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Non-Binary Body Contouring

Medically reviewed by Jennifer Richman on February 25, 2025.

This article is an introduction to the options for gender affirming body contouring, also referred to as transgender body sculpting, that are often solicited by non-binary and gender expansive patients. Much like top surgery for non-binary patients, body contouring beyond the gender binary is seldom discussed but is a viable option for surgery.

We recognize that there is no one way to “look non-binary.” Rather, the options discussed below can help patients interested in obtaining what is conventionally seen as an androgynous appearing body or a body with which it feels easier to fluidly express gender–depending on your unique goals. If you have questions or would like to create a unique, surgical plan tailored to your goals, you can request a free consultation with one of our board-certified surgeons.

Body Contouring Surgical Techniques Non-Binary Patients

The following techniques are available to patients who are interested in gender-affirming body sculpting surgery:

Liposuction:

The most common technique used in gender-affirming body contouring is liposuction. At the GCC (Gender Confirmation Center), our patients often choose to liposuction one or more of the following areas. The image below is not exhaustive of all liposuction options. That said, if you are interested in undergoing liposuction in one of the areas not mentioned below (e.g., in the back or abdomen), you can speak with one of our surgeons in a free consultation.

Please note that liposuction is not meant to be a weight-loss strategy, but rather a means of eliminating stubborn fat deposits that lifestyle changes have not been able to sufficiently reduce for the patient. Generally speaking, patients with a BMI over 32 are unlikely to see long-lasting results after a liposuction procedure. Liposuction also cannot alter the body beyond the boundaries of the bony structures, such as the rib and hip bones.

Abdominoplasty and other skin excision procedures

For many trans, non-binary and gender expensive folks, skin overhang and stretch marks—whether from a past pregnancy or other weight loss—can exacerbate feelings of gender dysphoria.

An abdominoplasty procedure involves the removal of unwanted fat, unwanted skin overhang and the tightening of abdominal muscles to create a flatter stomach. Your surgeon can tighten other areas of unwanted loose skin, such as in the arms or under the neck.

Please note that skin excision procedures always leave scars, which your surgeon can place in locations that make them easy to hide. For example, abdominoplasty scars are usually placed in the upper groin so that they can be covered by underwear and swimwear.

For patients who are concerned about skin overhang and/or stretch marks in their upper torso, many top surgery techniques can help tighten skin on the chest.

Fat grafting

Fat grafting procedures involve removing fat from parts of the body where it is not desired, such as liposuctioning the trunk (abdomen, flanks, and lower back). From there, the fat is purified and injected into other parts of the body, most often the buttocks and/or hips, to augment them. For more information on buttocks and hip augmentation for gender-affirmation, sometimes called a BBL,click here.

Silicone implants

Silicone implants can help augment certain parts of the body to help patients meet their gender alignment or gender euphoria goals. Most commonly at the GCC, we offer patients silicone implants to augment the breasts. We also have experience inserting silicone pectoral implants, to give patients the appearance of more prominent chest muscles.

Choosing Which Procedures are Right for You

At the GCC, our patients are in the driver’s seat when it comes to making a unique, surgical plan. During your free, virtual or in-person consultation, your surgeon will get to know your goals, review your medical history and help you set realistic expectations for surgery.

For some patients, it can feel intimidating to come into a surgical consultation. One of the best ways to come prepared is by reflecting on what you need and want out of gender-affirming surgery. For many patients, this can look like reflecting on the following questions:

• What about the shape of your body brings you gender dysphoria?
• What parts of your body do you often try to cover up with loose-fitting clothing? 
• What parts of your body do you try to exaggerate with tight-fitting clothing or prosthetics?
• What parts of your body bring you discomfort because you associate them with being either “too masculine” or “too feminine” when you look at them in the mirror?

Additionally, many patients find it helpful to go over the common effects of puberty on body shape to figure out which procedures would help them best address their gender dysphoria. You can find information on this topic in the section below:

Puberty and Body Shapes: Considerations for your Surgical Plan

Understanding how testosterone and estrogen affect bone formation and fat distribution has helped some patients reach clarity on which parts of their body they would like to alter through gender-affirming surgery.

Fat distribution

Generally speaking, an estrogenic puberty causes fat to accumulate in the hips, buttocks, and thighs, which can lead to a body looking “curvier.” 

Patients who are interested in “defeminizing” their body contour will often request liposuction and/or skin excision procedures that take away volume from these parts of the body.

On the other hand, testosterone tends to redistribute fat away from the areas and more towards the abdomen and thighs. Although hormone replacement therapy (HRT) can redistribute body fat, its effects are limited and generally do not result in a drastic change in body shape. This is especially the case if a patient is micrododing testosterone or microdosing estrogen. 

While we recognize that patients do not need to be on HRT to access body contouring surgery for gender-affirmation, most insurance providers will only cover these procedures for patients who have been on HRT for a year before surgery.

Waist-To-Hip-Ratio

Waist-To-Hip-Ratio (WHR) is the dimensionless ratio of the circumference of the waist to that of the hips. This is calculated as waist measurement divided by hip measurement (W ÷ H). The WHR is determined by the width of the pelvic bone and the person’s fat deposits. 

An estrogenic first puberty tends to result in a widened pelvis, which widens the hips (image A). Surgically, we cannot alter the bone structure of the pelvis. However, we can add fat to the buttocks and hips OR remove fat around the hips, buttocks and thighs to alter the WHR. 

The following numbers are based on averages that come from cisgender populations that have undergone full estrogenic or androgenic (testosterone) puberties. They are not meant to be prescriptive guidelines for what your body contouring results should be: 

• If someone wants a conventionally “masculine” body shape, the surgeon would aim for a WHR of 0.85-0.95.
• If someone wants a conventionally “feminine” body shape, the surgeon aims for a WHR of 0.70.
• If someone wants a conventionally “androgynous” body shape, the surgeon can aim for a WHR of 0.70 to 0.85.

Buttocks contouring

In addition, when thinking about non-binary body contouring, patients often pay special attention to the buttocks and hip region. In the image above, we see the body of a person who underwent estrogenic puberty on the left, and an androgenic puberty on the right.

If a nonbinary person desires a more “feminine” body shape, they can opt for fat grafting and liposuction to create more of the “S-curve” shape that we see on the left. Conversely, if the patient desires a more “masculine” body shape, your surgeon can work to create a more boxy body silhouette that looks more like the image on the right. That said when doing nonbinary gender-affirming body contouring, we work with every individual to design a unique, individualized plan that works for them. We also take into account the extent to which the patient’s final gender form will be expressed, meaning we will discuss the ideals and expectations of nonbinary body contouring at length.

Can I undergo body contouring at the same time as another procedure?

The answer to this question can be determined by your board-certified surgeon during your consultation. Although specific limitations will be determined by your medical history and financial possibilities, at the GCC we have the following trends in our practice.  

• Top surgery (chest reconstruction and breast augmentation) can be performed alongside most liposuction, fat grafting, and skin excision procedures. 
• Top surgery (chest reconstruction) patients can have silicone pectoral implants placed during or after their mastectomy procedure
• Facial surgery is generally not performed in tandem with body contouring unless the patient is undergoing a minimal number of facial procedures. That said, patients may undergo liposuction and skin tightening procedures with facial surgery. 
• Bottom surgery is generally not performed in tandem with body contouring. That said, Dr. Ley (she/her/they) can perform a mons reduction and/or penniculectomy—removing unwanted fat and skin in the upper groin area—at the same time as some bottom surgery procedures..

Conclusion

Overall, when thinking about non-binary body contouring, our goal is often to work towards eliminating characteristics that are conventionally gendered, depending on the goals of the patient. 

Nonbinary gender-focused body contouring can be a helpful procedure for folks who desire a different body shape or to change gendered aspects of their body shape. 

There is a natural and wide variety of body shapes that exist, and how one views gendered parts of a body are individually-, culturally-, and societally-based. While skeletal structures are a limiting factor, body fat can be removed or shifted via liposuction to create a body shape that affirms your gender. Because everyone’s body is different and every one has distinctive goals, we recommend consulting with your surgeon in a consultation to discuss which procedures are right for you.

You can find a summary of the information in this article in our printable PDF.