Secondary Surgery
PD Dr. Richard Fakin / Gender Reaffirming Surgery (GRS) / Secondary Surgery
Secondary transgender surgery
Madrid | Zurich
Secondary transgender surgery aims to correct and optimize results, as well as address potential postoperative complications from gender reassignment, facial and body feminization, breast augmentation, or mastectomy procedures. Often, this type of surgery combines reconstructive and aesthetic aspects to achieve a harmonious and safe outcome.
For many trans individuals who have experienced complications or unsatisfactory results due to inadequate surgical techniques or improper indications, the possibility of undergoing secondary surgery can raise doubts, fears, and indecision. Therefore, honest, objective, and empathetic communication with the surgeon is essential. Dr. Richard Fakin has extensive experience in both primary and secondary surgeries for trans patients, offering professional, transparent, and discreet care.
Would you like to learn more about the options we offer? Schedule your appointment with Dr. Fakin and our medical team.

Secondary vaginoplasty surgery
Indications for secondary surgery following vaginoplasty can be driven by aesthetic or functional reasons. Many of our patients request a secondary vaginoplasty with colon interposition due to insufficient neovaginal depth resulting from the penile inversion technique performed at other centers. Other common requests include scar revision, fat grafting to address overly reduced labia majora, reconstruction of the labia minora, urethral reduction, secondary commissuroplasty, or clitoral lifting, among other procedures.
Dr. Richard Fakin is internationally recognized for his expertise in both primary and secondary vaginoplasty surgeries, using techniques with skin, colon, or peritoneal grafts.
Learn more about Transgender Secondary Plastic Surgery procedures on our Facebook profile.
Secondary chest surgery
The principles of breast augmentation in trans women differ significantly from those used for cis women. Essential factors include minimal separation between the breasts, the definition of a new inframammary fold, and the achievement of an aesthetic cleavage. We often treat patients who are dissatisfied because their previous procedures did not take these fundamental principles into account.
To address these revisions, we offer state-of-the-art techniques and cutting-edge implants, such as silicone prostheses with different profiles, tissue pre-expansion using expanders, autologous fat transfer, various flaps, nipple reconstruction, and symmetry lift procedures, among others. Our goal is to achieve the desired appearance and improve symmetry, offering an effective and safe intervention.
Take the next step toward an appearance you feel comfortable with. Request your consultation with our specialists in Madrid or Zurich.
Learn more about Transgender Secondary Plastic Surgery procedures on our Instagram profile.


Secondary facial feminization surgery
In secondary facial feminization, it may be necessary to correct scars and asymmetries, as well as perform micro- and nano-fat transfers, grafts, or the use of flaps. Touch-ups on the nose and the periorbital area are also carried out. In numerous cases, we optimize or complete the feminization of bony structures of the forehead, chin, and periorbital region to achieve a more harmonious and feminine result.
Learn more about Transgender Secondary Plastic Surgery procedures on our Facebook profile.
Intimate secondary surgery
Indications for secondary intimate surgery can be aesthetic, reconstructive, oncological, or related to transgender procedures. In all cases, it is paramount to consider both function and appearance, applying state-of-the-art techniques and individualized postoperative care.
Dr. Richard Fakin is widely recognized for his experience in primary and secondary intimate surgeries, offering satisfactory results tailored to each patient’s needs.
Learn more about Transgender Secondary Plastic Surgery procedures on our Instagram profile.

Real cases before and after

