There are two main types of FTM surgery procedures: metoidioplasty and phalloplasty.
Metoidioplasty is a procedure that uses the existing clitoral tissue to create a penis. The clitoris is enlarged with testosterone, and then the suspensory ligament is severed so that the clitoris can hang down. The labia minora are then wrapped around the clitoris to create a shaft. Metoidioplasty does not require the use of a skin graft, so it is a shorter and less invasive procedure than phalloplasty. However, the penis created with metoidioplasty is typically smaller than a penis created with phalloplasty.
Phalloplasty is a more complex procedure that uses skin and tissue from another part of the body to create a penis. The most common source of tissue for phalloplasty is the forearm, but other sources include the thigh, abdomen, or back. The tissue is used to create a shaft, a urethra, and a scrotum. Phalloplasty can be performed in one or two stages. In one-stage phalloplasty, the entire procedure is performed at once. In two-stage phalloplasty, the first stage involves creating the shaft and urethra. The second stage, which is usually performed several months later, involves creating the scrotum and implanting a penile prosthesis.
Both metoidioplasty and phalloplasty are major surgeries that require a lengthy recovery period. The risks of both procedures include infection, bleeding, and complications related to anesthesia. There is also a risk of complications specific to each procedure, such as urethral stricture (narrowing of the urethra) after metoidioplasty or penile implant failure after phalloplasty.
The decision of which procedure is right for you is a personal one that should be made in consultation with your healthcare provider. There are many factors to consider, including your individual anatomy, your goals for the surgery, and your risk tolerance.
Here is a table summarizing the key differences between metoidioplasty and phalloplasty:
|Length of surgery||2-4 hours||4-8 hours|
|Recovery time||4-6 weeks||6-12 weeks|
|Risks||Infection, bleeding, complications related to anesthesia, urethral stricture||Infection, bleeding, complications related to anesthesia, penile implant failure|
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Female-to-male (FTM) surgery, also known as gender-affirming surgery or masculinizing surgery, involves a series of procedures to help align a person’s physical appearance with their gender identity as male. The specific surgeries involved can vary depending on the individual’s goals and needs, but commonly include:
- Chest Reconstruction (Top Surgery): This procedure involves the removal of breast tissue to create a flatter and more masculine chest. It can be done through subcutaneous mastectomy or double incision mastectomy, depending on the amount of breast tissue and desired outcome. Nipple grafting may also be performed to resize and reposition the nipples.
- Hysterectomy and Oophorectomy: These surgeries involve the removal of the uterus (hysterectomy) and ovaries (oophorectomy). Some transmasculine individuals opt to have these procedures to eliminate menstruation and reduce estrogen production.
- Metoidioplasty: This procedure is suitable for individuals who have undergone hormone therapy and have experienced significant clitoral growth. It involves releasing the ligaments that attach the clitoris to the surrounding tissue, resulting in a more prominent phallic appearance. Urethral lengthening (urethroplasty) may also be performed to allow for standing urination.
- Phalloplasty: Phalloplasty is a complex procedure that aims to construct a neophallus using various techniques. It typically involves using a flap of tissue, often taken from the forearm or thigh, to create the phallus. The neophallus may be combined with urethral lengthening (urethroplasty) to enable standing urination. Additional procedures such as scrotoplasty (creation of a scrotum) and placement of testicular implants may also be performed.
- Vaginectomy: This procedure involves the removal of vaginal tissue to eliminate the vaginal canal.
It’s important to note that the specific surgical procedures and techniques can vary based on the surgeon’s expertise, individual patient factors, and desired outcomes. It’s crucial to consult with a qualified gender-affirming surgeon who can provide personalized recommendations and guide you through the surgical process. They will assess your specific needs, discuss the available options, potential risks and complications, expected outcomes, and post-operative care.