What Is Metoidioplasty?
Metoidioplasty is a female to male gender reassignment procedure designed to provide trans men with a phallus through a more affordable and less invasive procedure compared to Phalloplasty.
Sometimes referred to as a “meta,” Metoidioplasty surgery takes advantage of Testosterone’s enlarging effect on the clitoris and results in a phallus of approximately 1.5-2 inches in length. Original sensation and erectile function of the clitoris is preserved, and the ability to stand to urinate can be provided through urethroplasty, a procedure that extends the urethra to the tip of the phallus. Metoidioplasty is discreet and does not produce obvious surgery scars.
What Should I Know About Metoidioplasty?
Dr. Rumer has a strong background in engineering and fine arts prior to becoming a plastic and reconstructive surgeon. As a result, she offers a few different approaches to Metoidioplasty. Dr. Rumer will perform a full evaluation at your consultation and together you will decide on a plan to meet your goals and maximize your surgery outcome.
- Metoidioplasty surgery results in a small phallus. Phallus size is largely dependent on how much clitoral growth testosterone has caused.
- Because of the small size, you will always get your best surgery result if you are close to your ideal weight before surgery.
- Understand your options and your needs: Each of the three Metoidioplasty procedures offer something a little different.
- Complications can include: Migration and/or extrusion of testicular implants; urethral fistula or stricture; infection.
- In most patients, the phallus’ glans will have a circumcised appearance.
- Hysterectomy is required and can be performed either before or along with Metoidioplasty.
What Does the Procedure Involve?
Metoidioplasty surgeries that include urethral extensions are performed in the hospital and require a one-night stay in the hospital. Metoidioplasty surgeries without urethral extension are performed in Dr. Rumer’s surgery center and the patient can leave the same day.
Simple Release or Simple Meta
This is the least invasive type of Metoidioplasty surgery and carries the lowest risk of complication. The testosterone-enlarged clitoris is released from the suspensory ligament and labia minora, and tissue is wrapped around the released clitoris to transform it into a phallus. Vaginectomy and Urethroplasty are not performed. (The patient will have a very small vaginal opening and will void from their native urethra.) If desired, Scrotoplasty and insertion of Testicular Implants can be done during the initial operation.
Ring Metoidiopasty is similar to Simple Release in that the testosterone-enlarged clitoris is released from the suspensory ligament and labia minora, and tissue is wrapped around the released clitoris to transform it into a phallus. Ring Metoidioplasty goes a step further with partial closure of the vagina and extension of the urethra. Patients with adequate phallus length (and not a lot of mons fat) are able to stand to void. Scrotoplasty and insertion of Testicular Implants can be done during the initial operation.
In a Full Metoidioplasty, a Vaginectomy (colpocleisis) is performed to create an anatomically male perineum. The testosterone-enlarged clitoris is released from the suspensory ligament and labia minora, and tissue is wrapped around the released clitoris to transform it into a phallus. Urethral extension is performed by combining an inner cheek (buccal mucosa) graft and genital flaps. Scrotoplasty and insertion of Testicular Implants can be done during the initial operation.
Dr. Rumer offers different Scrotoplasty techniques to choose from, resulting in either a bifid or joined scrotum.
Many patients will also benefit from a pubic lift or “mons resection,” a plastic surgery procedure that removes fat from the pubic mound and pulls the phallus into a higher, more natural-looking position.
How Long Is Recovery and When Can I Resume My Normal Activities?
You will experience some discomfort, swelling and bruising after your surgery. This can be minimized with pain medication and rest. You will be seen back in the office a week post-op. Patients should plan on staying in the area for 2-3 weeks after Full Metoidioplasty.
Be sure to inquire about Dr. Rumer’s Recovery Program which offers daily medical check-ups by Dr. Rumer and/or her Nurse Practitioner and optional on-site recovery accommodations. Most patients are ready to return to all activities after 4-6 weeks.