Genitourinary Surgery Procedure ||
Gender Affirmation Surgeries
What surgical options are available to transgender and gender non-conforming patients? Gender affirmation surgeries, also known as gender confirmation surgeries, are performed by a multispecialty team that typically includes board-certified plastic surgeons. The goal is to give transgender individuals the physical appearance and functional abilities of the gender they know themselves to be. Listed below are many of the available procedures for transwomen (MTF) and transmen (FTM) to aid in their journey.
Facial Feminization Surgery
The goal of facial feminization surgery, or feminizing facial surgery, is to transform the masculine features of the face into a more feminine or nonbinary appearance.
Transfeminine Top Surgery
The goal of transfeminine top surgery, or feminizing chest surgery, is to enhance the size and shape of the breasts to create a more feminine appearance to the chest.
Transfeminine Bottom Surgery
The goal of transfeminine bottom surgery, or feminizing genital surgery, is to reconstruct the male genitalia into female genitalia.
Facial Masculinization Surgery
The goal of facial masculinization surgery is to transform the feminine features of the face to a more masculine appearance.
Transmasculine Top Surgery
The goal of transmasculine top surgery, or masculinizing chest surgery, is to remove the breast tissue from both breasts and create a masculine or nonbinary appearance to the chest.
Transmasculine Bottom Surgery
The goal of transmasculine bottom surgery, or masculinizing genital surgery, is to reconstruct the female genitalia into male genitalia.
Hypospadias repair is surgery to correct a defect in the opening of the penis that is present at birth. The urethra (the tube that carries urine from the bladder to outside the body) does not end at the tip of the penis. Instead, it ends on the underside of the penis. In more severe cases, the urethra opens at the middle or bottom of the penis, or in or behind the scrotum.
Hypospadias Repair is done most often when boys are between 6 months and 2 years old. The surgery is done as an outpatient. The child rarely has to spend a night in the hospital. Boys who are born with hypospadias should not be circumcised at birth. The extra tissue of the foreskin may be needed to repair the hypospadias during surgery.
Before surgery, your child will receive general anesthesia. This will make him sleep and make him unable to feel pain during surgery. Mild defects may be repaired in one procedure. Severe defects may need two or more procedures.
The surgeon will use a small piece of foreskin or tissue from another site to create a tube that increases the length of the urethra. Extending the length of the urethra will allow it to open at the tip of the penis.
During surgery, the surgeon may place a catheter (tube) in the urethra to make it hold its new shape. The catheter may be sewn or fastened to the head of the penis to keep it in place. It will be removed 1 to 2 weeks after surgery.
Most of the stitches used during surgery will dissolve on their own and will not have to be removed later.
Vaginoplasty (also known as posterior colporrhaphy) is a procedure designed to tighten the vagina. An alternative is noninvasive vaginal tightening through heating tissues with radiofrequency waves or a laser. Patients with significant laxity may not experience a benefit from these treatments and may be better candidates for surgical tightening with vaginoplasty.
Reasons patients want a vaginoplasty
After childbirth, women may complain of vaginal laxity, resulting from the stretching of tissues and separating of muscles, sometimes to the point that a tampon falls out, and this lack of tone can contribute to sexual dysfunction.
What does a vaginoplasty do?
A vaginoplasty brings the separated muscles together, and the extra mucosa skin from the back side of the vagina is removed. The external skin can also be removed for a more aesthetic appearance.
Anesthesia for a vaginoplasty
While a vaginoplasty can be done under local anesthesia, many opt to have it done under general anesthesia.
Preparing for a vaginoplasty
Patients are asked to do a bowel prep prior to surgery.
Once the amount of tightening to be done is determined, a pie-shape wedge is marked to delineate the extra skin to be removed from inside the vagina. Beneath the skin, the tissues are tightened with strong sutures. Once the vaginal canal has been tightened, the mucosal skin is sutured closed. If there is external skin that protrudes, this can be reduced as well for a more aesthetic result.
What are the risks of vaginoplasty?
Risks from vaginoplasty include infection, bleeding, and pain, along with rare complications.
Recovering from a vaginoplasty
Patients may have one to two weeks of downtime. They may feel a deep ache for the first few days, and there is no tampon use or intercourse for eight weeks. Depending on the amount of tightening performed, some patients may be instructed to use dilators.
What are the results of a vaginoplasty?
This procedure typically results in a tighter vaginal canal, which can help enhance sexual satisfaction.
Hymenoplasty surgery is a procedure that restores the hymen. The hymen is the membrane that partially covers the vagina. Although an intact hymen is thought in many cultures to be a sign of virginity, it can be torn due to many other factors besides having sex.
WHAT IS HYMENOPLASTY?
During a hymenoplasty, we restore the hymenal ring by taking a thin layer of tissue from the vaginal wall and placing it in the location of the torn hymen. It is a surgical procedure performed under either local anesthesia with sedation or general anesthesia.
The hymen can tear for multiple reasons, not just penetrative sex. Common causes of a torn hymen include:
Riding a bike or a horse
A hymenoplasty can repair a torn hymen for women who want to restore it due to cultural, religious, or psychological reasons. It will tighten the vaginal opening and cause bleeding upon penetration. If your religion requires virginity before marriage and this is tested through an intact hymen, a hymenoplasty will help.
Penile and urethral reconstruction repairs abnormalities and diseases of the penis and the urinary tract. If necessary, we'll do multiple procedures at the same time.
Penile reconstruction includes:
Penis straightening of a bent or curved penis
Penile prosthesis insertion
Procedures to fix problems in the urine channel, including urethroplasty
Call your doctor if you have:
Excessive fluid drainage (soaking several pads per day)
Increased pain, redness, or tenderness
Pus draining from incisions
A fever greater than 101 degrees