About Our Philosophy

San Francisco, San Mateo, San Jose, and the Bay Area

Feminization surgery of the face or body is the beginning of a vision for transgender patients.

It is not unusual to have undergone a life, or at least, a period of time of desiring to transition towards femininity. Because of this, often patients feel compelled to be led down a path of what constitutes a feminine appearance, taking strides to conform to a genetic female standard. In fact, there are surgeons who will attempt to promote conforming to a genetic standard for each patient that walks into their office. This has often lead to unnecessary surgery and self realization that maybe the patient underwent procedures that made their appearance less attractive despite either sex.

Each patient has her own subjective view of beauty, so Dr. Beck listens and provides options to satisfy her needs. He is also very forward with what is and isn't realistic. This comes from his depth of surgical training, experience and continued education. Imaging each patient and using this as a road map assists both the patient and doctor to arrive at a realistic goal that will make feminization possible. What this accomplishes is a way to avoid unnecessary surgery and a realization that some of the characteristic of what makes the patient more feminine are the complete opposite of a genetic normal feminine face. Our philosophy is one of LISTENING to our patients and complementing their own beauty with enhancement surgery.

San Jose Facelift

Position statement:

The opinions expressed here are Dr. Beck’s. Some readers familiar with transgender literature may be disturbed to find them at odds with opinions expressed elsewhere and often. However, for those contemplating sex reassignment surgery, it should be comforting to discover that there is a vast middle ground between the sexes to be exploited by surgeons who recognize it. While there are some specific considerations, surgery on transgender patients has more similarities to general aesthetic surgery than it has differences.

The photo of the model on the left demonstrates how a female face can be attractive with strong, angular and somewhat “masculine” features. Regardless of sexuality, this is a beautiful face that stands as a reminder of the common elements between the sexes.

General Comments:

It is not uncommon for plastic surgical patients to express a desire for what amounts to a stylized appearance; overly large breasts, very small noses, ears set back too tightly to the skull, and for the transgender patient, overstated secondary sexual characteristics. It can be more challenging for the surgeon to redirect these interests than to acquiesce to them, but surgeons should resist the temptation to force anatomy into uncomfortable conformity to gender specificity. Creating a harmonious image requires sensitivity to the problem of balancing components that can be and should be changed against those that cannot or should not be changed.

There are some measurable differences in male and female faces, but there is also a broad middle ground.

Most of us have individual features that fall in various places on the scale of masculine to feminine. Very few people are consistently extreme in all of their features. Like individuals whose features are typical or average, those with features at the extremes of femininity or masculinity are seldom thought to be very attractive.


The role of the plastic surgeon is to offer aesthetic alternatives not to prescribe conformity to statistical norms.

A look through a publication like Vogue or W will show models, chosen for their attractiveness, whose features are not statistically "typical" for their sex. As in the photo on the left, the women have wide mandibles with prominent angles that are more statistically “male” than “female”.

Eyelid Surgery

High hairlines thought to be a “masculine” trait, are just as common as low “feminine” hairlines among beautiful women.

Especially relevant to the transgender community is the fact that although small noses may be prevalent in the general community, they are rarely seen in tall women.

People are often attractive because they DON'T conform to statistical norms.