Gender Affirming Services

Gender Affirming Services


Linea Cosmetic Surgery is here to help you through the rewarding experience of transitioning from Male to Female. We offer various types of procedures in Facial Feminization, Breast Procedures, Mastectomies, and Body Procedures. Every client is different and there is no right or wrong way to transition. Although it is rewarding, transitioning is a long process that requires patients and 12 continuous months of living as your preferred gender. Our goal is to help you become the you you want to be. 

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Complete Guide

Transitioning is a big step in someone’s life to becoming the person they were always meant to be. We want to provide you with the best tips and support on making the transition as easy as possible. Here are some links to help you during your experience.

Find Someone to Talk to:

Female Presentation:
TS Roadmap

Changing Your Name / Gender:
T-Vox, Susans, TS Roadmap, Lambda LegalTransrelief

Support Groups:
Gender Sanity

Advice on Coming Out:
TS Roadmap

Financial Resources:
Trans Medicare

Changing Your Name / Gender by State:
Lambda Legal

Feminizing Hormone Therapy:

Housing During Your Procedures:
 Palouse Transitions

Facial Feminization

Facial Feminization provides many types of procedures to help you achieve the feminine facial features you want. Linea Cosmetics offers Tracheal Shaving, Chin Augmentation, Rhinoplasty, Cheek Augmentation, Brow Shaving, and Lip Lifts.


Tracheal Shaving is a shaving of the ‘Adam’s Apple’ to achieve a more feminine neck. While males have a protruding and bulky neck, females tend to have a flat and smooth neck. Dr. Stiller makes an incision on a natural fold about the Adam’s Apple and removes the excess cartilage. This procedure is usually an outpatient procedure and is performed under anesthetics.

Chin Augmentation is an implant in the chin to create an oval shape of the face. Silicone implants are soft, smooth and flexible. They vary in shapes and sizes making them the most common implants in chin reconstructive surgery. An incision can be made under the chin or inside the lower lip to create a pocket for the implant to be placed in.

Rhinoplasty is a reshaping of the nose. An incision is made inside the nose to avoid visible scarring. Cartilage may be removed or tissue can be added to achieve the correct shape you are looking for. Females tend to have a more narrow, short, delicate nose while Males have a long, wide, prominent nose. Dr. Stiller can reshape the nose to be larger or smaller, change the angle of the nose, and remove bumps, indentations or other unwanted defects. After surgery, a splint is placed outside of the nose to help with recovery. 

Check Augmentation is an implant in the cheek to emphasize the cheek bones to achieve a feminine face. The implants are placed into the face via an incision in the upper mouth near the top of the gums or an external incision near the eye. The implant is then slid into place. There are 3 implant shapes used.

The most common shape is a Malar implant. The implant is placed directly on the cheekbones providing a higher contour to the face. This helps achieve the apple-like look of the face.

Submalar implants are placed in the mid-face instead of directly on the cheekbone. This will help correct a ‘sunken’ or gaunt appearance.

Malar/Submalar is an extended implant catering to both the mid-face and cheek bone.

Brow Shaving is the reduction of the frontal sinus wall to create a feminine looking forehead. Males tend to have a prominent brow bone that is flat or may even slope backwards. Females have a rounded, smooth, and more vertical forehead. Dr. Stiller will shave the frontal sinus wall to achieve a thin, arched look. The amount of Brow Shaving varies between patients.

Lip Lifts elevate the upper lip area to make it appear larger. It is not necessarily an augmentation as it is a reshaping to increase prominence of the lip line. Males tend to have thin, flat lips while females have full, top-turned lips. Lip lifts are performed with minor incisions under the nostrils, above the upper lip line, or corner of the mouth. The placement of the incision is based upon the goals the client wishes to achieve.


Breast Procedures

Linea Cosmetic Surgery offers various types of breast procedures to help you achieve the body you are looking for. We offer Breast Augmentations, Fat Grafting, Mastectomies, and Nipple Resizing. All of which can be used to help you be the you you were always meant to be.


Breast Augmentation is an implant in the chest to enhance and contour the breasts of an individual. An incision is made along the natural skin fold to reduce visible scarring.

There are two ways the implant can be placed in the chest. Submuscular pockets are placed between the chest muscle wall and rib cage. These are often used in small-breasted individuals as it provides extra padding. It also provides a more natural look and a decrease in scarring. Subglandular pockets are between pectoralis muscle and under the breast tissue and are often used in larger-breasted individuals.

Linea Cosmetic Surgery provides two types of breast implants. There are silicone and saline implants. Both of which have pros and cons.

Silicone Implants are approved by the FDA for patients 22 and older. They have a silicone shell and are filled with a thick, medical-grade silicone. They are softer than saline and therefore feel more natural. They also have a lower risk of leakage. In the case of a leakage, silicone implants will not collapse. However, they will have a ‘silent rupture’ making it very hard to know when your implant is damaged. Clients who chose silicone implants are recommended to have an MRI every 2 years to check their implants. In the case of a rupture, it can be painful and your implant may change shape causing accidental rotation and asymmetry. Silicone implants are also pre-filled causing a larger incision to be made for placement.

Saline Implants are approved by the FDA for patients 18 and older. They have a silicone shell and are filled with a salt water solution. They require a smaller incision than silicone because they are filled after they have been implanted. They are ideal for a patient with asymmetrical breasts because you can ‘custom fill’ your implants. There are also more options for the placement of the incision. In the case of a leakage, the saline from the implant will be absorbed by the body. This is harmless to the individual. However, they have a higher risk of leakage and quickly deflate when a leakage occurs. Similar to silicone implants, they can shift, change shape, harden, and ripple causing asymmetry in the breasts. Saline implants are firmer and don’t feel as natural.

Fat Grafting is the removal of fat from one are of the body and moving it to another.  The fat is removed by liposuction. Fat grafting allows an individual to contour the face a body giving them the appearance they desire. This procedure causes minimal scarring and is long-lasting. Unlike dermal fillers or injections, fat grafting has a lower risk of allergic reaction of foreign substances.

Nipple Resizing is the shaping or reduction of the areola. An incision is made in the nipple and the excess tissue is removed from the area. Typically, this procedure is not performed with a mastectomy in order to preserve the blood supply to the nipple. The procedure is usually done under local anesthesia.



Mastectomy is the opposite of a breast augmentation as it removes unwanted breast tissue. This is the first surgical step to becoming male. Mastectomy is also referred to as ‘Top Surgery’ in the transgender community. There are several different types of mastectomies.

Click Here to view our Lateral Incision Mastectomy Gallery


This procedure allows for the removal of all breast tissue and excess skin. An incision along the lower border of the pectoral muscle fold is made to allow for minimal, visible scarring. The nipple-areolar complex is downsized and placed as a graft in the desired location. This allows for proper placement and downsizing of the nipples. This procedure, however, does leave a scar on each side of the chest.

Mastectomy with liposuction removes as much fat as possible while avoiding damage to the skin or muscles. This procedure results in minimal scarring. Significantly reduced postoperative pain and a rapid recovery time are also benefits of this procedure.

The peri-areolar, or keyhole, incision consists of the removal of breast tissue through a small incision around the nipple. The nipple stays intact with the breast. This results in significantly reduced scarring. A suitable candidate should be young and slim with a small amount of breast tissue. Since the nipple stays intact, a person must have nipples that do not require repositioning.

The dermal pedicle flap consists of the full thickness of the skin and is attached by tissue where it receives its blood supply. An incision is made on each side of the chest along the lower pectoral muscle fold. The nipple areolar complex is then downsized and placed in a new opening. The ideal candidate is a large-breasted, or ptotic, individual. This procedure does result in scarring.

This procedure is best for individuals with larger or overhanging breasts. A double incision mastectomy consists of two horizontal incisions that are made at the top and bottom of the pectoral muscle. The original nipples may be removed, trimmed, and grafted onto the chest. This procedure allows for greater precision in the nipple size and position. The disadvantage is the scar. Double incision mastectomy may be performed with the pedicle technique. This will allow the nipple to stay intact via a stock of tissue. It is repositioned while staying connected. The technique is often chosen in an attempt to maintain sensation in the nipple.

An incision is made around the areola and continues down the midline of the breast. The incision continues across the inframammary crease. This procedure allows for reshaping and sculpting of the entire breast. The ideal candidate for this procedure is one with overly large or ptotic breast tissue as other procedures will result in excess skin around the breast.


Body Procedure

We offer various types of body procedures to contour your feminine look. Body Feminization, Orchiectomy, Clitoroplasty, and Labiaplasty are all procedures you can chose from to create your ideal body.


This process uses liposuction and fat grafting to contour the body to a more feminine silhouette. Dr. Stiller removes fat tissue to slim down and sculpt the desired areas. The fat is then placed in the buttocks and hips to achieve a feminine curve. The fat is removed from the abdomen, the area below the buttocks, and the lower part of the back to accentuate the buttocks and hips. Body feminization is designed for contouring, not weight loss. After surgery, you will notice an immediate change in the buttocks due to the permanent fat tissue, and swelling. The swelling will go down within three to six weeks.

Orchiectomy is a procedure where one or both of the testicles are removed. Bilateral Orchiectomy is performed as a single-stage surgery. The purpose is to lower the level of male hormones and prepare the genital area for later operations. Patients who undergo Orchiectomies take hormones over a period of several months to several years prior to the surgery. This surgery is not performed as an immediate response to a request. The standards of care for gender reassignment require a psychiatric diagnosis and a physical exam. Dr. Stiller needs two letters of evaluation and recommendation by mental health professionals; preferably a psychiatrist and a clinical psychologist.

Clitoroplasty is the creation of the clitoris in gender affirming surgery. Dr. Stiller creates a conically shaped clitoris with a fully preserved neurovascular bundle. The clitoral hood, labia majora, and labia minora are created using the remaining penile and scrotal tissue. This procedure is also referred to as a hoodectomy.

Labiaplasty reduces the length of the labia minora so it does not hang below the labia majora. Some patients experience twisting or tugging of the labia as well as itching or irritation. Patients who undergo Labiaplasty tend to have discomfort during every day activities, when they wear tight clothing, or during intercourse. Labiaplasty can also reduce asymmetry of the labia for patients who want to feel more confident. Dr. Stiller uses the diVa laser to perform this procedure.