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Specialty · Pilonidal and Gender-Affirming

Cleft Lift, Pilonidal and Gender-Affirming Surgery Cost

9 min readUpdated August 2026Typical 2026 ranges, not quotes
Bottom line

A cleft lift for pilonidal disease, the flap procedure with the lowest recurrence rate, typically costs $6,000 to $12,000 US cash-pay all-in and $2,500 to $5,000 at accredited Colombian hospitals; simple pilonidal excision runs $3,000 to $7,000 US. Gender-affirming top surgery (chest masculinization) runs $8,000 to $15,000 US self-pay and $4,000 to $7,500 in Colombia; metoidioplasty $15,000 to $40,000 US depending on stages; breast augmentation for transfeminine patients $6,500 to $12,000 US and $3,200 to $6,500 in Colombia.

Two unrelated clusters share this page because both are under-documented for pricing and both attract patients who have been quoted one number with no breakdown. Pilonidal surgery first, then gender-affirming procedures.

Pilonidal disease: excision vs cleft lift

Pilonidal procedures

All-in typical 2026, cash-pay
Line itemUSAColombia
Incision and drainageabscess, urgent care or ER$300 – $3,500
Simple excision, open healingweeks of packing$3,000 – $7,000$1,200 – $2,500
Excision with primary closuremidline$3,500 – $8,000$1,500 – $3,000
Cleft lift (Bascom)off-midline flap, lowest recurrence$6,000 – $12,000$2,500 – $5,000
Karydakis or Limberg flapalternative off-midline flaps$6,000 – $12,000$2,500 – $5,000
Minimally invasive (pit picking, laser, EPSiT)office or ambulatory$1,500 – $5,000$700 – $2,000
All-in typical range$300 – $12,000$700 – $5,000
US ranges are ambulatory-center to hospital self-pay. The cleft lift is performed by a limited number of colorectal and general surgeons in the US; ask for volume. Colombia figures are moderate confidence.

Pilonidal disease recurs after simple midline excision in roughly 20 to 40 percent of cases, which is why patients on their second or third operation search for the cleft lift. Off-midline flap procedures (cleft lift, Karydakis, Limberg) flatten the natal cleft and move the wound away from the midline, with recurrence rates under 5 to 10 percent in experienced hands. The cost premium over simple excision buys a longer operation and, usually, a surgeon who specializes in it. Recovery is 2 to 4 weeks with a drain for the first week; it travels well with a 10 to 14 day stay.

Gender-affirming surgery

Gender-affirming procedures

All-in typical 2026, self-pay
Line itemUSAColombia
Top surgery, double incisionchest masculinization with nipple grafts$8,000 – $15,000$4,000 – $7,500
Top surgery, periareolar or keyholesmaller chests$7,000 – $13,000$3,500 – $6,500
Breast augmentationtransfeminine$6,500 – $12,000$3,200 – $6,500
Facial feminization, stagedbrow, jaw, nose, tracheal shave$40,000 – $80,000$15,000 – $28,000
Tracheal shave alone$4,000 – $8,000$1,500 – $3,000
Metoidioplastysimple release; with urethral lengthening higher$15,000 – $40,000limited availability
Hysterectomylaparoscopic$9,200 – $16,000$3,800 – $6,500
Orchiectomy$4,000 – $8,000$1,500 – $3,000
Vaginoplastypenile inversion$25,000 – $50,000limited availability
Voice feminizationglottoplasty$8,000 – $15,000$3,500 – $6,500
All-in typical range$4,000 – $80,000$1,500 – $28,000
US ranges are self-pay at experienced gender-affirming programs; many US insurers cover some procedures with WPATH-aligned documentation. Colombian plastic surgeons routinely perform top surgery, breast augmentation, FFS, tracheal shave, and orchiectomy; genital surgery is available at few centers and we list it without routing. Verify SCCP certification and ask for gender-affirming case volume specifically.

Top surgery and breast augmentation are the most common procedures priced abroad because they are outpatient, well within the skill set of any board-certified plastic surgeon, and among the least likely to be insurance-covered without a long documentation process. Plan 7 to 10 days in Colombia for top surgery (drains out at day 5 to 7). Facial feminization is staged and higher-stakes; choose a surgeon with a dedicated FFS practice rather than a general plastic surgeon. For all gender-affirming surgery, ask whether the surgeon requires letters of support and what their revision policy is, since nipple graft and contour revisions are not rare.

Insurance note. In the US, coverage for gender-affirming surgery varies by state and plan and has changed rapidly; check your plan's current policy and the documentation it requires before assuming self-pay. If coverage is denied, the appeal and cash-pay process at noinsurance.co applies.

Credentials to verify before booking in Colombia. Surgeon license on ReTHUS, the national health-professional registry; specialty board membership (SCCOT for orthopedics and traumatology, ACC for general surgery, SCCP for plastic surgery); and the name of the hospital where the procedure is performed. JCI accreditation applies to hospitals, never to standalone clinics.

Why Colombia keeps appearing in these tables. The World Health Organization's 2000 World Health Report ranked Colombia's health system #22 in the world and #1 in the Western Hemisphere, ahead of the United States and Canada. That report has not been repeated, so for current verification pair it with two live anchors: JCI accreditation (a hospital-level credential; standalone clinics are not JCI-accredited) and ReTHUS, Colombia's national health-professional registry at rethus.gov.co, where any surgeon's license can be checked.

Get an itemized quote for pilonidal or gender-affirming surgery

Send the procedure and any prior operative reports or photos. Our Medellín-based team routes to SCCP-certified plastic surgeons or colorectal surgeons at accredited Colombian hospitals and returns itemized quotes within 48 hours.

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Frequently Asked

How much does cleft lift surgery cost?

$6,000 to $12,000 US cash-pay all-in; $2,500 to $5,000 at accredited Colombian hospitals. It costs more than simple excision because it is a longer flap procedure with much lower recurrence.

How much does pilonidal cyst surgery cost?

Simple excision $3,000 to $8,000 US; minimally invasive options $1,500 to $5,000; flap procedures $6,000 to $12,000. Colombia runs 55 to 65 percent lower.

How much does top surgery cost?

$8,000 to $15,000 US self-pay for double-incision chest masculinization; $4,000 to $7,500 in Colombia with SCCP-certified plastic surgeons.

How much does metoidioplasty cost?

$15,000 to $40,000 in the US depending on whether urethral lengthening, scrotoplasty, and other stages are included. It is performed at a limited number of centers; we do not currently route quotes for genital surgery.

Can I get gender-affirming surgery in Colombia?

Top surgery, breast augmentation, facial feminization, tracheal shave, orchiectomy, and hysterectomy are routinely available from board-certified surgeons at accredited hospitals. Genital reconstruction is limited to a few centers.

Related Cost Guides

Editorial disclosure: Surgery Cost publishes independent price research. When readers request quotes through our Colombia partner network at Colombia Medical, we may receive a referral fee from participating clinics. Referral fees do not influence pricing shown or which providers we list. All figures are typical 2026 market ranges, not binding quotes. Request an itemized written estimate before booking any procedure. Nothing here is medical advice.