Male-to-female (MTF) bottom surgery, also known as vaginoplasty or gender-affirming genital surgery, involves the surgical creation of female genitalia. The process typically includes the removal of male genitalia and the construction of a neovagina, clitoris, and labia. Here’s an overview of the MTF bottom surgery process:
1. Preoperative Evaluation and Counseling:
- Before surgery, patients typically undergo a thorough medical evaluation to determine their suitability for the procedure.
- Psychological assessments are standard to ensure that the individual is well-prepared mentally and emotionally for the surgery and its outcomes.
- Many medical guidelines require a period of living in the identified gender and undergoing hormone therapy for a specific duration before surgery.
- Hair removal (usually through laser or electrolysis) may be recommended for the surgical site to prevent hair growth inside the neovagina.
- Removal of the testes. This step reduces the size of the scrotal skin, which can then be used in the vaginoplasty procedure.
- Removal of the penis. The skin of the penis is typically used to create the vaginal lining.
- Construction of a neovagina using penile and/or scrotal skin or a graft from another part of the body (like the colon, in some techniques). The goal is to create a vaginal canal and an external opening.
- Depth of the neovagina can vary, but surgeons aim for a depth that allows for penetrative sexual intercourse.
- Creation of a neoclitoris, usually from a portion of the glans penis. This allows for the potential of sexual sensation since the glans is an erogenous zone.
- Construction of the labia majora and minora, using scrotal and other penile skin.
7. Urethral Shortening:
- The male urethra is shortened, and the opening is repositioned so that it functions similarly to a natal female’s urethra.
Postoperative Care and Recovery:
- After surgery, patients are typically advised to remain in bed for several days.
- A vaginal dilator is often introduced a few days after surgery. Regular dilation is crucial in the first few months after surgery to maintain vaginal depth and width.
- Initial recovery may take 6-8 weeks, with a longer period for complete healing.
- Sexual activity and the use of tampons are usually discouraged for several months after surgery to allow proper healing.
- Potential complications, such as strictures, fistulas, or issues with wound healing, are monitored and addressed as needed.
It’s essential to note that individual experiences and surgical techniques can vary, so the process described above is a general overview. Patients should have in-depth consultations with their surgeon to understand the specific techniques, risks, and expected outcomes.