UH Experts Offer a Wide Variety of Surgical Options for Female to Male (FTM) Transition

Choosing to surgically alter your body to align with your inner perception of self is a big decision and a permanent one. Although some transgender individuals may be comfortable simply living as their affirmed gender, others feel that surgery is an essential step to allow them to live the life they want as the person they know they are.

Once a decision has been made and the eligibility requirements for a female to male (FTM) surgical transition have been met, it is essential to choose a care team with experience and expertise to achieve the best possible functional and cosmetic outcomes. The multidisciplinary team of surgeons at University Hospitals have the advanced training and experience to provide our transgender patients with a full range of procedures from which to choose, and the compassion to support patients throughout this unique journey.

Surgical Procedures for Female to Male (FTM) Gender Affirmation

Facial Masculinization

This refers to a series of reconstructive surgical procedures that reshape female facial features to be more masculine. In general, cross gender hormone therapy with testosterone itself produces sufficient masculinization, however, some patients may opt to have one, two or all of the transformative surgeries listed below - some combinations may be done in one surgical session while other choices may require additional trips to the operation room. The plastic surgeons at University Hospitals will discuss your options with you and, together, you will create a plan of care.

• Cheek augmentation
• Forehead augmentation
• Jaw augmentation
• Chin augmentation

Chest Masculinization

In addition to hormone therapy which stimulates hair growth and increases muscle mass, surgical procedures to masculinize the chest include:

• Double incision mastectomy with free nipple grafts: This is the most common form of chest masculinization that allows for removal of the breast tissue with incisions that are placed near the border of the pectoralis major muscle. The nipples are removed and then grafted and sized to provide a more aesthetic masculine appearance.
• Subcutaneous mastectomy with peri-areolar incision: This procedure is less common and typically is only recommended for smaller-breasted patients. However, in the right patient, it can be a great option for providing a masculine chest contour.

Genital Masculinization

Reconstructive urologist, Shubham Gupta, MD collaborates with plastic surgeon, Tobias Long, MD, to create external male genitalia that is both functional and aesthetically pleasing. Procedures may include:

• Metoidioplasty – Transformation of the clitoris into a functional penis
• Phalloplasty – Creation of a penis from tissue taken from elsewhere on the body
• Vaginectomy (removal of the vagina) and hysterectomy/oophorectomy (removal of the uterus and ovaries) may also be offered concurrently

Buttock Masculinization

Liposuction: Removing fat from certain areas of the buttock region can provide a more masculine appearance.