A vulvoplasty is commonly referred to as a “zero-depth vaginoplasty.” It creates a vulva–labia majora, labia minora, a vaginal dimple and/or a clitoris–without the vaginal canal. This procedure is ideal for patients interested in having a vulva without a vaginal canal because they are not interested in having receptive vaginal penetrative sex. A vulvoplasty usually creates a clitoris from the penile gland tissues. This means that full erotic sensation is preserved; most patients can have their first orgasm 3-9 months after surgery. You can find more information on the recovery process here.

A vaginoplasty is a procedure pursued by patients interested in having a vaginal canal to use for penetrative solo and/or partnered sex. The depth of the canal can be discussed with your surgeon. To maintain a vaginal canal, lifelong dilation is required. At the GCC, the most common procedure we perform is a two-stage penile inversion vaginoplasty. This method is Dr. Ley’s signature approach and is preferred by patients because of its durability and the consistency of aesthetic results it produces. In other words, it yields a comparatively low revision rate to other procedures. Alternatively, the vaginal canal can also be lined with tissue from the rectum or inner abdomen. A traditional vaginoplasty creates …

We have compiled a guide on how to get bottom surgery. This includes information on scheduling a consultation, securing insurance coverage, candidacy requirements for surgery and more. Some instructions are specific to vaginoplasty patients. For example, you might need to first undergo permanent laser hair removal and/or electrolysis on the penis shaft and scrotum.

An oophorectomy is a removal of one or both ovaries. This procedure is pursued by patients to prevent or treat any medical complications associated with having a uterus; likewise, it can provide a sense of gender congruence to patients who do not wish to have this organ. It is not a requirement to undergo any other kind of bottom surgery procedure. Read more here.

A vaginectomy is a removal of the vaginal canal. This procedure can provide a sense of gender congruence for patients who do not wish to have a vaginal canal. Patients born with vulvas who would like to undergo a urethral lengthening to be able to urinate standing up are required to undergo a vaginectomy to prevent complications. Read more here.

A hysterectomy is a removal of the uterus. This procedure is pursued by patients to prevent or treat any medical complications associated with having a uterus; likewise, it can provide a sense of gender congruence to patients who do not wish to have this organ. Any patient who would like to have their vaginal canal removed should have this procedure done 8-12 months prior. Read more here.

A scrotectomy is the removal of the skin that makes up the scrotal sack. We do not recommend this procedure for patients who are interested in a vaginoplasty because it throws away skin that can be used to construct the vagina and/or vulva. Read more here.

An orchiectomy is the removal of the testicles. This procedure is one of the quickest and easiest to recover from. It is usually required to undergo a vaginoplasty and can be done at least 8 weeks before or during said procedure. Likewise, patients can get an orchiectomy without undergoing a vaginoplasty to simplify their hormonal regimen; removing the testicles allows someone to get off testosterone blockers and take less estrogen, possibly preventing certain health complications. Read more here.

Any surgery that involves the removal of reproductive organs has the potential to effectively be a sterilization procedure. We encourage patients to read about and consider their options around fertility preservation if they are interested in the possibility of having biological children.

Some patients request that their nipples and areolas be removed from their chest during top surgery. The option to have no nipples is common in patients who wish to have a chest without them or who would prefer to have 3D, hyper realistic nipples tattooed onto their chest to avoid dealing with the recovery protocols and potential complications associated with nipple grafting.