Our experience with transgender patients has taught us much about their desires. Quite often they feel that they have been born into the body of the opposite sex. Their goal is to have the appearance which matches their mindset; to be comfortable in their own skin. Many patients are very detail oriented and therefor have overly high expectations of what surgery can accomplish. Many patients want their appearance to match their behavior and personality; they want to feel normal and beautiful. Understanding this will make Plastic Surgeons more adept at helping transgender patients accomplish their goals.