Gender-Affirming Surgery
Serving patients in Fairfield County, Westchester County, and New York City
For many transgender and nonbinary people, undergoing gender-affirming surgery is an essential step in alleviating gender dysphoria. Whether you are seeking facial procedures, top surgery, or bottom surgery, the goal is to bring your body into alignment with your gender identity, providing the foundation for long-term transgender health and well-being.
As a Yale-trained MD and PhD specializing in plastic, reconstructive, and microsurgery, Dr. Leo Otake brings a rare level of expertise to gender affirmation surgery. Our practice provides a safe, welcoming space where our transgender patients can explore their surgical options with a healthcare team dedicated to evidence-based excellence and compassionate care.
Gender-affirming surgery encompasses a broad range of surgical procedures used to transition the body toward a person's affirmed gender. This can include "top surgery" to remove or create breast tissue, facial feminization surgery to soften features, or genital reconstruction (bottom surgery) to alter external genitalia.
Dr. Otake provides highly personalized surgical care, offering options for trans women, trans men, and nonbinary people. For those seeking a more feminine appearance, this may involve breast augmentation with breast implants or a tracheal shave to reduce the appearance of the Adam's apple. For those seeking a masculine profile, Dr. Otake focuses on creating a contoured, natural-looking chest. Each treatment is a collaborative effort between the patient and our healthcare team, ensuring a result that aligns with your unique needs.
On the day of your surgery, Dr. Otake and his team prioritize your safety and comfort. Most gender-affirming surgeries performed at our facility are done under general anesthesia. The surgical approach depends entirely on the specific goals of your treatment plan. For top surgery, Dr. Otake uses precise incisions to either remove breast tissue or place breast implants, carefully managing the skin and other tissues to ensure symmetrical, natural-looking results.
In facial feminization, he may address the thyroid cartilage or perform facial procedures to soften the jawline. Genital reconstruction is performed with meticulous techniques to preserve sensation and achieve an aesthetically pleasing result. Because of his expertise in plastic surgery and microsurgery, Dr. Otake handles tissue with extreme care to promote optimal healing and minimize visible scarring.
The primary condition addressed by affirming surgery is gender dysphoria, the psychological distress that occurs when a person's sex assigned at birth does not match their gender identity. By providing physical gender affirmation, these procedures have been shown to significantly improve mental health outcomes and overall well-being. Dr. Otake also addresses the functional and aesthetic needs that arise during a transition, ensuring the body functions as beautifully as it looks.
Dr. Otake performs gender-affirming work across the face, chest, and body. This includes specialized facial feminization to refine facial features, chest reconstruction (top surgery), and body contouring to relocate fat and tissue to a more masculine or feminine distribution.
The benefits of gender-affirming surgery are profound and often permanent. Patients frequently report a dramatic reduction in gender dysphoria and a renewed sense of confidence. By aligning your body with your gender identity, these surgical options allow you to move through the world with a sense of peace and authenticity.
Dr. Otake’s surgical care focuses on the structural integrity of the reconstruction. Whether it’s ensuring a tracheal shave is smooth or that breast augmentation looks natural, the benefit is a high-quality result that integrates seamlessly with the rest of your body. His background in transgender medicine ensures that every procedure supports your long-term health and transition goals.
Good candidates are individuals who have been living in their affirmed gender and have persistent gender dysphoria. Dr. Otake follows the informed consent model and works closely with your existing health care team to coordinate all aspects of your care. It is important to be in good general health and to have realistic expectations about the surgical procedure, recovery, and results. We also discuss matters such as fertility preservation during your consultation to ensure a holistic approach to your care.
Dr. Leo Otake and his team provide attentive support and guidance throughout your entire recovery process. Downtime and aftercare requirements depend on the specific procedures performed. For top surgery, you may need to wear a compression vest for several weeks to support the tissue and minimize swelling. A brief hospital stay may be required for more complex surgical procedures, while other surgeries can be performed on an outpatient basis.
You will need to avoid strenuous activity and may have temporary restrictions on sexual activity depending on the surgery performed. As an expert in wound healing, Dr. Otake monitors your progress through several follow-up visits to ensure the skin and tissue are healing beautifully and that you are supported at every step.
The results of gender-affirming surgery are often visible immediately, particularly with top surgery or a tracheal shave. However, the final appearance will settle over several months as swelling subsides and scars begin to fade.
These improvements are generally considered permanent. Patients often describe the results as a “weight being lifted,” allowing them to focus on their lives with a significant reduction in dysphoria. Dr. Otake’s commitment to exceptional surgical care means your results are built on a foundation of technical excellence, providing a look that is natural, harmonious, and affirming.
Dr. Leo Otake is a board-certified, fellowship-trained plastic surgeon who brings academic-caliber expertise to every patient he serves. As a Yale-trained MD and PhD, Dr. Otake is honored to apply this depth of education and clinical precision to the specialized field of gender-affirming care.
His extensive experience in reconstructive procedures ensures that your surgical journey is guided by the highest standards of safety and technical mastery. At our White Plains practice, you are more than a patient; you are a partner in a dignified, life-changing transformation.
While Dr. Otake follows an informed consent model, many insurance providers and hospital protocols still require letters from mental health professionals to cover gender-affirming surgery. During your consultation, our healthcare team will help you navigate these requirements to ensure a smooth treatment plan.
This varies by procedure. For some facial procedures or top surgery, hormone replacement therapy may not be a prerequisite, though it is often recommended to allow for tissue redistribution. We coordinate with your healthcare team to determine the best timing for your surgical care.
A tracheal shave, or chondrolaryngoplasty, is a procedure to reduce the size of the thyroid cartilage (the "Adam's apple"). It is a common part of facial feminization and is designed to create a more feminine appearance of the neck.
As with any surgery, there are risks such as infection, bruising, or issues with wound healing. Dr. Otake’s meticulous surgical approach and deep understanding of reconstructive surgery minimize potential complications and ensure a safe, successful outcome.
Every surgical procedure involves some scarring, but Dr. Otake is an expert in scar management. For top surgery, he places incisions in the natural contours of the chest. With proper wound healing and aftercare, these scars typically fade significantly over time and become very discreet.
