Detransition Surgery:

There are different surgical procedures involved in detransition surgery. These procedures may vary if you are detransitioning from male to female (MTF) and vice versa.

One of the most common detransition surgeries is MTF top surgery, like breast restoration. A trans male who underwent bottom surgery like phalloplasty and wants to reverse it can also undergo vaginoplasty.

We will further discuss these two procedures for you to have an idea of what can happen during your surgery.

Breast Restoration

Breast reconstruction or restoration is a surgical treatment that reconstructs the breasts to restore a woman’s femininity. This operation can be done in a few months or years following a mastectomy.

If you had your breasts removed through a gender affirmation top surgery, stopping your hormone treatment will not regrow your breasts. If you are decided to have breasts again as you go into your detransition journey, you may opt for breast restoration surgery.

Although it is not explicitly stated in the World Professional Association for Transgender Health (WPATH) standards of care, the doctor requires all trans and non-binary people to have a letter of recommendation from a qualified mental health professional before having MTF breast surgery.

Though there are different breast restoration methods available, artificial implants (implant reconstruction) and tissue flaps from another region of your body (autologous reconstruction) are two of the most commonly used. Surgeons may even integrate them to achieve the best outcomes.

In implant reconstruction, the plastic surgeon implants a saline (saltwater) or silicone gel-filled implant into the chest to recreate the breasts.

Autologous or “flap” reconstruction, on the other hand, creates the breast mound by utilizing tissue from another region of your body, such as the abdomen, thigh, or back. An implant may also be placed to provide extra support.

Implants are often placed on top of the muscle. You’ll feel far less discomfort with this technique.

On the other hand, the sub-glandular pocket might appear impressive depending on the female’s build. However, if the patient is skinny, the implant may be more visible.

For your reference, the American Society of Plastic Surgeons provides further information regarding transfeminine top surgery.

Vaginoplasty

Vaginoplasty is a vaginal construction or repair treatment. It solves various medical concerns, including vaginal damage after delivery and consequences from pelvic floor disorders. 

It is also used to create a transgender vagina, which assists individuals in achieving their desired gender identification.

However, if you’re detransitioning surgically, you might need a vaginal reconstruction or restoration using various surgical procedures. The specifics are determined by your goals or medical needs.

Most vaginoplasties include using a skin graft to build a new vaginal canal—the inside wall of the vagina. To do this, the surgeon will remove the skin from your scrotum and thin it so that it can function as a skin transplant.

If there is not enough skin from your scrotum to build a new vagina, the surgeon can take more skin from the sides of your abdomen, where the scar will be less visible.

The surgeon will build a gap between your rectum and bladder to form your new vaginal canal. After inserting your skin graft, a gauze or spongy material will be placed within your new vaginal canal for five days. The gauze applies pressure to the skin graft, causing it to develop into the surrounding vaginal tissue.