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Gender Confirmation Surgery oversees a number of procedures that will sculpt the chest and genitalia to align your body with your gender identity.

HOW LONG IS GENDER CONFIRMATION SURGERY?

The whole process takes over one year to complete and depends largely on your goals and the recovery time between procedures.

PROCEDURESURGICAL TIMERECOVERY TIME
CHEST
MASCULINIZATION
1-3 hours
Out-patient unless medical problems
First visit at 10 days if admitted to hospital and drains removed at this time; 6 weeks of no strenuous exercise
GENITALIAThe staged procedure with first stage 3 hours and second stage 8-12 hoursFollowing the first stage, 3-5 days in hospital then splint removed at 10 days. Following the second stage approximately 2-3 weeks in the hospital

MENTAL HEALTH EVALUATION

Your transition begins with the consultation from a qualified therapist who specializes in gender transition. This can be difficult for some, but it is important to remember that the results from Gender Confirmation Surgery are not commonly be reversed and your emotional well-being is very important to prevent any complications you experience in the future.

The clearance from a qualified therapist is required before you may begin Hormone Replacement Therapy (HRT) and begin surgery, as many surgeons require two letters of recommendation for bottom surgery and one for top surgery.

HORMONE REPLACEMENT THERAPY

Hormone Replacement Therapy brings out secondary-sexual characteristics and eases the emotional distress you experience from gender dysphoria.

CHEST CONSTRUCTION

Top Surgery, is the most common surgical procedure for transgender men. A masculine chest is sculpted by removing the breasts and resizing and repositioning the nipples. The procedure performed depends on the size of the chest preoperatively.  It can be managed with liposuction techniques, at times with direct excision of tissue below the nipple areolar complex or more often with a double incision mastectomy with free nipple grafts. This allows the patient to live more comfortably and eliminate breast binding, which is often very uncomfortable for the patient. For many transgender men, Top Surgery may be the only surgical procedure taken during the transition.

FTM GENITALIA

FTM Genitalia surgery will align your body to your gender identity by sculpting a neo-penis using tissue from the vagina for the urethra and skin harvested commonly from other parts of your body, commonly the forearm.

  • HYSTERECTOMY & OOPHORECTOMY
    Removes the reproductive organs, ie, uterus, and ovaries.
  • METOIDPLASTY
    Begins construction of the neo-penis by releasing the clitoris from the labia for lengthening and using labial minora tissues for the shaft skin around the clitoral body. If urethra lengthening is done for urination in the standing position a vaginectomy is commonly performed since this tissue is used for the lengthening. A scrotoplasty may or may not be desired.
  • PHALLOPLASTY
    Phalloplasty may be conducted with goals in mind.  First and foremost it is to relieve the patient’s gender dysphoria, allow the patient to have intercourse with their phallus, allow for the ability of sensation both tactile and erogenous, and to allow for urination in the standing position, which is often a harder goal to meet.  It can be performed in one or two stages utilizing tissue from the forearm, back, or thigh.  More commonly in our institution we perform a two stage technique for those patients who desire to urinate through a urethral conduit.
    • STAGE I:
    • VAGINECTOMY
      Vaginal walls are removed and the vagina and perineum are surgically closed. Tissue from the vagina is used for the formation of the neo-urethra on the patient’s forearm (radial forearm flap) – Flap prelamination
    • URETHROPLASTY
      Provides you with the ability to urinate standing up.
  • PHALLOPLASTY STAGE TWO
    Begins construction of the neo-penis by releasing the clitoris from the labia for lengthening and using labial minora tissues for the shaft skin around the clitoral body. If urethra lengthening is done for urination in the standing position a vaginectomy is commonly performed since this tissue is used for the lengthening. A scrotoplasty may or may not be desired.
    • FREE TISSUE TRANSFER
      A microvascular procedure whereby arteries and veins are connected to nourish the forearm flap (neo-penis) with blood. Intensive care unit is needed postoperatively to monitor the penis in the avent of a blood supply problem to the penile construction.
    • SCROTOPLASTY
      done at the time of phalloplasty and flap transfer
      Creates the scrotal sac from labia majora.
    • GLANSPLASTY
      Constructs the tip of the neo-penis.