FTM Bottom Surgery: What You Need to Know

FTM Bottom Surgery: What You Need to Know

Estimates indicate that there are about one and a half million Americans who refer to themselves as transgenders, having difficulties relating their inner image of being a woman or a man, especially with their physical body.

Fortunately, transgender people’s lives can be improved by bottom surgery or gender reassignment.


Let’s have a look at the common types of bottom surgery: Who Can Have Bottom Surgery, The Cost of Surgery, Pre-surgery considerations, Outcomes, What occurs pre-, peri-, and postoperatively.



What Is Bottom Surgery?


Gender-affirming surgery or gender reassignment surgery is a term synonymous with bottom surgery.

The procedure entails restructuring the sexual organs so as to conform to one’s preferred sex.

Also, the bottom surgery is uniquely designed for each person, depending on what you want your genitalia to look and act like.

Although bottom surgery may not be suitable for all trans people, it can change your life and help you to express yourself as you truly are if you suffer from gender dysphoria.


What Is Bottom Surgery?


Common Types of Bottom Surgery


These are three common types of bottom surgery.



  • Vaginoplasty


The surgical method employed in such cases is known as vaginoplasty, which applies to male-to-female transgender people.

This entails cutting down your old male organs and making the vagina through the use of your skin tissue from the penis or any other organs.

The process might also involve making a clitoris and labia.




  • Phalloplasty


Phalloplasty is a surgery that involves the construction of a neophallus if you were born with a woman’s sex.

This process entails harvesting from other areas of your body, such as the arm or thigh, and forming a penis.

It may involve the insertion of erectile devices that will help you in getting an erection.




  • Metoidioplasty


Metoidioplasty is a surgery that aims to increase the size of your clitoris, which has been enlarged from the inside by some hormones.

It also entails breaking up the ligaments, which limit the expansion of the clitoris.

The other forms of metoidioplasty involve urethral lengthening and the creation of a scrotum.




Who Can Have Bottom Surgery?


There are specific criteria that need to be met before undergoing the procedure. They include;



  • Persistent and Documented Gender Dysphoria


For you to have a bottom surgery, you should have had a continued feeling of being dissatisfied with the same gender, which may not correspond to the sex you were born in.

The feelings must be well-documented by a skilled mental health professional you have been visiting for some time.


Persistent and Documented Gender Dysphoria



  • Fully Informed About What the Surgery Involves


Before the bottom surgery is performed, you can find all the information you need on professional medical websites by consulting your surgeon or doctor and from patient education materials such as magazines, pamphlets, and brochures.


Fully Informed About What the Surgery Involves



  • Meet the Age of Majority at the Location


You should attain the required minimum age specified by law for the place or region in which surgery will be conducted.

However, there could be variations in age when determining a particular nation or region.


Meet the Age of Majority at the Location



  • Significant Medical or Mental Health Problems, If Any, Must Be Well-Controlled


If you are willing to go through the bottom surgery procedure, you must have all your health conditions, both medical and mental, under control.

Also, to make sure that you will have a safe and successful surgery, you need to undergo blood tests.


Significant Medical or Mental Health Problems, If Any, Must Be Well-Controlled



  • Receive 12 Consecutive Months of Hormone Therapy


If you are thinking of undergoing bottom surgery, your surgeons expect that you should go through several months of hormone treatment before you are considered for bottom surgery.

Hormone therapy puts your body in order and is intended to prepare you emotionally ready to undergo the surgery.


Receive 12 Consecutive Months of Hormone Therapy



  • Living in a Gender Role Consistent with Their Gender Identity for 12 Consecutive Months


During the transition period, you need to spend some years living as you desire to be called and operated accordingly.

This would make sure that you will be prepared for the emotional as well as social alterations that take place during the surgical procedures.


Cost of Surgery


Bottom surgery costs will greatly depend on which surgical operation is involved, the surgeon providing, the place you will have to go to for such an operation, and any other factor that may also add up to this cost, like whether there is any insurance cover.

In such a case, you might be required to write down special considerations that ensure your procedure.

Vaginoplasty in America can go around between $20,000 and $30,000, while phalloplasty may start at about $50,000 and reach as high as a hundred thousand dollars.


Cost of Surgery


You should expect to incur a bill for the surgeon’s service, the payment due to the anesthesiologist, and any other expenses relating to the hospital stay.

Similarly, you will be forced to make extra payments in the form of medicine and dressing for your surgical wounds as you progress toward recovery.


What You Need to Know Before Surgery


You must have realistic expectations about what you can achieve through bottom surgery prior to undergoing the procedure since it is a procedure that aims at ensuring that you look like your inner identity, enhancing your quality of life and happiness.

Nevertheless, it would be best if you understood that surgical outcomes might differ and that a total recovery of female genital touch and function is not possible.



  • What You Can Reasonably Expect in Terms of Outcomes


Depending on who is involved, the type of process, and recovery care, the consequences following bottom surgery can be different.

The surgery tries to manufacture your genitals as similar as possible to those of your preferred sex.

However, it has its limitations in reaching a full look and performance.


What You Can Reasonably Expect in Terms of Outcomes


The surgeons should be able to create for you a working neo-vagina that would enable you to have sexual intercourse with minimal lubrication if you are undergoing vaginoplasty surgery.

On the other hand, a lot of periodic dilation is normally needed in order to ensure vaginal depth and breadth.


If you are undergoing phalloplasty, a constructed neophallus will help facilitate urine passage while standing up and, at times, permit intercourse.

However, the neophallus may not provide you with similar sensitivity or erection capability as a natal male’s penis.


  • What Happens Before, During, and After Surgery


Several processes take place before, during, and after a surgical procedure is done.

These processes should be taken seriously to avoid any complications and risks.


  • a)   Before


You need to know that a pre-operative assessment of physical examinations, laboratory tests, and psychological evaluations will be performed on you ahead of the surgery.

These evaluations are meant to ascertain that you are healthy and mentally ready for surgery.


What Happens Before


  • b)   During


The particular technique for the surgery will be based on the selected procedure.

You are administered with general anesthesia before performing the surgery to ensure you do not feel anything at all during the procedure.


  • c)   After


Following the surgical procedure, you will be required to adhere to certain post-operative guidelines prescribed by your surgeon.

This could be wound care, analgesia, and dilator for vaginoplasty or penile erectile device in phalloplasty, respectively.

You will also be advised to have constant review sessions for tracking healing developments while making necessary interventions as well.


  •  How to Avoid Surgical Complications


Though bottom surgery typically has favorable outcomes, it may be associated with complications.

You must select a competent and well-practiced surgeon who has experience in doing such procedures, as this will help you avoid such complications.

It’s important not only that you follow precisely the preoperative and post-operative requirements of the surgeon but also that you regularly visit medical checkup appointments in order to provide ideal treatment, prevent complications, and accelerate the healing process.


 How to Avoid Surgical Complications



  • The Risks of General Anesthesia


Any type of surgery which involves general anesthesia has some degree of risk.

The risks you might experience include allergic reactions to the anesthesia, lung problems, or clot formation.

Nevertheless, such risk is of low magnitude, and it can be reduced by settling for a trusted surgical institution having proficient anesthetists.


The Risks of General Anesthesia


  • FTM Bottom Surgery FAQs


Phalloplasty, also called FTM Bottom surgery, is an affirmative operation that constructs a neo-penis out of skin grafts taken from other bodily areas like forearms and thighs, which raises more concerns and questions.


FTM Bottom Surgery FAQs


Here are some of the frequently asked questions:


How can I Prepare for Bottom Surgery?


Bottom surgery requires several stages of preparation, including locating an experienced surgeon who practices gender-affirming operations, among others.

The discussion with your surgeon will entail the goals and expectations and also ask about any concerns about your surgery.


How can I Prepare for Bottom Surgery?


Also, you might need some pre-operation tests as screening, such as physical tests in the hospitals, lab tests, among others, and some mental screening, such as psychiatric evaluation.

Such evaluations will make sure that you are healthy, have the mental readiness needed, and comply with all required standards.


How can you recover from Bottom Surgery?


Understanding your recovery after bottom surgery and what is necessary should not be taken lightly and demands time.

Depending on the procedure, common components of your recovery timeline may include the management of post-surgery pains and wounds and the gradual resumption of regular life.

During the recovery period, it is normal for you to experience physical discomfort, swelling, and bruising; nonetheless, these disappear as time goes by.


How can you recover from Bottom Surgery?


What are the risks and Side Effects of Bottom Surgery?


You can experience complications and risks after having a bottom surgery, which may include wound infection, hematoma formation, thrombosis, wound dehiscence, nerve damage, as well as undesirable aesthetic results.

You can avoid these risks by identifying a competent surgeon and undertaking rigorous compliance with the surgeon’s pre-and post-operative instructions and frequent follow-up visits to detect and manage any complications as they arise.




One major aspect of transformation for the transgender population is the bottom surgery, through which you aim to achieve the match between appearance and inner identity.

There are many choices in surgical procedures; therefore, you should be realistic about the surgery, know what you are doing, as well as a plan to recover after surgery.

Selection of a competent surgeon, knowing the risks and benefits, and strict adherence to pre-operative and post-operative instructions would enable you to gain a satisfactory result of the operation.

Although bottom surgery comes with inherent risks, it is a great procedure that gives you an extra confidence boost and improves your total health status.

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