Transgender Body Feminization

Q: Dr. Eppley, I am transgender and would like to feminize my figure. (transgender body feminization)

I have been putting on fat in preparation for a fat transfer to my butt and hips. I was worried having read on the internet that the fat can be lost over a period of a year and I would that very distressing. So I am thinking that I would like hip implants and a fat transfer from her upper body (where fat seems to sit when I put on weight) to my butt .(as this is where I would prefer fat to sit if I put on weight). It would be really helpful to talk this through. 

A: If one has enough fat to do a successful volumetric transfer to the buttocks this is always the first choice for buttock augmentation in lieu of implants. But be aware that gaining weight for the procedure, which many patients do, may not create sustainable fat/volume in the long run. Fat cells are being abnormally enlarged and reproduced in a body weight situation which will change after surgery. Thus those fat cells that survive the fat transfer process may not hold their lipid content when one goes back to their normal or physiologic weight. In short fat transfer to the buttocks (or anywhere actually) is not a predictable procedure and this is made even more unpredictable by gaining weight to do it.

But given that patients rarely have enough fat to graft with the buttocks and the hips, it would make the most sense to invest all the fat one has into the buttocks and use implants for the hips.

Dr. Barry Eppley

Indianapolis, Indiana