Gender-Affirming Surgery
In The Greater Toronto Area
What is Gender-Affirming Surgery?
At Valespring Cosmetic Surgery Institute, we offer a range of gender-affirming surgeries tailored to support individuals in aligning their physical appearance with their gender identity. These procedures are performed with the highest surgical standards and are designed for patients seeking private, out-of-pocket care. We focus on top surgery and transition-related body contouring, such as feminizing Brazilian Butt Lifts (BBLs). We do not offer OHIP-covered transition surgery, bottom surgery, or face-related transition surgery at this time.
For many, gender-affirming surgical procedures are an essential step in their transition journey. These procedures can offer physical, emotional, and psychological relief by reducing gender dysphoria and helping individuals feel more comfortable, aligned, and confident in their bodies.
Why Get Gender-Affirming Top Surgery?
- Alleviate Gender Dysphoria
- Feel More Comfortable and Confident
- Wear Clothes More Freely
- Reduce or Eliminate the Need for Binding, if applicable
- Support Mental Health
- Increase Social Comfort and Safety
- Achieve Personal Gender Expression
- Improve Physical Health
Am I a Candidate for Gender-Affirming Surgery?
At Valespring Cosmetic Surgery Institute, patient safety and dignity are our top priorities. We adhere to all safety guidelines to ensure the highest standards of medical care, including when it comes to gender-affirming procedures.
During your consultation, Dr. Dreckmann will personally perform a comprehensive medical assessment and physical examination to determine if Gender-Affirming Surgery is a safe and appropriate option for you. This includes reviewing your medical history, discussing your goals, and ensuring that you are well-informed and supported throughout the process.
We are committed to providing compassionate, respectful, and individualized care in a welcoming environment for all gender identities.
- You are in overall good physical and mental health, with no uncontrolled medical conditions.
- You are at or near a stable weight with BMI < 35
- You can calculate your BMI here
- Smokers should quit smoking at least 4 weeks prior to surgery
- Not currently pregnant or breastfeeding
- Realistic expectations
- Looking to reduce gender dysphoria and improve your overall emotional well-being and self-confidence.
- With a consultation at Valespring Cosmetic Surgery Institute, Dr. Dreckmann will help provide realistic expectations by aligning your desired surgical results with your age, lifestyle, physique and proportions so that you have a clear idea of what you can expect in the post-operative period
Why Choose Dr. Dreckmann for your Transition Surgery?
Dr. Stephanie Dreckmann is one of the leading top surgery specialists in Canada, recognized for her advanced training in gender-affirming procedures and experience in chest masculinization and feminization surgeries. At Valespring, we follow rigorous safety protocols and utilize state-of-the-art surgical techniques and equipment to prioritize patient safety and deliver optimal results. Dr. Dreckmann applies innovative, patient-centered methods to ensure your gender-affirming surgery experience is both safe and empowering, with outcomes tailored to your goals and comfort.
Gender-Affirming Mastectomy Overview
Procedure
- The procedure usually takes 2 to 4 hours, depending on the type of procedure performed and the complexity of the case.
- For most patients, an incision is made along the lower chest to remove breast tissue and create a flatter, more masculine or gender-neutral contour. In some cases, the nipples and areola are resized and repositioned for a natural appearance (common in the double incision technique). For individuals with smaller chest sizes, a periareolar or keyhole incision may be used for minimal scarring.
- Additional steps, such as liposuction or skin tightening, may be included to achieve the desired chest shape and symmetry, which can extend the overall surgery time.
Anesthesia
- General Anesthesia is most commonly used so that the patient is fully asleep for the procedure.
Recovery
- Expect to take 7–14 days off work or school to rest and allow swelling and bruising to improve.
- Avoid strenuous activities and heavy lifting for 4–6 weeks to support healing.
- You’ll wear a compression binder for several weeks to reduce swelling and help shape your chest. Swelling and bruising may last a few weeks, with final results appearing over several months.
- Recovery times vary, always follow your surgeon’s personalized care plan for the best outcome.
Types of Gender-Affirming Top Surgery
Gender-Affirming Mastectomy
(Chest masculinization)
Top surgery using periareolar or double incision technique
Gender-affirming mastectomy, also known as “chest masculinization” or “top surgery,” involves the removal of breast tissue to create a flatter, more masculine or gender-neutral chest. It is most commonly sought by transgender men and non-binary individuals.
Double Incision Mastectomy with free nipple grafting
Recommended for patients with a larger chest or less skin elasticity. This method involves horizontal incisions across the lower chest to remove breast tissue and excess skin. The nipples are removed, resized, and grafted into a more masculine position. This approach provides excellent chest contouring and allows for precise nipple placement.
Periareolar Mastectomy
Ideal for patients with smaller chest sizes and good skin elasticity. This technique uses incisions around the areola to remove breast tissue with minimal scarring and no need for nipple grafting or repositioning. It offers a subtle, natural result with a quicker recovery period.
Both procedures are tailored to your anatomy and gender goals, with results designed to minimize dysphoria and promote comfort in your body and clothing. Often they are combined with liposuction for enhanced chest contouring results.
Gender-Affirming Breast Augmentation
(Feminizing Breast Augmentation)
Gender-affirming breast augmentation is a surgical procedure designed to create a fuller, more traditionally feminine chest. This procedure is ideal for transgender women or non-binary individuals seeking breast development beyond what hormone therapy can achieve.
The surgery typically involves placing silicone or saline implants behind the breast tissue or chest muscle to enhance volume and shape. Incisions are typically made under the breast fold. Implant size, type, and placement are carefully selected in consultation with the patient to ensure a natural and satisfying result. Less commonly, fat transfer augmentation is performed as an alternative to the use of traditional implants.
Gender-affirming breast augmentation can significantly reduce gender dysphoria and enhance self-confidence, especially when performed as part of a gender transition.
Radical Breast Reduction
Gender-affirming chest contouring without full masculinization
Radical breast reduction is an option for individuals seeking significant reduction in breast size and chest dysphoria without fully masculinizing the chest. This procedure removes large amounts of breast tissue and skin, reshaping the chest into a smaller, flatter form while preserving nipple sensation and positioning when possible.
It is ideal for non-binary individuals or patients who don’t desire a completely flat chest but want to reduce volume for gender affirmation, physical comfort, or clothing fit. Incisions are typically made in an anchor pattern (around the areola, vertically down the breast, and along the crease) to allow for maximum tissue removal and reshaping.
This procedure offers a middle-ground solution between cosmetic breast reduction and full mastectomy, and is customized to the patient’s goals.
Minimal-Scar Mastectomy Techniques
For select candidates with very limited chest tissue and high skin elasticity.
Some patients may be eligble for minimal-scar or scarless techniques using liposuction or very small incisions. These are not widely applicable but may be appropriate in specific low-volume cases.
Very limited scarring
Typically used only in unique situations
May not achieve full flatness or contouring
Let us guide you through your Surgical Transition Toronto
Book a Free Gender-Affirming Surgery Consultation Now!
How Much Does Gender-Affirming Surgery Cost?
Gender-Affirming Mastectomy
$10000+
- Cost Includes:
- Gender-Affirming Mastectomy
- Includes anesthesia
- Compression garment
Gender-Affirming Breast Augmentation
$10000+
- Cost Includes:
- Gender-Affirming Breast Augmentation with implants
- Includes anesthesia
- Compression garment
Gender-Affirming Body Contouring
Prices vary depending on scope of work.
- Cost Includes:
- Gender-Affirming Body Contouring
- Includes anesthesia
- Compression garment
Consultations are free with no obligation
If you have any questions about our pricing or have specific needs, do not hesitate to contact us
Prices serve as a guideline only. Fees will be adjusted based on each patient’s individual anatomy and the complexity of the case.
Prices do not include HST
See Our Other Types of Body Contouring Surgery
Liposuction
Body Lift
Brazilian Butt Lift (BBL)
Arm Lift
Mommy Makeover
Thigh Lift
FAQs about Gender-Affirming Surgery
What is gender-affirming top surgery?
Gender-affirming top surgery is a transition-related surgical procedure designed to create a chest that aligns with your gender identity. For transmasculine and non-binary individuals, this may involve removing breast tissue to create a flatter, more masculine or androgynous chest shape. The procedure may also include chest contouring and nipple resizing or repositioning, depending on your anatomy and personal goals.
The goal of gender-affirming top surgery is not only aesthetic and it’s often an important step in relieving gender dysphoria and helping patients feel more at home in their bodies. Every surgical plan is personalized to reflect your needs, identity, and comfort.
Am I eligible for gender-affirming surgery?
Most patients seeking gender-affirming surgery are eligible, as long as they’re in good overall health and have a clear understanding of the procedure and recovery process. You don’t need to be on hormones, and your gender identity does not need to fit a specific label. We welcome transmasculine, non-binary, and gender-diverse individuals.
Eligibility is generally based on a few key factors:
You’re physically healthy with no major medical issues
You have realistic expectations about the outcome
You can safely undergo anesthesia and surgery
You’re emotionally prepared for the changes and recovery, with adequate support systems in place
Do I need to be on testosterone (T) to undergo gender-affirming surgery?
No, you do not need to be on testosterone to have gender-affirming surgery.
Hormone therapy is a personal choice. Many patients choose to have gender-affirming surgery without ever starting testosterone, especially if their goals don’t include other physical changes that hormones cause.
We support each patient’s unique gender journey. Whether you’re on T, planning to start, or never intend to, we’ll work with you to create a surgical plan that aligns with your identity and goals.
Will I have scars after gender-affirming mastectomy?
Yes, scarring is a normal part of the healing process for any surgery. The size, placement, and appearance of your scars will depend on the surgical technique used and your individual skin type.
Double incision (the most common method) typically leaves horizontal scars under the pectoral line and includes nipple grafts.
Peri-areolar and keyhole techniques, often used for smaller chests, leave minimal scarring around the areola.
Scars will be most visible in the first few months and gradually fade over time. We’ll give you detailed aftercare instructions including scar care to support optimal healing. If desired, we can also discuss future options like scar treatments to minimize their appearance.
Most patients find that the confidence and comfort gained far outweigh concerns about scarring.
What is the recovery time for gender-affirming top surgery?
Most people need about 1 to 2 weeks of downtime after gender-affirming top surgery. During that time, you’ll want to rest, avoid lifting your arms above shoulder level, and follow your post-op care instructions closely.
Here’s what recovery generally looks like:
Week 1: Rest and light movement. You’ll likely have some swelling, bruising, and tightness. We’ll check in with you and remove drains if you have them.
Week 2: Many patients feel well enough to return to desk jobs or classes, but still need to avoid heavy lifting or strenuous activity.
Weeks 4–6: You can slowly ease back into more physical activities, including exercise, once we clear you.
3+ months: Scars begin to mature, swelling continues to go down, and your final chest shape becomes more visible.
Everyone heals a little differently, and we’ll walk you through what to expect and when it’s safe to return to your normal routine.
Will I need drains after surgery?
It depends on the surgical technique and your individual case. Some patients do go home with small surgical drains to help prevent fluid buildup under the skin. If drains are used, they’re usually in place for about 5 to 7 days and are removed during a follow-up visit.
Sometimes drain-free techniques can be offered, especially with double incision procedures. If that’s something you’re interested in, we’ll talk about it during your consultation and let you know whether it’s a good fit for you.
Either way, you’ll receive detailed instructions on how to care for your chest during recovery, with or without drains.
Can I customize my gender-affirming mastectomy results (like keep nipples or have none)?
Yes, your gender-affirming mastectomy is tailored to your goals. Many patients choose to keep their nipples, which may be resized or repositioned for the most natural look. Others prefer to remove their nipples entirely for a smooth, nipple-free chest, and that’s completely valid too.
During your consultation, we’ll talk in detail about your aesthetic preferences and what’s surgically possible based on your anatomy. Our goal is to create a result that feels right for you.
What are the risks or complications of gender-affirming surgery?
Gender-affirming surgery is generally very safe when performed by an experienced surgeon, but like any surgery, it carries some risks. Possible complications include:
Bleeding or hematoma (blood collecting under the skin)
Infection
Changes in nipple sensation, including numbness or hypersensitivity
Scarring that may be more noticeable or raised
Partial or full loss of the nipple graft
Asymmetry or uneven chest contouring
Delayed wound healing
We take every precaution to minimize risks and support your recovery. During your consultation, we’ll review your personal health factors and walk you through what to expect, so you feel confident and informed.
If any issues arise during recovery, our team is here to provide prompt care and guidance.
Will I lose nipple sensation?
Nipple sensation after gender-affirming top surgery varies depending on the surgical technique and individual healing. Procedures like keyhole or peri-areolar mastectomies often preserve more sensation because the nipples aren’t fully detached. However, with double incision mastectomies, which is common for larger chests, the nipples are typically removed and grafted back on, which can result in reduced or altered sensation.
Some patients experience numbness immediately after surgery but regain partial sensation over time. It’s important to know that while some sensation may return, full feeling is not guaranteed.
During your consultation, we’ll discuss what you can expect based on your specific surgery plan.
How do I prepare for gender-affirming surgery?
Preparing for gender-affirming surgery helps ensure a smoother procedure and recovery. Here’s what we recommend:
If applicable, stop binding at least 2 weeks before surgery to give your skin a chance to heal and breathe.
Avoid smoking for several weeks before and after surgery, as it can affect healing.
Arrange for help: You’ll need someone to drive you home and assist you during the first few days post-op.
Follow your surgeon’s instructions about medications, fasting, and any pre-surgery tests.
Prepare your recovery space with easy-to-reach essentials, comfortable clothes, and pillows to keep you propped up.
During your consultation, we’ll provide a detailed checklist tailored to your needs and answer any questions to help you feel ready and confident.
Can I go home the same day?
Yes! Gender-affirming surgery is typically performed as an outpatient procedure, which means you can go home the same day once you’ve recovered from anesthesia and your surgeon gives the okay.
You’ll need a friend or family member to drive you home and stay with you for at least the first 24 hours to help with basic tasks. We’ll provide detailed post-op care instructions to make your recovery as smooth as possible.
Running and weight lifting can typically be resumed after 4-6 weeks.
Each patient is different, and you should always follow your plastic surgeon’s specific advice for recovery.
When can I go back to work or school?
Most patients feel ready to return to work or school within 1 to 2 weeks after gender-affirming surgery, especially if their job or classes don’t involve heavy physical activity.
If your work requires lifting, strenuous movement, or long hours on your feet, you might need 4 to 6 weeks to fully recover.
Everyone heals differently, so we’ll provide personalized guidance based on your surgery and daily routine to help you get back safely and comfortably.
How do I care for myself after surgery?
Proper self-care after gender-affirming surgery is key to a smooth recovery. Here are some important tips:
Follow all post-op instructions from your surgeon closely, including wound care and medication schedules.
Keep your incisions clean and dry until your surgeon says it’s okay to shower.
Wear any compression garments or dressings as directed to support healing and reduce swelling.
Avoid heavy lifting, stretching, or strenuous activities for at least 4 to 6 weeks.
Attend all follow-up appointments so your surgeon can monitor your healing and address any concerns.
If you notice signs of infection (increased redness, swelling, warmth, or discharge), fever, or sudden pain, contact our office right away.
Will I need revisions?
While the majority of patients are happy with their initial gender-affirming surgery results, some may benefit from revision or refinement surgery. This can be for reasons like improving symmetry, refining scar appearance, adjusting nipple placement, or addressing healing issues.
Revisions are often straightforward, but they’re not required for everyone. During your follow-up visits, we’ll discuss your goals and any concerns to determine if a revision or refinement might be beneficial for you.
Our priority is helping you achieve a result that feels right and comfortable.
What if I’m non-binary and don’t want a “masculine” chest?
We understand that not everyone wants a traditionally masculine chest after gender-affirming surgery. Whether you’re non-binary, genderqueer, or simply want a chest that feels more neutral or unique to you, your goals guide our approach.
Gender-affirming surgery is often highly customizable from creating a softer contour to preserving or removing nipples so your chest reflects your identity, not anyone else’s. During your consultation, we’ll work closely with you to design a surgical plan that aligns with your vision and comfort.
Your body, your choice. We’re here to support whatever feels right for you.
Can I sleep on my side or stomach after surgery?
Right after gender-affirming top surgery, it’s best to sleep on your back with your upper body slightly elevated. This helps reduce swelling and prevents pressure on your healing chest.
Most surgeons recommend avoiding sleeping on your side or stomach for at least 4 to 6 weeks to protect your incisions and ensure the best healing. After that, as you heal and feel comfortable, you can gradually try other positions.
We’ll give you detailed guidance during your recovery to keep you safe and comfortable.
Why choose Valespring for your gender-confirming surgery in Toronto?
At Valespring, we offer gender-affirming surgical care in a private setting, allowing patients to access experienced surgical teams, typically without lengthy waitlists. Valespring Cosmetic Surgery Institute offers expert, personalized care in a modern, fully-accredited surgical facility. Led by board-certified plastic surgeon, Dr. Stephanie Dreckmann, the clinic specializes in private gender-confirming procedures with an inclusive, patient-centered approach. Conveniently located in Richmond Hill, Valespring provides transparent pricing, flexible financing options, and both in-person and virtual consultations to make your journey comfortable and accessible. Our approach is personalized, respectful, and confidential, supporting each patient’s goals through safe, affirming, and timely surgical care.
Do you offer OHIP-covered transition surgery?
No. Please note that Valespring does not provide any OHIP-covered surgeries under general anesthesia. We are able to provide private gender-affirming surgical services which are not part of the provincially funded (OHIP) transition surgery program.