Metoidioplasty
Metoidioplasty is a surgical procedure designed to create a penis for female-to-male transgender individuals. The procedure utilizes the skin and tissue surrounding the clitoris. After 1-2 years of hormone therapy, the clitoris becomes enlarged. During the procedure, the clitoris is carefully released from its surrounding tissue and then wrapped in skin, creating a phallus.
Tissue from the vagina is used to extend the urethra to the tip of the newly constructed penis, allowing for urination while standing.
To create a more masculine appearance, fat is removed from the pubic area to create a flat pubic region. Fat is also removed from the labia, which are then sculpted to resemble a scrotum. Artificial testicles can be inserted to complete the aesthetic. While the resulting penis is smaller than a typical adult male penis, resembling that of a 10-year-old child, it offers a significant step in gender affirmation and may provide sexual sensation.
Types of female-to-male metoidioplasty at Kamol Cosmetic Hospital:
- Simple Release: This procedure focuses on surgically releasing the clitoris from the surrounding tissue. This enhances the visibility and shape of the clitoris, making it appear more penis-like. It does not involve creating a urethra or closing the vagina. Urination remains unchanged. This procedure is less invasive and takes approximately 2 hours.
- Full Metoidioplasty: This is a more comprehensive surgical procedure that lengthens the clitoris by releasing it from surrounding tissue, making it more prominent. The procedure also extends the urethra to the tip of the clitoris using tissue from the vagina. This allows the individual to stand and urinate like a male. Additionally, the vagina can be closed, and artificial testicles can be inserted during the same procedure. This surgery takes approximately 6 hours.
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| Figure 1. | Figure 2. |
| The figure shows a diagram of a ring valve. |
Schematic diagram of total metoidioplasty with ring valve and testicular implants. |
Benefits of Metoidioplasty:
- Lower risk.
- More affordable.
- The surgery efficiently combines multiple procedures in one operation, including closing the vagina, creating a urethra, constructing a phallus, and inserting an artificial testicle. This comprehensive approach takes approximately 5-6 hours.
- Natural erectile function.
- The phallus retains the erotic sensitivity of the clitoris.
- The procedure results in minimal scarring.
- Recovery is typically rapid. Patients generally stay in the hospital for 4 nights and can return to their daily routine within 3 weeks, including using the men's restroom and urinating while standing.
Disadvantages of Metoidioplasty:
- The resulting penis size is limited, ranging from 3 to 8 centimeters, and is not large enough for penetrative intercourse.
- Prior to surgery, male hormone therapy is required for at least 1-2 years to enlarge the clitoris to a suitable size for the procedure. This can be a lengthy process.
Preparation before Metoidioplasty surgery
- Consult with a skilled plastic surgeon before the surgery to discuss the procedure, preparations, medications, and necessary tests such as physical examinations, blood tests, and chest X-rays.
- Obtain evaluations from at least two psychiatrists to ensure you are confident in your decision to transition to your chosen gender.
- Maintain good health and be prepared for surgery and anesthesia.
- Undergo male hormone therapy for at least 1 year to allow the clitoris to mature sufficiently for surgery.
- Stop taking hormones at least 2 weeks before surgery.
- Be over 20 years old to provide legal consent for the surgery.
- Maintain a healthy weight with a BMI under 24 to reduce surgical risks.
- Stop smoking at least 2 weeks before surgery.
- Avoid medications that affect blood clotting, such as aspirin or vitamin E.
- Plan for time off work, prepare mentally for the surgery, and arrange for post-operative wound care.
Post-operative care for Metoidioplasty surgery
- After the surgery, you will be kept in the recovery room for 3-4 hours to recover from the anesthesia. You will then be transferred to the hospital room.
- The catheter should be kept in place for at least 3-weeks to allow the urethra to heal properly.
- Properly care for the urinary catheter to prevent complications.
- Empty the urine bag frequently.
- Avoid putting pressure on the newly constructed penis to ensure adequate blood supply.
- After surgery, keep the penis raised and upright to minimize swelling.
- Attend follow-up appointments with the doctor for wound cleaning and care for 2-3 weeks after surgery.
- Stitches will be removed 7 days after surgery.
- Expect temporary symptoms such as itching, swelling, blood in the urine bag, constipation, and nausea for the first 1-2 weeks after surgery.
Possible risks and complications after Metoidioplasty surgery
- Risks of urethral surgery include fistulas, which may require further surgical repair.
- Urethral stricture may occur, requiring regular dilation of the vagina.
- Other potential complications include wound rupture, bleeding, delayed healing, infection, pain, swelling, bruising, scarring, and potential rejection of artificial testicles.
Recovery after Metoidioplasty surgery
- The recovery period depends on the type of surgery. Full recovery from female-to-male metoidioplasty takes at least 3 weeks. You can return to work but avoid lifting heavy objects. Normal exercise can be resumed after 2 months.
Why Kamol Cosmetic Hospital is famous for metoidioplasty
- Kamol Hospital has a team of highly skilled and experienced surgeons specializing in metoidioplasty. This complex procedure requires expertise to achieve optimal results.
- The hospital is equipped with modern facilities and equipment, ensuring a safe and effective surgical environment.
- Kamol Cosmetic Hospital is renowned for its exceptional patient care, with friendly and attentive staff.
- Located in Bangkok, Thailand, a popular medical tourism destination, Kamol Hospital offers affordable metoidioplasty procedures compared to other countries.
- The hospital caters to international patients, with staff proficient in English and other languages.
- Kamol Cosmetic Hospital has a proven track record of successful metoidioplasty procedures, with high patient satisfaction and minimal complications.
Kamol Hospital is a leading choice for gender reassignment surgery due to its high-quality surgical standards, world-renowned surgeons, affordable prices, comprehensive services, and excellent post-operative care, including accommodation options in hotels and service apartments.
Getting to Know for Metoidioplasty or Baby Penis
Metoidioplasty VS Phalloplasty
Phalloplasty and metoidioplasty are two surgical procedures used to create a penis in individuals assigned
Benefit of Metoidioplasty
Metoidioplasty is a surgical procedure that is often used to help transgender men achieve a more masculine genital appearance.
Limitation of Metoidioplasty
One significant limitation of metoidioplasty is the potential for inadequate penile length.
Before and After for Metoidioplasty
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Frequently Asked Questions (FAQs)
A: Metoidioplasty is a surgical procedure used in female-to-male (FTM) gender-affirming surgery to create a neophallus (new penis) from the clitoris. It involves releasing the clitoris from its surrounding tissues and lengthening it to create a more masculine appearance.
A: There are several techniques for performing metoidioplasty, including:
- Simple release: This involves releasing the clitoris without further lengthening or urethral construction.
- Full metoidioplasty: This typically involves clitoral release, urethral lengthening, and sometimes vaginectomy (removal of the vagina) and scrotoplasty (creation of a scrotum).
- Ring flap metoidioplasty: This technique utilizes a flap of tissue from the anterior vaginal wall and labia minora to create the urethral extension.
A: Metoidioplasty offers several advantages over phalloplasty (creation of a penis using tissue grafts):
- Sensation preservation: Metoidioplasty preserves the clitoris, which is highly sensitive, allowing for greater sensation in the neophallus.
- Less invasive: It's generally less invasive than phalloplasty, with a shorter recovery time.
- Lower risk of complications: Metoidioplasty typically has a lower risk of complications, such as flap failure or infection, compared to phalloplasty.
- In Good Health: Candidates should be physically and emotionally stable, with realistic expectations about the outcomes.
- Hormone Therapy: Must undergo hormone therapy until the clitoris has grown at least 2–3 cm.
- Real-Life Experience: Demonstrates living in their affirmed gender.
- Psychiatric Clearance: Requires a letter of support from a qualified psychiatrist.
- Age Requirement: Must be at least 20 years old.
A: The ring flap technique is a specific method used in metoidioplasty to create the urethra (the tube that carries urine out of the body). It involves using a flap of tissue from the anterior vaginal wall and labia minora, rather than tissue from the mouth (buccal mucosa), to create the urethral extension. This technique can offer advantages in terms of sensation and cosmesis.
A: The ring flap technique offers several potential benefits:
- Improved sensation: Using genital tissue for urethral construction may preserve more sensation compared to using buccal mucosa.
- Enhanced cosmesis: The ring flap technique can create a more natural-looking urethra and neophallus.
- Reduced complications: It may reduce the risk of complications associated with buccal mucosa grafts, such as strictures (narrowing of the urethra) or fistulas (abnormal openings).
A: While metoidioplasty offers several benefits, it also has some limitations:
- Limited size: The neophallus created through metoidioplasty is typically smaller than that achieved with phalloplasty.
- Urethral complications: There's a risk of urethral complications, such as strictures or fistulas, although the ring flap technique may reduce these risks.
- Not suitable for everyone: Metoidioplasty may not be suitable for individuals with certain anatomical characteristics or those who desire a larger neophallus.
A: Recovery from metoidioplasty typically involves:
- Hospital stay: You'll likely stay in the hospital for a few days after surgery.
- Catheterization: A urinary catheter will be placed to drain urine while the urethra heals.
- Activity restrictions: You'll need to avoid strenuous activities and pressure on the surgical area for several weeks.
- Pain management: We'll provide pain medication to manage any discomfort.
- Follow-up appointments: You'll have regular follow-up appointments to monitor your healing and address any concerns.
A: Most individuals who undergo metoidioplasty are satisfied with the results. The procedure can significantly improve their quality of life, body image, and self-esteem. With proper care and follow-up, the results can be long-lasting.
A: The cost of metoidioplasty varies depending on the surgeon's fees, the facility where the surgery is performed, and the specific techniques used. At Kamol Hospital, we offer competitive pricing and transparent cost structures. We encourage you to schedule a consultation for a personalized quote.
A: Choosing a qualified and experienced surgeon is crucial for a successful outcome. Look for a surgeon who:
- Is board-certified in plastic surgery or urology.
- Has extensive experience in performing metoidioplasty.
- Offers the specific techniques you are interested in.
- Has a strong track record of positive patient outcomes.
A: We'll provide you with detailed pre-operative instructions, including:
- Stopping smoking: Smoking can impair healing and increase the risk of complications.
- Adjusting medications: Certain medications may need to be stopped or adjusted before surgery.
- Preparing your home: Make sure your home is set up for a comfortable recovery, with easy access to essential items.
A: While metoidioplasty is generally safe, potential complications include:
- Urethral complications: Strictures (narrowing of the urethra), fistulas (abnormal openings), or urinary incontinence.
- Wound healing problems: Infection, bleeding, or scarring.
- Nerve damage: Changes in sensation or numbness in the surgical area.
- Aesthetic concerns: Dissatisfaction with the appearance or size of the neophallus.
A: During your consultation, we will:
- Discuss your goals and expectations.
- Review your medical history.
- Perform a physical examination.
- Explain the different surgical techniques.
- Answer your questions and address any concerns.
A: Long-term considerations include:
- Regular follow-up appointments: To monitor your health and address any concerns.
- Urethral dilation: This may be necessary to prevent strictures.
- Hormone therapy: To maintain masculinization.
- Sexual function and satisfaction: We'll discuss ways to optimize your sexual health and well-being.
