Surgery Types

I will be discussing a few different types of surgery and will probably add more information later.

There are three general types of surgeries:
1. Chest reconstruction surgery (sometimes called top surgery or male chest contouring)
2. Hysterectomy and oophorectomy (removing the uterus and ovaries)
3. Genital reconstruction surgery (sometimes called bottom surgery)

Within the Chest reconstruction surgery group, there are two subgroups:
1. Double incision/Bilateral mastectomy
2. Keyhole/Peri-areolar incision

Double incision/Bilateral mastectomy:

• usually used for guys with larger chests (usually B or higher)
• two incisions are made across the breasts, right below the nipples
• the skin is peeled back and the fatty tissue is removed, using a scalpel
• the skin is then trimmed and put back over the chest

Pros:

- best method for guys with large chests
- muscle growth and hair growth can help hide scars
- resizing and placement of the nipples make the chest more masculine looking

Cons:

- huge scars
- little or no nipple sensation
- may require revision
- areas of numbness
- appearance of puckering along the scars

Keyhole/Peri-areolar:

• effective for individuals with small chests (cup A or smaller is preferred, but a lot of surgeons will do size B)
• incisions are made around the areola
• fatty tissue is "scooped" out
• areola might be sized down
• skin is pulled taut toward the incision
• the incision is closed

Pros:

- minimal scarring
- sensation in the nipples

Cons:

- nipple placement might not be ideal
- possibility of sagging skin
- chest may not appear completely flat
- may need revision
- risk of nipple loss

Genital reconstruction surgery:
1. Metoidioplasty
2. Centurion
3. Phalloplasty

Metoidioplasty:

• clitoris grows because of testosterone
• the ligament holding the clitoris is cut, bringing the clitoris forward
• it will look like a small penis
• scrotal implants may be available

Pros:

- unassisted erection when aroused
- natural looking
- no visible scars

Cons:

- too small for penetration
- sometimes the clitoris doesn't get big enough by using testosterone


Centurion:

• round ligaments are freed from the labia majora and brought together along the shaft of the clitoris
• it provides girth
• the extraction of the round ligaments leaves a pocket
• silicone scrotal implants are placed into the pocket
• a urethral extension is made by using a catheter, which will be removed when it is healed

Pros:

- natural looking
- erotically sensate penis
- unassisted erection
- no visible scars

Cons:

- too small for penetration
- sometimes clitoris doesn't get big enough by using testosterone

Phalloplasty:

• many different types
• Gillies: flap of abdominal skin is rolled into a tube to create a penis
• Suitcase handle: improvement on the Gillies, flap is attached to the abdomin for a few weeks for proper blood supply and then released to hang down
• Free tissue flap transfer: more recent and improved; a flap of skin is removed, nerves and blood vessels in tact, and transferred to the groin area
• MLD flap: skin is taken from the torso, under the arm; considered to produce the most realistic looking penis; more erotically sensate
• scrotoplasty: paired with the phalloplasty; labia majora hollowed out and silicone implants are inserted to create a scrotum

Pros:

- average-sized penis
- realistic looking
- can urinate through
- can engage in penetrative sex

Cons:

- multiple surgical visits
- may need revisions
- expensive
- scarring
- pain
- long time for recovery

Personally, I am planning to get peri-areolar chest surgery and the MLD phalloplasty. The chest surgery will leave little scarring and that's what I want (also I have a small chest). The MLD is the best bottom surgery available. The pros outweigh the cons for me.

Even though I told you what I want for myself, only you can decide what's best for you. Even if you choose not to have any surgery, you will always be a man. Think very seriously about all your options before you make the choice. Surgery is serious and can not be undone.