery provides a solution for masculinizing body shape when diet and exercise fall short.

The "Ideal" Male Physique

There is no single type of body composition that describes the "ideal" body shape as this is highly subjective, however the concept of the ideal male physique can still be helpful as a reference when considering the goals and benefits of Body Masculinization Surgery.

Traditionally, the ideal male physique is composed of a strong and well-defined chest, broad shoulders, a trim waist, and minimal fat distribution in the hips, buttocks, and thighs. This looks is sometimes referred to as the "classic V-shaped" figure.

Achieving the classic V-shape look can be challenging for some trans men. Hormone therapy and Top Surgery, combined with a smart diet and weight training, is often the best approach for developing a more masculine physique. Keeping weight down helps reduce curves overall while back and shoulder work outs broaden and define the upper body. Together, these help achieve the waist-to-chest ratio that describes the V-shape torso. Still, many trans men will find that some areas of fat are near-impossible to reduce without surgical intervention.

The sex hormone differences between men and women are to blame.

Generally, men carry less body fat than women, and when they do carry extra weight, it tends to be in the upper body, while women carry extra weight in the hips, buttocks and thighs.

As a consequence, many transgender men also carry extra weight in ways that can accentuate feminine-looking curves. It's not surprising then that Body Masculinization Surgery is increasingly considered a necessary part of female to male gender reassignment surgery.

Areas That Can Be Treated to Achieve a More Masculine Body Shape

The goal of Body Masculinization Surgery is to broaden the appearance of the chest and shoulders while slimming the waist. This creates the V-shape torso look. The areas commonly treated to achieve this are:

• Upper body: Chest and back
  
• Abdomen (Abdominoplasty, aka "Tummy Tuck")
  
• Flanks ("love handles", "back bacon")
  
• Hips
  
• Buttocks
  
• Inner and outer thighs ("saddlebags")

Multiple areas can be treated in one surgery. For example, Abdominoplasty and liposuction of the hips and thighs are often combined. This approach allows the surgeon to visualize the body as a single aesthetic unit and tends to produce the best results.

Body Masculinization = Liposuction

Body Masculinization Surgery is performed using Liposuction, a safe procedure that suctions and removes fat from targeted areas. For example, Liposuction is used in Top Surgery to remove fat from under the arms and provide a masculine-looking contour to the pectoral muscles. In Body Masculinization Surgery, Liposuction is used to remove fat from the flanks, thighs and other areas to create contours that are slim and sleek—traits of the classical male physique.

Liposuction is performed on an outpatient basis, under general anesthesia or local anesthesia with twilight sedation. A 3.7-5mm diameter hollow tube (cannula) is inserted through small, strategically placed incisions and vacuum is applied to break up and suction out fat. (Liposuction is considered a nearly scar-less procedure because the incisions are so small.)

Surgery time depends on the number and size of areas being treated but is generally 1-2 hours in duration.

Ideal Candidates for Body Masculinization Surgery

Not all trans men are good candidates for Body Masculinization Surgery. It's important to note that BMS is not intended to be a substitute for maintaining a good diet and getting regular exercise. Healthy transgender men who are close to their ideal body weight, have good muscle tone and no excess, sagging skin, but also have fat that has not responded to weight loss strategies are ideal candidates for Body Masculinization.

Check out these great results from Top Surgery and Body Masculinization! Surgery performed by Dr. Joel Beck.

Post-Op and Recovery from Body Masculinization Surgery

After surgery, patients are fitted with a compression garment. Typically, the compression garment is worn 24/7, with a break for showering, for about 4 weeks. Depending on which areas were treated, patients may also have Jackson-Pratt drains, as is often the case with Top Surgery.

What to expect after Body Masculinization Surgery:

• General discomfort, mild-to-moderate pain
  
• Swelling, may persist for weeks
  
• Bruising

Tips for recovering after Body Masculinization Surgery:

• Bed rest and limited activity for a few days after surgery; pain should significantly reduce 4-5 days post-op. Light walking is recommmended.
  
• Take pain medication, if needed (being in pain makes it harder to heal.)
  
• Take the antibiotics you are prescribed to reduce risk of infection.
  
• Resume light physical activity after a week.
  
• Avoid heavy lifting and more strenuous exercise for at least four weeks, possibly longer depending on the size and number of areas treated.
  
• Talk to your surgeon about Arnica homeopathic remedies, bromelain and other supplements to reduce swelling and bruising after surgery.

Follow-up appointments with your surgeon will take place one day after surgery and then typically at one week and one month after surgery, and possibly at longer intervals if the patient is local to the surgeon.

Important Considerations

As a surgical procedure, Liposuction is considered very safe however all surgeries carry potential risks. Temporary side effects are to be expected and include mild-to-moderate discomfort, bruising and swelling. Complications include infection, fluid build-up (hematoma, seroma), nerve damage and blood clots. Many complications can be avoided by following the pre- and post-operative instructions.

Fat removal is permanent, but patients must have a healthy diet and exercise habits to maintain results.

Buttock Liposuction must be done conservatively to avoid loose, droopy skin.

Some patients may require a revision to treat loose skin, uneven contours, or lumpy/dimpled results.

Finally, while Body Masculinization Surgery can provide a more masculine appearance, results may not be "perfect". It's very important for patients to have realistic expections about outcomes.

What to Expect at Your Consultation

Review of your health history, including previous surgeries, drug sensitivities, daily habits and lifestyle.
Discussion about the procedure(s) you are interested in, including risks and expected outcomes.
Evaluation of your body contours, including excess skin, fat deposits, muscle tone. Measurements may be taken.

How Much Does Body Masculization Cost?

The cost of Body Masculinization Surgery is dependent on the size and number of areas being treated. Fees often include the surgeon's fee, Anesthesiologist's fee, OR fees, compression garments and follow-up appointments. In general, you can expect cost to be in the range of $3500-$15,000. Dicsounts may be available if Body Masculinization Surgery is being combined with Top Surgery.

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Body Masculinization Surgery (BMS) is an ideal procedure for trans men who would like to obtain a more masculine body shape and for whom weight loss strategies and muscle building have not helped entirely. BMS can precisely remove fat from targeted areas of the body and help match a trans man's physique to their transition goals. Improved self-esteem and restored confidence are important reasons why BMS has become an essential stage of transition for many trans men.

Last updated: 04/08/24