(Also sometimes spelled "metaoidioplasty," a term meaning "a surgical change toward the male")Metoidioplasty--a surgical procedure developed in the 1970s--takes advantage of the fact that ongoing testosterone treatment in a trans man typically causes his clitoris to grow longer. The amount of clitoral growth varies with each individual, but it is not uncommon to see an increase in size to about the length of one's thumb. By cutting the ligament that holds the clitoris in place under the pubic bone, as well as cutting away some of the surrounding tissue, the surgeon is able to create a small phallus from the elongated clitoris. This is why metoidioplasty is sometimes referred to as a "clitoral free-up" or "clitoris release"-- the clitoris is freed from some of its surrounding tissue and brought forward on the body in a manner that makes it appear like a small penis. In order to further enhance the result, fat may be removed from the pubic mound and skin may be pulled upward to bring the phallus even farther forward.
Metoidioplasty may also involve the creation of a scrotum (scrotoplasty) by inserting testicular implants inside the labia majora, then joining the two labia to create a scrotal sac. This is often done in two stages, where in the first stage, tissue expanders are inserted in the labia in order to gradually stretch the skin in preparation for the insertion of permanent testicular implants at a later date. Some surgeons may insert the implants in the first procedure, and join the two labia in a later procedure.
Metoidioplasty may additionally involve a urethral lengthening procedure to allow the patient to urinate through the penis while standing. Surgeons may employ tissue from the vaginal area or from inside the mouth/cheeks to create a urethral extension. Usually, a catheter is placed inside the urethral extension for 2-3 weeks while the body heals and adapts to the new arrangement.
Depending on the surgeon and the desires/goals of the patient, the vaginal cavity may or may not be closed or removed (this is typically referred to as a "vaginectomy," "colpectomy," or "colpocleisis"). Often, a vaginectomy is performed in conjunction with scrotoplasty and/or urethral lengthening.
The typical operating time for a metoidioplasty procedure is about 3-5 hours, and may require additional follow-up procedures and revisions at a later date. Time required may differ depending on the options chosen by the patient (i.e., if he chooses scrotal implants and/or urethral lengthening), as well as the available tissue for the procedure, and the overall health and condition of the patient. Recovery time is usually between 2 to 4 weeks of very limited activity.
Metoidioplasty may also involve the creation of a scrotum (scrotoplasty) by inserting testicular implants inside the labia majora, then joining the two labia to create a scrotal sac. This is often done in two stages, where in the first stage, tissue expanders are inserted in the labia in order to gradually stretch the skin in preparation for the insertion of permanent testicular implants at a later date. Some surgeons may insert the implants in the first procedure, and join the two labia in a later procedure.
Metoidioplasty may additionally involve a urethral lengthening procedure to allow the patient to urinate through the penis while standing. Surgeons may employ tissue from the vaginal area or from inside the mouth/cheeks to create a urethral extension. Usually, a catheter is placed inside the urethral extension for 2-3 weeks while the body heals and adapts to the new arrangement.
Depending on the surgeon and the desires/goals of the patient, the vaginal cavity may or may not be closed or removed (this is typically referred to as a "vaginectomy," "colpectomy," or "colpocleisis"). Often, a vaginectomy is performed in conjunction with scrotoplasty and/or urethral lengthening.
The typical operating time for a metoidioplasty procedure is about 3-5 hours, and may require additional follow-up procedures and revisions at a later date. Time required may differ depending on the options chosen by the patient (i.e., if he chooses scrotal implants and/or urethral lengthening), as well as the available tissue for the procedure, and the overall health and condition of the patient. Recovery time is usually between 2 to 4 weeks of very limited activity.
