Female to Male
Surgery Reversal
Journey
As an MTF detransitioner, undergoing first female to male surgery is only one chapter of your detransitioning journey.
It is part of the process that you have to go through, and it’s nothing to feel regretful or ashamed of.
Understanding the whole process of female to male surgery is also key to acceptance.
So in this article, we will discuss FTM surgery and how to reverse it after you have decided to detransition.
Dr. Gary J. Rosenbaum is a board-certified plastic surgeon with extensive experience in breast-related surgeries.
If you’re looking for a doctor who understands your needs and can help you with how to detransition MTF through breast restoration, schedule a consultation here.
What is Female to Male Surgery?
Female to male surgery, also known as gender affirmation surgery or gender-affirming surgery, is a form of sex reassignment surgery.
The following are the two major sex reassignment surgeries for female-to-male transgender patients:
- Subcutaneous mastectomy (SCM)
- Genital transformation, which might include vaginectomy, metoidioplasty, scrotoplasty, and phalloplasty
To understand these different types of procedures involved in FTM surgeries, we will discuss each one further below.
Mastectomy in Female to Male Surgery
Mastectomy is the medical word for the partial or total surgical removal of one or both breasts. Female to male surgery patients undergo subcutaneous mastectomy.
A subcutaneous mastectomy is an FTM top surgery that removes breast tissue during male chest reconstruction. Subcutaneous means “under the skin.” This form of mastectomy removes subcutaneous tissue from the interior of the breast and excessive skin.
The surgeon shapes the chest into a more manly form, adjusting the size and location of the areolae and nipples as necessary.
Hysterectomy
The surgical process of removing the uterus is called hysterectomy. It can either be partial or complete.
A partial hysterectomy involves removing only the uterus. The cervix may also be removed in a complete hysterectomy.
If the right and left fallopian tubes and ovaries are also removed, then the hysterectomy is paired with bilateral salpingo-oophorectomy (BSO).
If hormone replacement therapy does not cease menstruation, transgender people may opt to have these surgeries to achieve that end.
Vaginectomy
Vaginectomy is a surgical treatment that removes the vaginal lining and seals the vagina. In an FTM surgery, a vaginectomy combines a colpectomy and a colpocleisis.
Colpectomy is the removal of the vaginal lining or epithelium. Meanwhile, colpocleisis is the fusing of the vaginal walls, which provides support for pelvic organs.
Transgender people who opt to have vaginectomy usually desire to have the vagina removed and replaced with male-appearing perineum. Some people also undergo this procedure to eliminate the discharges generated by the vaginal mucosa.
Scrotoplasty
Scrotoplasty, also known as oscheoplasty, is a surgical procedure used to repair or create a scrotum.
When a trans man or transmasculine person gets a scrotoplasty, the labia majora are dissected to generate hollow chambers. They are then joined to form an approximation of a scrotum.
If there is insufficient skin to form a scrotum, the surgeon may utilize tissue expansion before the procedure.
Phalloplasty in Female to Male Surgery
A phalloplasty is a multi-stage surgical treatment involving the following:
- construction of the penis
- lengthening of the urethra
- formation of the penis tip
- formation of the scrotum
- removal of the vagina
- placement of erectile and testicular implants
In a phalloplasty procedure, the surgeon takes a piece of tissue from the arm or thigh to construct a penis.
Metoidioplasty
Metoidioplasty is a lower body operation that generates a penis by cutting ligaments surrounding the clitoris to liberate it from the pubis and lengthen the shaft.
The main advantage of metoidioplasty is the absence of scarring outside of the vaginal region. It is also far less expensive than a phalloplasty.
According to a 2014 study, 9 out of 10 who underwent FTM surgery were satisfied with their transition. No patient expressed regret after undergoing surgery.
While FTM surgeries usually have high satisfaction rates, some people still feel the need to detransition for various reasons. Some of the common reasons for detransitioning are pressure from their families, discrimination from society, and medical complications.
Whatever the reason may be, know that you have options for detransitioning and reversing your female to male surgery.
Check them out below.
Social Detransition
Some transgender people may choose to only detransition socially. This means that a person can present themselves as their birth sex again by changing their post-transition name or going back to using the pronouns associated with their birth sex.
Social detransition is the easiest detransition method to achieve. However, it’s still possible to encounter discrimination and judgment from society after doing this.
Medical Detransition
Medical detransition is for trans people who underwent medical intervention to affirm their gender identity.
For example, if you underwent hormone replacement therapy, you can reverse some outcomes once you stop taking hormones.
Some transgender hormone treatment effects last for a long time, such as fertility issues, breast tissue enlargement, and growth of sex organ tissues. In most cases, these effects are irreversible.
If you underwent gender affirmation surgeries like female to male surgery, you can get breast restoration surgery to reverse FTM top surgery.
Breast Restoration
in Female to Male Surgery
To reverse an FTM top surgery, you may opt to undergo a breast restoration procedure.
Breast restoration is a surgical procedure that reconstructs the breasts to restore one’s femininity. Surgeons can perform this procedure several months—or even years—after a patient’s mastectomy.
Though there are different breast reconstruction procedures to choose from, two of the most utilized are artificial implants (implant reconstruction) and tissue flaps from another part of your body (autologous reconstruction). Surgeons may even combine them for the best results.
In implant reconstruction, the plastic surgeon inserts saline (saltwater) or silicone gel-filled implant in the chest to restore the breasts.
On the other hand, autologous or “flap” reconstruction is done by using tissue from another part of your body (such as the belly, thigh, or back) to create the breast mound. You may also use implants for additional support.
With all the breast restoration options available for the reversal of FTM top surgery, it’s best to consult your healthcare provider to discuss your suitable options.
Deciding to undergo surgery to reverse the changes from your initial FTM surgery may overwhelm you. You need a healthcare team to understand and support you through your detransitioning journey.
If you are looking for detransitioning options in a safe and non-judgmental space, schedule a consultation with board-certified plastic surgeon and breast restoration expert, Dr. Gary Rosenbaum.
Monstrey, S. J., Ceulemans, P., & Hoebeke, P. (2011, August). Sex Reassignment Surgery in the Female-to-Male Transsexual. NCBI. https://doi.org/10.1055/s-0031-1281493
Garcia, M. M., Christopher, N. A., De Luca, F., Spilotros, M., & Ralph, D. J. (2014, April 17).
Overall satisfaction, sexual function, and the durability of neophallus dimensions following staged female to male genital gender confirming surgery: the Institute of Urology, London UK experience – Garcia. Translational Andrology and Urology. https://tau.amegroups.com/article/view/3748/4689
- Vandenbussche, E. (2021). Detransition-Related Needs and Support: A Cross-Sectional Online Survey. Journal of Homosexuality. Taylor&Francis Online. https://www.tandfonline.com/doi/full/10.1080/00918369.2021.1919479
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312187/