Metoidioplasty and phalloplasty are two surgical options for creating a penis in female-to-male (FtM) gender confirmation surgery.

Here’s a basic comparison:

Metoidioplasty:

• Procedure: Metoidioplasty takes advantage of the fact that testosterone therapy enlarges the clitoris. During surgery, the enlarged clitoris is released from its ligaments and moved forward to a more typical position for a penis. Additional procedures can be performed to create a scrotum and lengthen the urethra to allow for urination through the neopenis.
• Result: The resulting penis is smaller (usually around 2-3 inches when erect) but can become erect without the need for a penile implant. Sexual sensation is typically preserved since the clitoral nerve is not disturbed.
• Recovery: Recovery time is generally shorter and less complex than for phalloplasty, and the procedure has fewer complications.
• Cost: The cost is generally lower than for phalloplasty.

Phalloplasty:

• Procedure: Phalloplasty involves constructing a penis using skin from another part of the body, such as the forearm, thigh, or back. This results in a larger penis than with metoidioplasty. A urethral extension can be created, and a penile implant can be inserted in a later surgery to allow for erections.
• Result: The resulting penis is larger and more like a cisgender male’s penis in terms of size and appearance, but the ability to achieve an erection requires a penile implant. The use of skin grafts can lead to scarring on the donor site.
• Recovery: Recovery from phalloplasty is generally longer and more complex than from metoidioplasty, with a higher risk of complications such as fistulas or strictures in the newly created urethra.
• Cost: The cost is generally higher due to the complexity of the procedure and the potential need for multiple surgeries.

Choosing between metoidioplasty and phalloplasty is a personal decision that depends on the individual’s goals, overall health, financial resources, and other factors. Both procedures have pros and cons, and it’s important to discuss these in detail with a knowledgeable healthcare provider.

As always, this information is based on my last training data up until September 2021, and the procedures might have been updated or changed since then. Always consult with healthcare professionals to get the most recent and relevant information.