Understanding MTF Bottom Surgery: Techniques and Outcomes

Vaginoplasty and related procedures for transfeminine individuals have evolved significantly. This guide explores current surgical techniques, expected outcomes, and key considerations for making informed decisions about bottom surgery.

Primary Surgical Techniques

Penile Inversion Vaginoplasty

The most common technique using existing penile and scrotal tissue.

Key Features:

• Creates functional vaginal canal

• Preserves sexual sensation

• Natural-appearing external genitalia

• Maintains ability to orgasm

• Creates clitoris from penile tissue

• Uses scrotal tissue for labia

Considerations:

• Requires adequate donor tissue

• Hair removal needed

• Regular dilation required

• Depth varies by anatomy

Peritoneal Pull-Through Technique

Uses peritoneal tissue to line the vaginal canal.

Key Features:

• Additional depth possible

• Self-lubricating properties

• Less dilation long-term

• Natural tissue healing

• Reduced risk of stenosis

• Can combine with traditional techniques

Recovery Process

Hospital Stay (5-7 days)

• Pain management

• Catheter care

• Initial wound care

• Movement restrictions

• Medical monitoring

Early Recovery (1-6 weeks)

• Regular dilation

• Wound care

• Limited activity

• Hygiene routines

• Follow-up visits

Long-term Care

• Continued dilation

• Pelvic floor therapy

• Scar management

• Regular check-ups

• Sensation development

Dilation Schedule

First 3 Months

• 3-4 times daily

• 15-20 minutes each

• Strict scheduling

• Size progression

• Cleanliness crucial

After 3 Months

• Gradual reduction

• Maintenance schedule

• Individual adjustment

• Lifetime commitment

• Sexual activity helps

Potential Complications

Early Complications

• Bleeding

• Infection

• Wound separation

• Catheter issues

• Pain management

Long-term Considerations

• Stenosis

• Granulation tissue

• Sensation changes

• Aesthetic concerns

• Revision needs

Cost Considerations

Direct Costs

• Surgical fees

• Hospital stays

• Anesthesia

• Post-op supplies

• Travel expenses

• Recovery care

Remember that successful outcomes depend on thorough preparation, careful follow-up care, and commitment to long-term maintenance. Work closely with your healthcare team to develop an individualized surgical plan that meets your specific needs and goals.