What Is FTM Bottom Surgery?
FTM (female-to-male) bottom surgery is a series of gender-affirming procedures designed to create male genitalia for men and non-binary individuals. These surgeries play a crucial role in helping individuals align their physical bodies with their gender identities. For many, FTM bottom surgery is a life-changing step toward feeling more comfortable and confident in their bodies.
This blog will explore what is FTM bottom surgery, the types of surgeries offered at Reconstructive Surgical Arts, and how the process works.
What is FTM Surgery?
FTM surgery refers to the collection of gender-affirming procedures that help individuals transition from female to male, focusing on creating male genitalia. FTM bottom surgery, in particular, focuses on constructing a functional and aesthetically pleasing penis, with additional procedures that enhance the overall result, such as urethral lengthening and scrotoplasty.
Female-to-male bottom surgery is highly customizable, with various options depending on the patient’s goals, anatomy, and medical history. The most common procedures include phalloplasty, metoidioplasty, urethral lengthening, and scrotoplasty. These procedures are often done in stages and require a highly skilled surgical team, such as the experts at Reconstructive Surgical Arts, who work closely with each patient to achieve optimal results.
Types of FTM Bottom Surgery
Phalloplasty
Phalloplasty is one of the most commonly chosen FTM bottom surgeries and involves the creation of a penis using a tissue graft from another part of the body. This can come from the forearm, thigh, or back, and the choice of the donor site is crucial in determining the outcome of the surgery. The process for phalloplasty includes several stages:
Tissue Harvesting: The surgeon removes tissue from the selected donor site to construct the neophallus. The most common donor site is the forearm, as it provides the best sensation and girth.
Neophallus Construction: The harvested tissue is sculpted into the shape of a penis, and nerves and blood vessels are connected to provide sensation and proper blood flow.
Urethral Lengthening: This allows the individual to urinate while standing.
Glansplasty: The head of the penis (glans) is shaped and constructed to resemble a natural penis.
Phalloplasty offers the possibility of both sexual functionality and aesthetic outcomes. It is a complex procedure, and the choice of donor site plays a major role in the final appearance and sensation. Patients may also opt for testicular implants and, in some cases, erectile devices for penetrative sex.
Metoidioplasty
Metoidioplasty is another form of FTM bottom surgery that differs from phalloplasty in several key ways. Instead of using a tissue graft, metoidioplasty involves releasing and repositioning the clitoris, which has been enlarged through hormone therapy. The result is a smaller penis, but one that retains sensation and allows for erections naturally.
The steps for metoidioplasty include:
Clitoral Release: The clitoris is freed from its surrounding tissue, allowing it to protrude more and resemble a small penis.
Urethral Lengthening: Similar to phalloplasty, urethral lengthening is often performed to allow urination while standing.
Scrotoplasty: This involves creating a scrotum using the labia and, if desired, adding testicular implants for aesthetic and functional purposes.
Metoidioplasty is a less invasive procedure than phalloplasty, with a shorter recovery time. However, the size of the neophallus is typically smaller, which may limit penetrative sexual activity. Many individuals choose metoidioplasty for its simplicity and the fact that it preserves a more natural sensation.
Scrotoplasty and Testicular Implants
Scrotoplasty is a key component of both phalloplasty and metoidioplasty. It involves using the labial tissue to create a scrotum, which can then house testicular implants. Testicular implants provide a more natural appearance and enhance the overall aesthetic of the surgery. While not necessary for everyone, they are an option for individuals who desire a more complete male genital appearance.
Urethral Lengthening
A major goal for many undergoing FTM bottom surgery is the ability to urinate while standing. This is achieved through urethral lengthening, where the urethra is extended to the tip of the neophallus. Urethral lengthening can be performed during both phalloplasty and metoidioplasty, though it is more complex with phalloplasty due to the length of the new urethra. This procedure is critical for enhancing functionality, though it comes with risks and requires careful post-operative care.
How Does FTM Surgery Work?
Understanding how FTM surgery works requires breaking down the stages of the procedure. Both phalloplasty and metoidioplasty are multi-step processes that can take several months to complete. The surgical journey usually includes the following:
Consultation and Evaluation: Before surgery, patients meet with the surgical team to discuss their goals and receive an evaluation of their health, medical history, and expectations.
Surgery Stages: Depending on the type of surgery chosen, the procedure can involve multiple stages:
Phalloplasty often includes the initial tissue graft and neophallus construction, followed by urethral lengthening and scrotoplasty in later stages.
Metoidioplasty typically takes less time, but additional stages may be needed for urethral lengthening or implants.
Post-Operative Care: Recovery from FTM bottom surgery is an ongoing process that requires several weeks of rest and careful management of the surgical site. Follow-up appointments with the surgical team are critical for monitoring healing and addressing any complications.
Long-Term Results: Over time, the body adjusts to the changes, and most individuals see the final results after several months. Sexual functionality and aesthetic outcomes vary depending on the type of surgery and the individual's healing process.
What Does FTM Bottom Surgery Look Like?
The aesthetic outcome of FTM bottom surgery depends largely on the type of procedure chosen and the individual's body. Phalloplasty results involve a penis with a natural appearance, often accompanied by a scrotum and testicular implants. The size and sensation vary based on the donor site and the individual’s anatomy.
Metoidioplasty results in a smaller penis that retains natural sensation and the ability to achieve erections, though it may not be sufficient for penetrative sex. However, both procedures provide individuals with a physical body that aligns more closely with their gender identity, which can have a profound impact on self-esteem and well-being.
Contact Reconstructive Surgical Arts
FTM bottom surgery is a deeply personal and life-changing procedure that offers individuals the opportunity to align their physical bodies with their gender identities. By understanding how does bottom surgery works, individuals can make informed decisions about their surgical options and choose the best path forward. Whether opting for phalloplasty, metoidioplasty, or other procedures, the team at Reconstructive Surgical Arts is here to guide and support patients through every step of the process.
If you are considering FTM bottom surgery, we encourage you to schedule a consultation with our experienced surgical team. At Reconstructive Surgical Arts, we provide compassionate, expert care to help you achieve your goals and live as your most authentic self.
