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For those patients who identify as non-binary, it is critical to understand what appearance will best affirm their gender, as their particular wishes may not conform to traditional ideas of male and female gender expression. At Align Surgical, we will take the time to get to know you and understand what types of change in appearance you are looking for. We truly understand that each patient is on an individual journey, and we always avoid a “one-size-fits-all” mentality. The procedures required to meet your goals may involve variations to the standard top surgery, breast augmentation, facial, and bottom surgery techniques. We will therefore be sure to create a surgical plan which is customized, and in accordance with whichever appearance best affirms your gender.

Non-Binary Cosmetic Surgery San Francisco

Dr. Dev Gurjala Discusses Non Binary Surgery

Top Surgery

“Top Surgery” refers to modification of the chest to either masculinize or feminize this part of the body. Non-binary patients may seek mastectomy and reconstruction of the nipples and areolas to achieve a masculine chest, although some patients desire variations in theses standard techniques to achieve their goals in gender expression. Procedures may include mastectomy without nipple reconstruction, modifications in the size and placement of the nipple-areola complex, modifications in placement and shape of the incisions, and desire to achieve a more androgynous or gender neutral chest, among others. Top surgery for Non-Binary clients who seek to feminize their upper body typically involves the use of implants, but once again, we will discuss with you a variety of options to achieve your goals. All clients who undergo top surgery can expect:

  • An alignment of your internal and external selves
  • Increased confidence
  • More access to the kind of clothes you wish to wear
  • Long lasting results

While top surgery is not for everyone, it may be a wonderful option that will help you reach your goals. At Align Surgical, our skill, knowledge, and technical expertise can help change your profile in ways hormones cannot, and help you feel more at home in your own body.

Genital surgery

Genital surgery (sometimes referred to as “bottom surgery”) is available to clients who wish to augment their lower body in order to create alignment with their gender identity. Commonly performed genital surgeries include vaginoplasty, when a vagina, vulva, labia, clitoral hood and clitoris are constructed from scrotal and urethral flaps; and phalloplasty, the construction of a phallus using your own tissue. Benefits of genital surgery can include:

  • Life-changing gender confirmation
  • Ability to have enjoyable intercourse
  • Improved confidence
  • Profound sense of completion
  • Natural-looking, and natural-feeling, aesthetic results
  • Long-lasting outcome

In addition to vaginoplasty and phalloplasty procedures, there are several additional procedures and surgeries that can accompany bottom surgery; additional work is dependent on the desired outcome and specific health needs of each client. For transmasculine/non-binary/gender expansive individuals, variations may include vaginoplasty-preserving phalloplasty, nullification, and any other modifications the patient may desire in phalloplasty. For transfeminine/non-binary/gender expansive individuals, variations may include pursuing only orchiectomy, nullification or nullo procedure (penectomy, orchiectomy, and scrotectomy without genital feminization), minimal-depth vaginoplasty (or zero-depth vaginoplasty) or vulvoplasty, or phallus-preserving vaginoplasty.

As all patients who undergo genital surgery have their own goals and desires for the outcome of their transition, Dr. Satterwhite, Dr. Rodriguez, and Dr. Gurjala work closely with clients in their San Francisco Align Surgical Associates Inc. offices in order to create a personalized procedure plan that will give you the most seamless and satisfying results.

Facial contouring procedures

Many non-binary clients are interested in facial procedures that can help support their transition, creating contouring and lines that better align with their gender identity and gender expression. These procedures can include:

  • Rhinoplasty
  • Brow, face, chin or eyelid lifts
  • Facial fat transfer
  • Lip augmentation
  • Ear surgery (otoplasty)
  • Forehead, cheek, chin, and mandible contouring

Non-surgical options (BOTOX, Juvéderm, etc.)

At Align Surgical Associate Inc., we know how important it is to feel that you are presenting the self that you truly are to the world. We will work closely with you to determine how non-surgical facial contouring procedures can help you achieve results that will enhance every aspect of your face.


Each member of our surgical team – Dr. Satterwhite, Dr. Rodriguez, and Dr. Gurjala – has a deep, personal, and profound commitment to helping people align their existence with their self-image. We work exclusively with non-binary people, trans women, and trans men, offering the highest quality of surgical and professional care to all people seeking gender confirmation surgeries in San Francisco. Celebrated for our compassion, attentiveness, stellar results, and deep respect for the community, our team at Align Surgical Associates offers safe, appropriate care and exquisite results in a comfortable, inviting environment.

Dr. Satterwhite, the founder of Align Surgical, serves the Bay Area as one of the top facial feminization and gender-confirmation surgeons working today. He is a Diplomate of the American Board of Plastic Surgery and holds a medical degree from Stanford University in Palo Alto, CA. Dr. Satterwhite trained in the plastic surgery residency at Stanford Hospital, considered one of the foremost training facilities in the world, before embarking on a distinguished craniofacial fellowship in Miami, FL under the guidance of an internationally respected authority, Dr. Anthony Wolfe.

Dr. Gurjala is a compassionate, dedicated gender confirmation surgeon who is honored to guide his patients through this life-affirming process. He is an acclaimed board-certified plastic surgeon who has devoted much of his professional career to performing these vital surgical procedures. As an innovator, Dr. Gurjala is able to redesign the human body to match the identity of the individual with a very natural look, whether doing breast augmentation, mastectomy, body contouring, vaginoplasty, or phalloplasty.

Dr. Rodriguez is a highly-skilled, compassionate plastic surgeon who is board-certified by the American Board of Plastic Surgery. She is a member of the World Professional Association for Transgender Health and is devoted to achieving optimal outcomes for every client she treats. Accredited by the Surgical Review Corporation as a “Surgeon of Excellence in Gender Confirmation Surgery,” Dr. Rodriguez’s passion for excellence is evident from start to finish.

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