Affirmation, By Design

Gender Affirming Medical
and Microsurgical Associates

Bottom
Surgery

Bottom surgery is an important component of transitioning for many transgender and nonbinary individuals. At GAMMA, we approach this care with deep respect for its physical, emotional, and social impact. Whether you’re pursuing vaginoplasty, phalloplasty, or metoidioplasty, we provide individualized surgical options grounded in surgical excellence, trauma-informed care, and trans-centered values. Our team is here to support you through every stage of your care—with clarity, compassion, and commitment to affirming your identity.

Bottom Surgery

Vaginoplasty Metoidioplasty Phalloplasty

Facial
Feminization

Facial feminization surgery is a critical part of care for many transfeminine and nonbinary individuals. It can help reduce gender dysphoria and support safer, more affirming experiences in everyday life. At GAMMA, FFS is more than an aesthetic procedure—it is a reconstructive process designed to align facial structure with gender identity. Every patient’s needs are different, and we collaborate with you to tailor your surgical plan with respect, precision, and attention to both safety and nuance.

Facial Feminization

Browbone Reduction Rhinoplasty Jawline Reduction Trach Shave

Facial
Masculinization

Facial masculinization surgery helps transmasculine and nonbinary individuals achieve greater facial harmony and gender congruence. This may involve jaw and chin augmentation, brow bone reshaping, or malar enhancement. At GAMMA, we recognize the importance of these changes not just in how you’re perceived, but in how you see yourself. Our surgical approach is precise and individualized, designed to align your facial features with your gender identity.

Facial Masculinization

Forehead Augmentation Chin Augmentation Adam’s Apple Augmentation

Top
Surgery

Top surgery is one of the most commonly pursued gender-affirming procedures—and for many patients, one of the most transformative. Whether you’re seeking a gender-affirming mastectomy or breast augmentation, our team offers evidence-based techniques tailored to your goals and anatomy. We take the time to understand what this surgery means to you and provide care that centers your safety, autonomy, and affirmation throughout the process.

Top Surgery

Double Incision Keyhole Nerve Preservation Breast Augmentation

Out-of-town Patients

We regularly care for patients who travel from across the country. If you’re coming from out of town, GAMMA offers logistical guidance and support to help make your surgical experience as seamless as possible. From pre-op planning to nearby lodging recommendations, we’re here to help you feel confident, prepared, and cared for—every step of the way.

Jonathan
Keith, MD

Dr. Keith is a board-certified, fellowship-trained plastic surgeon with expertise in gender-affirming and microvascular reconstructive surgery. He is a founding surgeon at GAMMA (Gender Affirming Medical and Microsurgical Associates), where his practice is dedicated to delivering safe, affirming, and expert surgical care to transgender and nonbinary individuals.

Meet Dr. Keith

Drew
Marano, MD

Dr. Drew Marano is a board-certified, fellowship-trained plastic and reconstructive surgeon with specialized expertise in gender-affirming surgery. As a founding surgeon at GAMMA (Gender Affirming Medical and Microsurgical Associates), Dr. Marano offers compassionate, expert care to transgender and gender-diverse individuals seeking gender affirmation through surgery.

Meet Dr. Marano

Patient Reviews

Warmth & Professionalism

I cannot express enough gratitude to Dr.Keith and his team for the care and compassion they provided during my journey. They were attentive, friendly, and always there to answer my questions no matter how small they are. Their warmth and professionalism made me feel completely supported every step of the way.

View Reviews R.H
Right for me

I genuinely don’t even know if I can express just how much I owe to Dr Keith and his team. I’m two months out from surgery and I couldn’t have asked for better people to guide me through this process. I had seen Dr Keith speak, and heard stories of friends and colleagues who had worked and gotten surgery with him before I even met him and I just instantly knew that he was the right doctor for me.

View Reviews E.J
Felt Completely Supported

I recently had surgery performed by Dr. Jonathan Keith, M.D., and I can’t express enough how positive my experience was. From the moment I walked into the office, I felt completely supported in my decisions. The entire staff was incredibly welcoming and made me feel like part of the family, which put me at ease immediately.

View Reviews K.N
Amazing Surgeon

Dr Jonathan Keith is an amazing surgeon. He creates works of art. Dr Keith is also a compassionate doctor who takes the time and explains what he is doing. From the moment he walked into the room to the moment he left the room to prepare for surgery he made me feel at ease and cared for. Great bed side manner and skilled surgeon combined is a rare find and he has an abundance of both.

View Reviews J.A