Female To Male Surgery: Purpose, Procedure, and Benefits and Side Effects

The term 'female to male surgery' refers to a surgical technique that could aid a transgender man who was born with the gender assigned to a woman in completing their transition. During this series of procedures, the patient's face, chest and genitalia are altered to make sure that their gender identification precisely matches their physical characteristics, that their dysphoric (Gender Identity Disorder) symptoms go away, and that they are able to fully express who they truly are.

Transmen might get surgery to have a physique that matches their gender. It could entail operations on the face, chest, or genitalia. Typical female to male surgery involves these procedures;

The term 'facial masculinization surgery' (FMS) covers a wide range of operations that can be done to give the face a more chiseled and masculine appearance. FMS is a crucial part of the female-to-male transition because face features provide essential visual indications as to one's gender. Because each patient undergoing FMS will have different objectives and requirements, the doctors at Pristyn care will collaborate with you to create a specific surgical strategy. Forehead lengthening/augmentation, cheek augmentation, rhinoplasty, chin recontouring, jaw contouring, and thyroid cartilage enhancement (Adam's Apple surgery) are typically included in FMS.

This liposuction procedure is relatively safe and minimally invasive and is often preferred by the transman who wants to develop a more masculine contour throughout the upper and lower body. A broad, well-defined upper torso, a trim waist, and little body fat in the lower body are all characteristics of the classic male shape. The body can become more masculine through diet, exercise, and hormone therapy, but some areas of fat storage may be impossible to address without surgery. In order to minimize the feminine 'hourglass' form and produce a manly physique, BMS is a liposuction procedure that targets fat in the flanks, inner and outer thighs, upper torso, chest, back, and/or buttocks.

Also, through mastectomy a transman patient may get his surplus breast tissues removed to achieve a more masculine chest. A variety of procedures may be used to provide the desired aesthetic effect, depending on the individual needs and anatomy of the patient. These include adjunctive lateral chest wall liposuction, peri-areolar/'keyhole' surgery, and bilateral mastectomy with free nipple grafts.

A transman may elect to have gender confirmation surgery as the last phase of his transition gender confirmation. The Centurion process, a cutting-edge method, is used by the surgeons to do gender confirmation surgery. The patient first has a vaginoplasty followed by a full hysterectomy, which includes the removal of the ovaries, during this treatment. The remaining outer genitalia are then used to construct a male urethra and a penis with some sensation and function. The head of the penis, which gives rise to erectile function, is formed by the clitoris. Testicular implants are then inserted after the labia majora have been used to create a scrotum.

Under gender confirmation surgery many procedures are performed;

Hysterectomy & oophorectomy

During this procedure reproductive organs, ie, uterus, and ovaries are removed.

Metoidioplasty
It begins construction of the neo-penis by releasing the clitoris from the labia for lengthening and using labial minora tissues for the shaft skin around the clitoral body. If urethra lengthening is done for urination in the standing position a vaginectomy is commonly performed since this tissue is used for the lengthening. A scrotoplasty may or may not be desired.

Phalloplasty stage-I
Vaginectomy: Vaginal walls are removed and the vagina and perineum are surgically closed. Tissue from the vagina is used for the formation of the neo urethra on the forearms flap – Flap prelaminationUrethroplasty: It provides you with the ability to urinate standing up.

Phalloplasty stage-II
Free tissue transfer: A microvascular procedure whereby arteries and veins are connected to nourish the forearm flap (neo-penis) with blood. The intensive care unit is needed postoperatively to monitor the penis in the event of a blood supply problem to the penile construction.

• Scrotoplasty: done at the time of phalloplasty and flap transfer. Creates the scrotal sac from labia majora.
• Glansplasty: Constructs the tip of the neo-penis.

Transmen who undergo gender confirming surgery get long-term benefits in terms of their mental health. Here are some of the many benefits of female to male surgery;

• Improved mental health and overall well-being
• Lessen gender dysphoria
• Enhanced self-esteem
• Satisfaction with one's body
• More acceptance in society as a man.

Surgery can change a person's physical features to match their gender identity. Transmen who were born with female sex and are now experiencing gender dysphoria frequently choose to undergo female to male surgery. When your biological sex does not correspond to how you identify as, you may have gender dysphoria, which is a distressing disorder. Adults with gender dysphoria feel stuck in another person's body, which causes them to be unhappy, anxious, and uncomfortable.

Two uncommon conditions that can also lead to gender dysphoria are hermaphroditism and congenital adrenal hyperplasia (CAH). People frequently undergo a variety of surgical and nonsurgical procedures in an effort to more closely match their physical appearance to their gender identity in these circumstances since it is usual for them to try to live in accordance with their gender identity.

Risks can vary depending on the surgery and like any other surgery female to male surgery also carries some risks and complications, which might include:

• Bleeding
• Infection
• Bladder problems
• Altered sexual function
• Side effects from anesthesia

The advantages and disadvantages of every surgical procedure may be discussed in further detail by your medical professional. When performed by a qualified team of surgeons at Pristyn Care, serious complications are typically quite rare.

You need to consult a reliable healthcare professional before the procedure. You might be able to learn more about the pre- and post-surgery preparation and treatment from your medical professional;

• Obtain a certification from a psychiatrist prior to surgery for your surgeon’s reference in order to counter or validate the psychiatrist's assessment of your situation and the need for this permanently changing gender surgery
• Permanent Gender Surgery can only be proceeded when two certifications from two different psychiatrists have been received
• The patient and the surgeon both need to certify that they are aware that the procedure is irreversible and that the patient will not be able to reproduce or procreate in the future in an affidavit that must be submitted to the court before gender surgery can be performed
• Let your doctor know about any medications you take. This covers prescription drugs, over-the-counter drugs (such cough syrup or allergy tablets), inhalers, patches, herbal remedies, and vitamin supplements. Tell your doctor if you are allergic to any medications
• Follow your doctor's advice when it comes to taking your drugs. Before surgery, you might need to stop taking some blood thinners and medications that make it more difficult for your blood to clot. Your medicine dosage may need to be adjusted if you have diabetes. Consult your doctor before quitting any medicine
• Pack essentials in your hospital bag, such as a toothbrush, robe, and slippers, to make your stay more comfortable since female to male surgery is a major operation procedure and may require you to stay for minimum one to two nights in the hospital
• Follow your doctor's recommendations for what to eat and drink prior to surgery. You should probably abstain from eating or drinking after midnight the night before surgery. If you usually take your medication in the morning, ask your doctor or nurse for instructions
• Tell your surgeon or the hospital staff if you have a cold, the flu, or any other illness the day before surgery
• Inform your doctor if you think you could be expecting a child

Once the patient is made aware of this, they are given further instructions prior to the procedure.

During female to male surgery, the uterus, ovaries, and breasts are removed, a 'neophallus' is created utilizing tissue from the forearm or other regions of the body that can experience sexual attraction and also extending the urethra to facilitate standing urinating.

Where sex change surgery in India can vary from INR 2,00,000 to INR 7,00,000, top surgery for female to male surgery can alone cost around Rs. 75,000 to 1 lakh 50 thousand, based on the doctor and the procedure you opt (whether double incision or key hole technique). Keyhole technique is minimally invasive compared to double incision and costs around INR 1 lakh, whereas double incision may range between INR 1,20,000 to INR 1,50,000.

Much complex bottom surgery typically can cost you around INR 3,00,000 to INR 4,00,000 based on whether you choose metoidioplasty or phalloplasty and the doctor you pick. Also you will have to pay for the subsequent stages of the surgery.

A lot of other variables may also affect the cost of surgery. Along with tier-1 or tier-2 cities; hospital or clinic brand names, the fees of the treating consultant, admission fee, type of the surgery, post-surgical complications that are involved, admission room that you opted for, may have an influence on hospital billing expenses.

The total cost of the procedure may also be impacted by the number of diagnostic tests performed. The entire cost of the surgery may be reduced based on the patient's insurance plan.

Expenses for female to male surgery can also vary from individual to individual due to the following reasons:

• Surgeon fee
• Health condition of the patient
• Post-procedure complications that are involved
• Psychologist and psychiatric fee, if the help is required
• Type of the hospital
• The room that you opted for
• Admission fee.

When you leave the hospital, it's crucial that you follow all the directions your surgical team gives you. If you had top or bottom surgery, you shouldn't engage in strenuous work or push, pull, or lift anything heavier than five pounds for a few weeks after the procedure. This guarantees that your scar will heal properly and won't spread out and get bigger.

• Pain: Following surgery, you could feel some discomfort for a few days. However, in most cases, within four to five days, your pain will subside and can be treated with over-the-counter medication.
• Drains and dressings. When you leave the hospital, with lots of dressings and potentially drains placed on or in your surgical sites. Once you have had surgery, wait to remove them and go to your doctor. Your doctor's office will provide you with information on how to empty any drains you may have. These drains aid in preventing fluid buildup in the surgical wounds. Please keep track of the volume of water draining out. At your initial post-operative consultation, your drains will typically be taken out.
• Showering and bathing: Shower only the part of your body where no incision has been made or do it only if you can save the bandages and dressings from getting wet until you visit the doctor. Try instead a sponge bath to wash your body until your doctor gives you the all-clear to take a shower and a bath.
• Compression clothing: You will put on a compression vest following chest masculinization surgery. Following surgery, this vest is attached to your body in the operating room. Wearing the vest at all times is crucial to avoiding postoperative bleeding and fluid accumulations.

Your doctors may advise you to limit your consumption to ice chips only following female to male surgery, and the day following the procedure, they may only recommend a liquid and low-sodium meal. However, after your doctor gives you an all-clear, you can resume your normal eating habits. In the meantime, it is advised that you consume a balanced diet full of vital nutrients for the first few weeks to hasten your recovery.

• Prunes
• Yogurt
• Baby food
• Apple sauce
• Frozen dessert bars
• Pineapple
• Papaya
• Soups
• Plenty of water and juices
• Bread for toast
• Low-sodium diet
• Almonds
• Grapes
• Apples
• Apricots
• Berries
• Currants
• Prunes
• Cherries
• Cucumbers
• Pickles
• Tomatoes
• Chinese Black Beans
• Meat

Keep in mind that drinking alcohol and smoking can interfere with your medicine and are not recommended for your recovery. In order to prevent any discomfort that may result from bloating, you should also stay away from cheese and a high-sodium diet.

Similar to any other type of surgery, female to male surgery has its own risks and complications. As the procedure can vary from minimally invasive to invasive and open surgery, chances of risk can also go up, therefore, it's crucial to have a thorough health evaluation before making a surgical decision. The knowledgeable staff at Pristyn Care follows the best practices to ensure your safety.

After female to male surgery, it is typical to feel tightness, edema, discomfort, or fluid draining. However, because female to male surgery is not a single treatment but rather a combination of numerous surgeries performed on various body areas, the level of pain you experience varies depending on the procedures you are having.

Genital reconstruction is perhaps the most difficult treatment, although the discomfort may be managed with the help of the medications the doctor will prescribe. Similar to breast removal surgery, facial masculinization surgery may be extremely painful at first but is typically manageable with at-home care. After a few months, most patients no longer experience severe pain and may begin taking advantage of the benefits of gender-affirming surgery.

You should choose a surgeon carefully who is a skilled medical professional with plenty of expertise and success rate to reduce the pain and infection risks.

Your recovery time will be impacted by the operation(s) or combination of operations you will have:

Rhinoplasty with cheek surgery: The duration of swelling is two to four weeks

A chin and jaw operation: Edema often disappears in two weeks. It could take up to four months for the swelling to go down completely

Chest surgery: For one to two weeks swelling and pain last after a chest procedure. You must abstain from intense activity for at least a month

Bottom surgery: Most patients take at least six weeks off from their normal routines after surgery. You'll need to visit your doctor every week for a few months. These check-ins ensure that your recovery is progressing as planned.

It's important to understand that most people's transitioning process requires more than just surgery. After the procedure, you should continue to consult a counselor or therapist. These professionals can assist you with social changes and mental health issues.

Female to male surgery can sometimes have unfavorable anesthetic reactions, blood loss, blood clots, and infection as side effects. The following are a few typical negative effects of transgender surgery;

• Hematoma
• Abscess development
• Loss of sensation from seroma
• Irregular contours
• Breakdown of graft(s)
• Urological complications with scarring

It's crucial to discuss these adverse effects in detail with your surgeon.

Your surgical care team will take a number of steps to prevent these problems from arising, recognize them when they do, and effectively address them.

After your surgery, your healthcare professional will advise you on how to care for your wounds. The instructions will vary depending on the treatment you underwent and other circumstances, such as;

• Whether you need to stay in the recovery room for 5 to 6 days or will be discharged after a 2-day typical hospital stay
• Small-scale work can be restarted in two weeks. You should wait four to six weeks before starting more strenuous exercise
• While in the recovery period, it could be required to wear a compression binder for six weeks. The recommendations of the surgeon are important
• Depending on the procedure done, there can be just mild pain or discomfort for a few weeks after the surgery which can be managed with over the counter painkillers.
• Consult your doctor for the removal of stitches

Basic wound care

• You shouldn't take a shower or a bath unless your doctor instructs you to
• If necessary bath with a sponge
• Regularly replace the bandage or dressing
• Wash your hands well with soap and water before putting on the bandage
• Apply prescribed lotions or ointments to the surgery wounds
• Avoid the sun while you are recovering
• Daily visit the medical facility for the examination of the surgery site for any signs of infection.

Transmen who were born female but identify as male might transition to their desired gender with the help of female to male surgery. The surgery could involve one or more surgeries to alter the patient's face, chest, or genitalia in order to give them the most masculine traits possible. Working with a mental health professional is necessary both before and following surgery. Your likelihood of being happy with the outcomes of your surgery increases if you have a therapist you can rely on.