Dr. Omar Tillo, our medical director and senior plastic surgeon, recently hosted a Reddit AMA answering real questions about gender-affirming body contouring and fat -transfer procedures.
During the discussion, he shared honest, experience-based insights on procedure options, safety, results, recovery, and what really matters when aligning surgical outcomes with personal identity.
With over 4,500 surgeries performed, award-winning expertise, and international recognition for his contributions to body sculpting, Dr. Tillo is one of the UK’s leading specialists in gender affirming body transformation.
Hi, I’m Dr Omar Tillo, a consultant plastic and reconstructive surgeon. I work with trans+ patients on a range of body sculpting procedures using fat transfer techniques. Whether you’re curious about the process, or have questions about safety and outcomes – Ask Me Anything!
byu/omar_tillo intransgenderUK
Key Topics Discussed During the AMA
During the AMA, Dr. Tillo answered a range of thoughtful questions from the LGBTQIA+ community, offering clear guidance on procedures, safety, expectations, and decision-making around body contouring and fat transfer:
Procedures and Treatment Options
Dr. Tillo explained how different body contouring and fat transfer procedures work, how they’re adapted for trans+ patients, and how to choose the right approach based on anatomy and goals. He covered:
- Fat transfer vs implants for breast augmentation in trans women
- Composite breast augmentation (implants + fat) and when it’s beneficial
- Brazilian Butt Lift (BBL) for transfeminine and transmasculine patients
- Targeting areas that hormones don’t typically change, like hip dips and contour gaps
- Masculinising vs feminising BBL techniques
- Replacing breast implants with fat transfer
- Fat grafting to hips, thighs, and transition zones for smoother proportions
Preparation, Recovery and Practical Tips
He also shared advice on preparing for gender affirming surgery, candidacy considerations, and how lifestyle factors can affect results, including topics like:
- Whether a specific weight or BMI is required before surgery
- How surgeons assess donor fat (rather than relying on body fat percentage alone)
- Typical surgical timelines and wait times
- What happens to fat transfer results with future weight or hormone changes
- Tattoo placement considerations before gender-affirming surgery
Risks, Results and Common Myths
Dr. Tillo addressed common concerns, debunking misconceptions about gender-affirming body contouring procedures. He discussed:
- Realistic fat retention rates (typically 50–70% long-term survival)
- Why fat transfer results are softer and more subtle than implants
- How BBL safety has evolved and why technique matters
- The importance of avoiding intramuscular fat placement
- When surgery may not be recommended, even if a patient is eager
- How experienced surgeons decide when not to operate
Costs, Access and Practical Considerations
He also provided clear answers about pricing, access to care, and how decisions are made within a multidisciplinary framework:
- Typical starting costs for BBL and breast fat transfer
- What affects pricing (number of liposuction areas, volume needed, combined procedures)
- How many trans+ patients Dr. Tillo has treated
- How surgery is performed within fully accredited hospital settings
- The role of multidisciplinary care involving anaesthetists, psychologists, and GPs
- What patients can expect during consultations
Read the Full Reddit Conversation
To see Dr. Tillo’s full responses in his own words, you can read the complete Reddit AMA here.
