Below is our step-by-step process:

  1. Schedule your consultation. We can do consultations in-person, by phone or virtually.
  2. Obtain letters of support for your gender-affirming surgery from a mental health professional and those prescribing your hormones. Letters must be dated within 1 year of your operation. If you have any pre-existing medical conditions, specific letters of medical clearance, labs and studies may need to be obtained. We will advise you at your initial consultation.
  3. Mark your surgery date on your calendar.
  4. Our office and insurance teams will begin the insurance authorization process at least 2-3 months before your surgery date.
  5. Receive your comprehensive surgical confirmation packet in the mail 1-2 months prior to your surgery with pre-operative and post-operative instructions.
  6. Surgery!
  7. Pay your balance (if paying out of pocket).

Our office is quite adept at working with most insurance plans. After your initial visit with one of our surgeons, you will have a consultation with our administration/financial team, who will provide more information about the insurance process. Our goal is to make this process as easy as possible for you.

  • A picture or copy of the front and back of your insurance card.
  • Updates on any change to your insurance.
  • If you have more than one insurance policy, let us know which one is legally designated as your primary insurance. You may need to contact your insurance companies to determine this if you do not know.
  • If you have an HMO plan, we need an updated referral from your assigned Primary Care Physician within 90 days of your surgery date.

Please contact the office you wish to speak with, and our administrative team will get in touch with you:


San Francisco

Phone: 415-530-5335



Los Angeles

Phone: 310-751-5886


Preparing properly for surgery can ensure a smooth, seamless experience. We will provide you with detailed instructions about how to prepare for your operation several weeks before your surgery date to ensure you have the best and safest outcome possible. We will always be available to answer any questions you may have throughout this process.   The following list will help set you up for success before your surgery:  
  • Enlist friends and family to cover chores and childcare while you heal.
  • Shop for anything you might need during the healing process before your surgery, so they are available to you during recovery.
  • Find someone who can drive you home after your surgery – you will not be discharged alone!
  • Discuss with your doctor any medications, including herbs and supplements, you are currently taking. You may be asked to stop taking certain medications prior to surgery.
  • Follow any dietary changes recommended by your doctor prior to your procedure.
  • Stop smoking a full month before your surgery date.
  • Get plenty of rest and sleep.
  • Exercising prior to surgery will help build stamina and energy for recovery.
  • If needed, rearrange your furniture to prepare for recovery, and, if applicable, prepare to move your sleeping quarters to the first floor.
  • Inform anyone who may be affected by your recovery, such as your job, clients, teachers, etc.
  • If you are receiving a Brazilian Butt Lift (BBL), body contouring or liposuction, you’ll need to set up lymphatic massage sessions once you’ve established your OR date. We recommend you have at least 12 sessions for the first 4-6 weeks (2-3 sessions per week), starting 1 to 3 days after your operation. Even if you are not getting BBL, body contouring or liposuction, your surgeon may recommend lymphatic massaging.

On the day of your surgery, you’ll want to wear comfortable, loose-fitting clothing, as you may have bandages and/or compression garments on after your surgery. Avoid tight-fitting clothing that may constrict you.


Additionally, please leave valuables and jewelry at home, remove nail polish and acrylic nails and do not wear makeup the day of your surgery. If you use contacts, please wear glasses to your surgery instead. If you wear dentures or other prosthetic devices, please be sure to advise your medical team ahead of your surgery.

A few weeks before your surgery, the doctor may order a physical exam, blood and urine lab tests, a chest x-ray, and an electrocardiogram to test your heart function. These are all standard tests to ensure you are in optimal shape for your surgery.

After your procedure, you will most likely experience swelling, bruising, tenderness and discomfort. These are the body’s normal reactions to surgery.

Your surgeon will provide prescriptions for pain medications, as well as compression garments, dressings and drains, depending on the type of procedure you have. If non-absorbable sutures are used, they will typically be removed around 7-14 days post-operation.


If your surgery is more complex, like facial surgery, your doctor may recommend that you stay overnight 1-2 days post-operation before heading home. All surgical procedures will require a follow-up appointment with your doctor 1-week post-operation.


We will do everything possible to ensure you are well prepared and well cared for, so you can start enjoying your results!

Some suggested supplies to have on hand after your surgery include:


  • Books, magazines, movies
  • Neosporin or Aquaphor
  • Ice packs for pain
  • Extra underwear
  • Sweatpants
  • Lap desk
  • Thick pillow or medical donut for comfort while sitting or traveling
  • Hand mirror that allows you to see what you’re doing when changing dressings

Lymphatic Massaging


Lymphatic massaging, in addition to compression, is an essential component for healing after Brazilian Butt Lift (BBL), body contouring, liposuction, and many other surgical procedures. It is essential to set up your lymphatic massage sessions once you’ve established your OR date. We recommend you have at least 12 sessions for the first 4-6 weeks (2-3 sessions per week), starting 1 to 3 days after your operation.


It is important to go to a lymphatic massage therapist who has experience and knowledge about this specialized type of treatment. Luciana Andrus (based in San Francisco and Marin County) and her team are skillful and compassionate in their approach to lymphatic massaging and can be found at


Hyperbaric Oxygen Therapy (HBOT)


We recommend that patients start hyperbaric oxygen therapy right away following their surgeries. There is no pain involved, no needles are used, it’s entirely nonsurgical and noninvasive.


In a unique therapeutic environment, you’ll breathe 100% oxygen (compared to the 21% we normally breathe) for up to two hours, as you relax and watch television. The oxygen infusion will help speed your recovery immensely and is strongly advised.

The lymphatic system is disrupted after an operation, so specialized massaging will help your body drain this fluid as you heal. This will significantly reduce inflammation, swelling, pain, and bruising; speed up the healing process; and prevent scarring, fibrosis and contour deformities.

HBOT is highly effective for gender-affirmation surgeries because it helps optimize the healing process and maximize your outcomes. HBOT has many benefits, including:


  • Speeds up wound healing
  • Fights off life-threatening infections
  • Increases circulation
  • Promotes healing in damaged tissue
  • Drug free and non-invasive


For more information about HBOT, please see here.

San Francisco

Please check out our Additional Resources page for a list of national and local organizations that offer resources and support.

Los Angeles 

For additional resources, please visit our patient resources page.


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