FAQ – FTM Surgery

We will provide all the necessary guidelines for a complete pre-op preparation, depending on the type of surgery. You will be accompanied by a team representative from the International Patient Department throughout your stay at the hospital.

You need to be on hormonal therapy for at least one year. You need to have two recommendation letters by two different board certified psychiatrists who work with transgenders, as well as one recommendation letter by your endocrinologist stating that you are eligible to perform a surgery of gender transformation to a male.

The recommendation letters need to be completed and sent to us for verification one month before the surgery. The letters must be written by a Board Certified Psychiatrist or Gender Specialist according to WPATH Standards of Care.

Details are to be discussed with an anesthesiologist one month before the surgery is scheduled.

The following analyses are mandatory: HIV, Hepatitis B and C Tests, all performed up to one month before the surgery. The last testosterone injection should be administrated three weeks before the surgery. At least three weeks before the surgery you must stop the intake of, but not strictly limited to, Aspirin and other non-steroidal anti-inflammatory medications (i.e. Ibuprofen, Advil…) used to minimize clot formation, as well as all vitamin supplements, Omega 3 and similar products and a wide array of over-the-counter medications of suspicious origin (Shark Tail, Algae, Gingko, Ginseng, etc.) At last, but not least, some foods like garlic, onion and strong spices that might provoke severe bleeding, should be avoided too. However, as this is only general information provided to all patients, you must discuss all other individually specific issues with our doctors.

If we perform hysterectomy together with oophorectomy and vaginectomy and metoidioplasty, the surgery lasts for about 3.5 hours. If we perform vaginectomy and metoidioplasty, the surgery lasts for between 2.5 and 3 hours.

We always perform a one-stage surgery. We are famous for it! At the patient’s requirement, it is possible to perform a multi-stage surgery.

It is recommended to start with topical use of testosterone gel three months before the surgery, in addition to a continuous vacuum pump usage.

It is recommended that each patient continues to use a vacuum pump for six months up to one year after the surgery, for 10 to 15 minutes, three times a day, in order to prevent the shrinkage of the straightened neopenis.

Suprapubic urine drainage usually remains 3 weeks after surgery, with the application of an antibiotic prophylactic.

We create a one sac scrotum whenever possible, but if there is no available skin for one sac scrotoplasty, it is possible to create it in another stage.

No, it is not normally included. I do not perform it in some patients due to the preservation of the neopenis vascularisation and its scrotal skin because of the risk of postoperative complications from skin vascularisation. In some patients it is possible to perform it. Upon viewing the photos of your genitals, I can answer if in your case it is possible to be performed or not.

We usually use testicle prostheses of a medium size (about 18cc) for a more pleasing appearance of the new external genitals. The medium size prostheses can be replaced with larger ones later when the scrotum becomes bigger.

We create the urethra by using a combined buccal mucosa graft with the available genital skin flaps originating from the labia minora or dorsal clitoral skin. We also use a part of the anterior vaginal wall in urethral lengthening, since it is close to the natural female urethral opening in order to prevent fistula formation in that region.

Approximately 20 per year. The majority of patients come with mastectomies previously performed in their countries.

Patients usually stay for10-14 days after the surgical procedure.

It depends on the type of work. Three weeks off work is usually enough for a complete recovery after the surgery.

According to all data received from our patients and their reports of complications, our success rate in metoidioplasty is 92%. The complications are mainly related to urethral reconstruction, such as fistula or urethral stricture. Some of the fistulas are closed spontaneously, and some require minor surgical repairs.

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