Your Options for Transfeminine Bottom Surgery

What Is Transfeminine Bottom Surgery?

Orchiectomy

An orchiectomy is a surgery that removes the testicles, resulting in sterility as well as a loss of testosterone. A simple or scrotal orchiectomy is most commonly performed for transfeminine bottom surgery, which uses an incision made in the scrotum.

Given the emotional benefits that trans women experience as a result of the removal of the testicles, many of our transfeminine bottom surgery patients choose to undergo just an orchiectomy. However, others may choose to undergo a vaginoplasty in order to create a more feminine appearance and functionality of their genitals.

Vaginoplasty

A vaginoplasty is a gender-affirming surgery that transforms the male genitals into a beautifully feminine and functional vulva and vagina. When performed by a board-certified surgeon with experience in transfeminine surgeries, patients can expect full and normal functionality when urinating and having sexual intercourse. The vaginal canal is
created in order to allow penetrative intercourse, usually through a penile-inversion technique. A scrotal skin graft may be used to augment the length of the penile tube. The anterior vaginal is created from mucosal tissue and is thus self-lubricating. The urethra is shortened and re-oriented so that the urinary stream will be into the toilet bowl when seated. A clitoris is constructed to be sensate, able to be stimulated and facilitate orgasm. Labia majora and minora are created to give a feminine appearance. A vaginoplasty as described as above is designed to be a one-stage procedure when performed at Restore. The patient may have
orchiectomy prior to the procedure, or at the same time.

Zero Depth Vaginoplasty

This procedure is similar to Vaginoplasty as described above, without the creation of the actual vaginal canal. When looking at the patient, one would not be able to tell whether the patient had traditional Vaginoplasty or Zero Depth Vaginoplasty. One might prefer this procedure to traditional vaginoplasty for a number of personal reasons – she might not want to dilate postoperatively, she may not want to have penetrative sex, she may want to avoid possible complications associated with traditional vaginoplasty, among others.

The physical and emotional benefits of this procedure are incredibly life-changing. However, this is a very significant surgery with permanent results. It’s important that all patients considering this surgery are fully prepared and aware of the risks and benefits of surgery.

The Transfeminine Bottom Surgery Procedure: What to Expect

Our biggest priority at Restore Medical Center is you. We want to be sure that each and every one of our gender reassignment patients are able to get the surgeries they need to feel more like the person they are inside. However, we also want to be sure that each patient has all the information and details necessary to make a well-informed decision about surgery.

You will be able to ask any and all questions about transfeminine bottom surgery during your private one-on-one consultation. Our board certified plastic surgeon is sensitive and understanding to your situation and will work closely with you to create the best plan for your unique situation.

In accordance with the WPATH Standards of Care, each of our patients is recommended to meet with two gender therapists to help ensure that surgery is an appropriate treatment for the patient’s dysphoria. Restore Medical will work with you to help facilitate these meetings so that you may get to surgery sooner than later if that will help alleviate your gender dysphoria.

In the weeks and days leading up to your procedure, our surgery team will provide you with detailed pre-surgical instructions. If at any time you have any questions regarding your surgery, please do not hesitate to call our office or your surgeon directly.

It’s important that you have a friend or loved one with you to drive you to and from your appointment, as well as to provide care and assistance during your initial recovery. An overnight hospital stay may be necessary.

Orchiectomy Surgery
During a simple or scrotal orchiectomy, the penis will be taped against the abdomen and an incision will be made in the scrotum. Your Restore Medical Center surgeon will then remove the testicles and parts of the spermatic cord through this incision. Once removed, incisions are closed and covered with surgical dressings.

Vaginoplasty Surgery
There are a couple different methods for vaginoplasty surgery, as well as accompanying procedures like labiaplasty and cliteroplasty. We will detail the steps of your specifically personalized procedure with you during your consultation.

Penile inversion vaginoplasty, often referred to as the “gold standard,” is most often performed as a single-stage procedure that incorporates orchiectomy, partial penectomy, and penile dissection with the creation of the vaginal cavity, labiaplasty, and cliteroplasty.

Once the surgery is completed, all incisions are closed and covered with surgical dressings.