For both metoidioplasty and phalloplasty, it is a patient’s choice as to whether or not they undergo urethral lengthening. This is the procedure that extends the urethra to the tip of the penis, which facilitates peeing standing up. That said, a vaginectomy is required to extend the urethra to prevent medical complications.

Generally speaking, phalloplasties are more taxing surgeries that have a more difficult recovery process than metoidioplasty. Some phalloplasties require multiple surgeries to construct the penis. You can learn more about recovery from a phalloplasty here. A metoidioplasty leaves virtually no visible scarring. A groin flap phalloplasty leaves a very concealable scar on the groin, a thigh flap phalloplasty leaves a large scar that can be covered up by shorts, whereas a forearm flap phalloplasty leaves a large scar across the forearm.

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 your procedure. For example: If you would like to undergo a urethral lengthening to pee standing up, a vaginectomy (removal of the vaginal canal) needs to be performed to prevent complications. That means you will need to undergo a hysterectomy beforehand. The GCC does not require that patients undergo testosterone hormone replacement therapy (HRT) to undergo either a metoidioplasty or phalloplasty. That said, if you would like to maximize bottom growth before a metoidioplasty, we recommend that you wait 1-2 years on HRT before surgery. You …

Dr. Ley is renowned for her bottom surgery revision procedures. As a former patient herself, she has a deep and personal understanding of how to support patients through revision surgeries. She offers the following services and more: Revisions to the labia and/or clitorial hood to conform with a patient’s goals around size, symmetry, tightness and protrusion Deepening or otherwise reconstructing the vaginal canal (for example, if it becomes shallower because of a lack of dilation) Fixing urinary issues

A penile-preserving vaginoplasty creates a vaginal canal and labia at the base of the penis, keeping the penis in-tact. The vaginal canal can be constructed from external skin (taking grafts from the scrotum and/or the hips) or internal tissue (such as the lining of the abdominal wall or the colon). Vaginal canals created from the lining of the abdominal wall and the colon have the chance of being self-lubricating, although results are not consistent across patients. If you are curious about the recovery process, you can check this guide.

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.