Bottom surgery refers to the plastic surgical procedures performed on the genitals to give the look—and in some cases, functionality—that matches their gender identity. Not every transgender person wants to undergo bottom surgery, but it can significantly improve self-esteem and quality of life for those who do.
You may also have bottom surgery. This can be done to remove the uterus, ovaries, and vagina. It may also include creating a penis and scrotum.
Phalloplasty is a type of "bottom surgery" (surgery on the genitals) available to transgender men, or those who identify as transmasculine. It involves the surgical creation of a penis from skin and other tissue harvested from another part of your body.
Your doctor can insert an erectile implant to allow you to get an erection. They can transport your clitoris to the base of your penis to enhance sensations. Another option is "nerve hook up." During this part of the procedure, doctors connect nerves from the donor tissue to your pelvis to enhance sensation.
Vaginoplasty. Transgender vaginoplasty involves creating a vagina, clitoris, labia majora, and labia minora using your existing genital tissue. Our surgeons use a penile inversion technique. This procedure is effective both for people who have and those who have not had orchiectomy in the past.
Will I be able to receive sexual pleasure after phalloplasty? The penis after phalloplasty has full erogenous sensitivity so that it can indeed receive sexual pleasure and reach orgasm quite normally.
Depending on multiple factors, the transition process can take anywhere from months to years to complete. These include the age when a person recognizes that their true gender identity doesn't match their bodies, whether they choose to start medical treatment, and which treatments they choose.
People will need to follow the advice of their healthcare team for proper healing and to check when they are safe to have sex following a metoidioplasty or phalloplasty. People can expect to still have sexual arousal, erection, and orgasm after lower gender-affirming surgery.
Previous groups have reported that the majority of patients retain the ability to achieve orgasm following phalloplasty (3,7,8).
Bottom surgery typically has a longer recovery time than breast augmentation or minor adjustments to your facial structure. However, all surgeries can cause patients some degree of pain. Luckily, pain after transgender surgery is rarely unbearable and can typically be managed with at-home treatment.
For example, individuals who have bottom surgery may have changes to their sexual sensation, or trouble with bladder emptying. In general, significant complications are rare, as long as an experienced surgeon is performing the procedure. With any surgery, there is a small risk of complications, including: Bleeding.
Top (chest gender confirmation) surgery is performed approximately twice as often as bottom (genital) surgery. In studies that assessed transgender men and women as an aggregate, top surgery accounts for 8 to 25% and bottom surgery accounts for 4 to 13%.
The surgery can be divided into “top surgery” and “bottom surgery.” “Top surgery” creates breasts for male-to-female transgender patients or removes breasts for female-to-male transgender patients. “Bottom surgery” for male-to-female transgender patients includes removing male genitalia and creating female genitalia.
Top surgery is surgery that removes or augments breast tissue and reshapes the chest to create a more masculine or feminine appearance for transgender and nonbinary people.
Bottom Surgery
Urethroplasty (urethral lengthening), Vaginectomy (removal of vagina), and Scrotoplasty (creation of scrotum) are generally performed in conjunction with either Metoidioplasty or Phalloplasty, however you may elect to forego any these procedures.
Transfeminine bottom surgery is typically performed in a hospital setting, and will likely use general anesthesia.
So, these phalluses tend to be a maximum 5.5 inches long (that's the average length of a phallus in North America). If you choose an ALT (leg) phalloplasty, there's more skin and a longer artery, so a longer phallus can be constructed, up to 8.5 inches.
Patients can still stand to urinate and use a urinal but the opening of the urethra may be along the shaft of the penis rather than the tip. Another risk of surgery is that the urethra can stricture down again.
The first sex-change operation in a transsexual patient, i.e. the construction of a penis (so-called phalloplasty), took place in the Netherlands in Arnhem in 1959-1960. The operative technique had already been described in 1938 and was perfected after World War II.
A phalloplasty makes it easier to have penetrative sex and creates a longer phallus. Some men also feel it looks more natural. If you initially choose a metoidioplasty, you can opt to undergo a phalloplasty later on. A phalloplasty, however, is not reversible.
In my experience, the average age range for Penile Enlargement Surgery (PES) is from early 20's to 70 years old. Although extremes at each end are not rare. For instance, a person must be 18 years old to give legal consent needed unless one is legally an “Emancipated Minor”.
Your body will begin to redistribute your weight. Fat will collect around your hips and thighs and the muscles in your arms and legs will become less defined and have a smoother appearance as the fat just below your skin becomes a bit thicker.
Gender affirming surgery can be very expensive. It can cost between $20,000 to more than $100,000, depending on which procedures you need.
Social transitioning may include things like:
coming out to your friends and family as transgender or nonbinary; asking people to use pronouns that feel right for you; going by a different name; dressing/grooming in ways that feel right for you when other people can see you; and.