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Medically Reviewed by:

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Female to Male Surgery: What Does It Entail?

Female to male surgery can be used to help trans men feel that their outsides are more aligned with their insides. Depending on your goals, you may want to consider several different procedures. Here’s what you need to know about your surgical options and recovery time: 

Female to Male Surgery: What Does It Entail?

In addition to hormonal therapy, surgery can be used to address the gender dysphoria experienced by transmen. There are four different procedures that transmen may want to consider to feel more comfortable and confident in their bodies when it comes to surgery. 

The decision to get surgery and then which procedures to undergo are extremely personal, and there are no “right” or “wrong” approaches. 

Here’s what you need to know about some of the different surgical options available for transmen so that you can make an informed decision regarding your transition: 

Procedure #1: FTM Top Surgery (Mastectomy)

One procedure available for transmen is known as “top surgery” or a mastectomy. This procedure involves removing unwanted breast tissue from the chest area to achieve a more masculine appearance. 

The procedure is less invasive if you have small breasts and will likely utilize either a periareolar approach or a keyhole approach. These two approaches minimize the effect on the nipples. 

If you have larger breasts, however, the procedure is more invasive and will likely require a double bilateral mastectomy approach wherein your nipples will have to be re-grafted back onto your chest. 

Procedure #2: Facial Masculinization Surgery (FMS)

Another procedure available for transmen is known as facial masculinization surgery or FMS. This procedure aims to achieve a more chiseled and masculine face by sharpening traditionally soft female features. 

There are several different components involved in an FMS, depending on your goals. For instance, you could undergo a forehead augmentation to give you a longer forehead. You could undergo a cheek augmentation to provide you with stronger cheekbones. You could undergo chin and jaw recontouring to provide you with a stronger and more masculine chin and jaw area. 

Finally, you could undergo a thyroid cartilage enhancement to give you the appearance of an Adam’s Apple. 

Procedure #3: Body Masculinization Surgery (BMS)

If you want to take a full-body approach, you may consider body masculinization surgery or BMS. This procedure aims to achieve a more masculine body shape by utilizing liposuction to redistribute fat throughout the body. 

Small incisions will be made in areas where females traditionally store more fat — such as the hips and abdomen. A surgical tube will then be inserted into these incisions to essentially suck out the fat in the area. Some of the different areas targeted during a BMS procedure include the flanks, inner and outer thighs, upper body, chest, back, or buttocks. 

Procedure #4: Gender Confirmation Surgery (GCS)

The last procedure available for transmen is known as gender confirmation surgery or GCS. This procedure aims to provide trans men with genitalia that matches their gender identity through a technique known as the Centurion procedure. This is also known as sex reassignment surgery. 

The Centurion procedure involves many different steps that work to transform the vagina into a penis. First, a vaginoplasty and complete hysterectomy are performed. From there, the clitoris is used to form the head of the penis to provide erectile capability. 

The last step in the process involves forming a scrotum with the labia majora and testicular implants. The urethra will also be lengthened to allow urination to eventually take place. 

Often, a phalloplasty will occur, which is when a flap (skin graft) is taken from the patient’s arm, thigh, back, or abdomen to help form a neopenis. After this procedure takes place, the patient can choose to undergo a urethral lengthening procedure that will allow for a longer phallus; in other words, it will require a longer neourethra. 

Some complications that may develop from a metoidioplasty or phalloplasty include a urethral fistula. Essentially it happens when the urethra and the urethral stricture are narrowing, which causes the urine flow to be blocked. 

Who Is a Good Candidate for Female to Male Surgery?

The decision to undergo female-to-male surgery should not be taken lightly. Health care professionals want to make sure that only qualified candidates undergo these serious procedures. You might be a qualified candidate for a female to male surgery if:

  • You have been diagnosed with persistent gender dysphoria wherein your gender does not match your identity
  • You have been under the consistent care of two mental health professionals who can each provide a letter of recommendation regarding your decision to undergo female to male surgery
  • You have been living as a member of your desired sex
  • You are old enough to consent to the procedure(s) on your own 
  • You have a positive outlook on the procedures with realistic expectations of the results
  • Your medical or mental health concerns, if applicable, are reasonably well-controlled either through medication or otherwise 

What Is the Recovery Process for Female to Male Surgery?

The recovery process for a female to male surgery varies depending on the procedures performed and your own body. Everyone heals differently, so it’s important to remain patient and follow the instructions from your surgeon to promote a complication-free recovery process. 

That being said, if you’re looking for the easiest recovery process, then body masculinization surgery might be the best option for you since it only involves small incisions. On the other hand, gender confirmation surgery is the most invasive and requires the longest recovery time of about six weeks. 

How To Find a Surgeon for Female to Male Surgery?

When undergoing female to male surgery, you want to work with a qualified surgeon who is experienced in this area and shares your goals. You also want to work with someone you’re comfortable with since these procedures are personal and intimate. 

If you’re looking for the best, look no further than Dr. Applebaum in Beverly Hills. He has over 25 years of experience, during which he has performed research, established his surgery center, and earned numerous awards. 

Contact Dr. Applebaum today for an in-person or virtual consultation regarding your gender goals. 

Final Thoughts on Female to Male Surgery

No matter which approach you decide to take to female to male surgery, the right plastic surgeon can help guide you through the process and help you achieve a confidence-boosting look. 

Medically reviewed by Dr. Robert Applebaum

Dr. Robert Applebaum is a world renowned and highly respected Plastic Surgeon who is Board Certified by the American Board of Plastic Surgery. In his nearly 30 years as a practicing physician, Dr. Applebaum has become known as an innovator in the field of laser technology techniques for plastic surgery procedures. He has published numerous articles and scientific papers about the use of laser technology and educates physicians worldwide on the applications of laser technology for plastic surgery. Dr. Applebaum primarily practices out of his private outpatient surgery center, Four Thirty Six Aesthetic Surgery Center, which is located in Beverly Hills.


Gender Affirmation Surgery: What Happens, Risks & Benefits | Cleveland Clinic

What Is Gender Dysphoria? | American Psychiatric Association

Centurion Metoidioplasty – FTM Surgery | Metoidioplasty.net

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