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How many operations will it take to meet my surgical goals? How long will I have to stay in the hospital after each procedure?

In plastic and reconstructive surgery, when we talk about the number of procedures required to reach a certain goal, and how much time is required between procedures, we are talking about staging. Please note that metoidioplasty by itself is a single stage. Depending on the additional associated procedure(s) a patient wants to get with a meta, there may be a need for additional surgeries to be performed at later dates. Likewise, any patient that undergoes a metoidioplasty can eventually get a phalloplasty performed in the future if they choose. Metoidioplasty Staging Stage Length of hospital stay Procedure description STAGE I No UL: Outpatient With UL/vaginectomy: 2 days Metoidioplasty +/- urethral …

What other bottom surgery procedures can I get with or after a metoidioplasty?

Whether you chose a simple meta or a meta with PUL, you can also opt to have a scrotoplasty, hysterectomy, oophorectomy, mons resection, testicular implants, or a variety of other procedures to help you feel as aligned as surgically possible with your body. If you would like to learn more about these additional procedures, you can click here. To learn more about how these additional procedures can fit into the timeline of a metoidioplasty, we encourage you to look over the section below. Additionally, some individuals who have undergone metoidioplasty may desire to have a phalloplasty in the future. This surgical option remains available even after undergoing a simple meta …

Is a hysterectomy or vaginectomy required to get a metoidioplasty?

A vaginectomy is a removal of the vaginal canal. We honor a patient’s decision to preserve their vagina or front hole when it aligns with their gender affirming goals. That said, whenever a urethral lengthening is performed, Dr. Ley requires a vaginectomy due to the very high risk of complications. Patients who opt for a simple meta can also get a vaginectomy if they choose, though it is not required. Patients who get a vaginectomy with a metoidioplasty can have both procedures conducted on the same day. That said, in order to undergo a vaginectomy, a patient must have undergone a hysterectomy, or removal of the uterus, beforehand. The removal …

What complications may arise from a metoidioplasty?

Many patients report that the emotional recovery process after any kind of bottom surgery is more difficult than the physical recovery process. This is especially the case if complications arise. The most common complications, like wound openings, resolve with time and proper home care. Even then, it is normal for complications to result in temporary feelings of frustration, sadness and even regret. It is hard to experience delays in the healing timeline: prolonging when you can get back to work, sit comfortably without a supportive pillow for long periods of time, or engage in sexual activity. We encourage you to be patient with your body as it heals from surgical …

What is the recovery process for a metoidioplasty?

If you get a simple meta, you will most likely be discharged from the hospital the day of your operation. If you get a meta with PUL you can expect to stay in the hospital for two nights and use a catheter to urinate for 2-3 weeks. It is completely normal to experience swelling and bruising around your genital area; this will slowly decrease over the next few weeks. For most patients, after about 6 months, the swelling is expected to completely resolve and you should be able to clearly see your final surgical result. For some, this may take longer. Starting the day after surgery, patients are encouraged to …

Can I get an erection? If having penetrative sex and/or maximizing penis size is a priority for me, which procedure should I choose?

Generally speaking, a metoidioplasty can allow patients to experience erections since their natal erectile tissue is preserved and released. This would not require the surgical insertion of an erectile device, as is the case with phalloplasties. If the results are healing well, a patient can begin to use a penis pump after about 3 months post-op to enlarge their size and better facilitate the possibility of penetration. That said, if a patient’s greatest priority is achieving a great amount of phallic girth and length, a phalloplasty might be their best option. More concretely, the size of the penis created by a metoidioplasty, compared to a phalloplasty, will be smaller and …

Do I need to have a certain BMI to get a metoidioplasty?

Weight in itself is not the sole restrictive factor in determining one’s eligibility for a particular procedure. Decisions are always made in light of you as a whole and certainly, it is not a point to be dismissed whether one’s weight is “too high” or “too low.” BMI in itself does not necessarily correlate with one’s health status or even level of obesity. At the Gender Confirmation Center (GCC), we do have BMI eligibility restrictions for certain procedures. It is important to note that body composition, not the weight itself, is a major determinate. BMI itself does not reflect this point. If you have specific questions, you can discuss them …

If I want to be able to urinate standing up, which procedure can help me achieve that?

A meta with PUL takes the labia minora to reposition and lengthen the urethra so that it comes out at the end of the penis shaft. It is precisely the urethral lengthening which will allow the patient to urinate from their penis and stand to pee. On the other hand, a simple meta would not change the location of the urethra. This means that a patient would still likely need an external apparatus, like a specialized packer, to urinate standing up.

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