DETRANSITION SURGERY

MTF surgery male to female

MTF Surgery

The Process of
Transitioning to Womanhood

Most transgender women begin their gender confirmation journey with hormone therapy and supportive counseling.

While some transwomen are content simply living as their affirmed gender, others believe that MTF surgery is necessary for them to live the life as the person they know they are.

But what is Male-To-Female surgery, and how is it done?

Continue reading this article to find out.

Dr Gary Rosenbaum MD

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.

CONTACT DR. ROSENBAUM

What is MTF Surgery?

Male To Female surgery—also called transfeminine surgery—is a surgical process that allows patients to obtain female characteristics.

The MTF surgery procedures:

MTF Top Surgery

When it comes to MTF top surgery, it mainly involves breast surgeries. After all, many transgender women associate full, round breasts with femininity and beauty. 

But while hormone therapy usually causes some breast tissue to grow, patients who want a larger bust may consider breast augmentation. 

Breast Augmentation

Breast augmentation is the most common MTF top surgery among transgender people. It involves either the insertion of breast implants into the chest or fat grafting from the abdomen to the chest. 

Depending on your individual needs and anatomy, your surgeon may place the implants either over (subglandular placement) or under (submuscular placement) the chest wall muscle.

Here are your two breast augmentation options.

Breast Implants

Your doctor may insert silicone or saline implants above or below the pectoralis major muscle to increase breast volume and create a more feminine chest. Doctors create incisions for implant insertion near the armpit or at the base of the breast.

Fat Grafting

Fat harvested from your abdomen can add volume to your breasts. You may need several rounds of treatment to achieve your desired breast volume. 

This option does not necessitate the use of implants.

MTF Bottom Surgery

A transwoman may choose to undergo gender confirmation surgery (GCS) to complete her transition journey. Female genitalia with function and feeling is created through MTF bottom surgery. MTF bottom surgery may involve the following procedures:

Orchiectomy

Orchiectomy is the surgical removal of the testicles. All other tissues and genital organs are still present.  This procedure is appropriate for MTF surgery patients who want to eliminate testosterone production without getting full genital reconstruction.

Vaginoplasty

Vaginoplasty is a surgical procedure that involves creating a vagina, clitoris, labia majora, and labia minora using your existing genital tissue. The penis is turned inside out to form the inner walls of the vagina in a process known as penile inversion. The head of the penis makes the clitoris, while the urethra forms the labia by shortening and repositioning it. You must have your testes removed as part of the vaginoplasty procedure. But whether you had orchiectomy in the past or not, you can certainly get a vaginoplasty.

Facial Feminization Surgery

Facial feminization surgery (FFS) refers to a group of procedures used to make the facial features appear softer and more feminine. FFS is a critical component of the male-to-female transition because the face provides important visual cues about one’s gender. FFS involves various procedures to meet each patient’s needs and desired results. These procedures may include:
  • Forehead and brow bone reshaping
  • Jaw and chin contouring
  • Nose reshaping or rhinoplasty
  • Hairline advancement
  • Tracheal shave
  • Lip lift and plumping
If you’re planning to undergo Male To Female surgery, it’s best to discuss your desired results with your healthcare provider so you can have a treatment plan that’s tailor-fit for you.
What to Expect During Post-Op
In breast implant surgeries, most patients are not required to stay in the hospital after the procedure. But this procedure is still usually done under general anesthesia.

For MTF bottom surgeries, most people spend days in the hospital after surgery. Vaginoplasty recovery can take up to three months and requires intensive post-operative care. Thus, it is important to have someone to help take care of you after surgery. 

It may take one to two days for people to regain full mobility after an orchiectomy. They may be able to return to work within a few days to a week of the procedure.

When Can You Have Sex After Surgery?

The surgical area must completely heal first before the patient can have sex. That’s because sexual activities may delay wound healing and cause complications. 

Johns Hopkins University advises abstinence from sexual activities within 12 weeks after a vaginoplasty. It may take two to eight weeks to recover from an orchiectomy fully. You’re prohibited from certain activities, such as driving or heavy lifting, for a few weeks after surgery. 

Follow your doctor’s post-op MTF surgery guidelines before participating in any sexual activity.

Dilation

After vaginoplasty, you need to use a vaginal dilator to stretch the vaginal canal and keep it open. Dilation twice a day for at least ten minutes may be required following surgery.  This is to prevent loss of vaginal depth and width.

Your health care provider will give instructions on using a dilator safely and properly.

Hygiene and Aftercare Tips

Keeping the genital area clean and free of infection after a vaginoplasty is vital. You must keep the vagina dry on the outside. An absorbent pad placed between the labia may help absorb any excess moisture.

Once your doctor gives you the go signal to bathe, gently wash the area with soap and water. Remember to avoid scrubbing or allow shower spray to reach the surgical site.

You may need to douche one to two times per week, depending on the amount of vaginal discharge. If there is a lot of discharge, more frequent douching may be necessary.

Mild discomfort, bruising, and swelling around the surgical site are normal after an orchiectomy. To avoid infection, you may use topical antibiotics.

You should consult with a healthcare professional if you have questions about post-op MtF surgery recovery. Remember,  it may take some time to heal, recover, and adjust to sex and intimacy after surgery, so be patient with your recovery. 

And if you’re planning to undergo MTF detransition surgery, book a consultation with Dr. Gary Rosenbaum to discuss your needs and desires.

References:
  1. Coombs, D., Grover, R., & Gurunluoglu, R. (2019, February 1). Breast augmentation surgery: Clinical considerations. Breast augmentation surgery: Clinical considerations. https://www.ccjm.org/content/86/2/111

  2. Gender Affirmation Surgeries. (n.d.). Johns Hopkins Medicine. Retrieved May 4, 2022, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/gender-affirmation-surgeries
  3. Meltzer, T. (2016, June 17). Vaginoplasty procedures, complications and aftercare | Gender Affirming Health Program. UCSF Transgender Care. Retrieved May 2, 2022, from https://transcare.ucsf.edu/guidelines/vaginoplasty