Overview of FTM Bottom Surgery/ Genitourinary Reconstruction

By Top.me

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Everyone has the right to feel at ease in their skin and to have their looks represent their inner selves. Transgender individuals can have a wide range of operations that give them physical traits and features that more closely resemble their gender identification.

FTM bottom surgery is a highly sought-after procedure, and many FTM trans people get it yearly. From a complete phalloplasty to a perineoplasty, we take a closer look at what it takes to get FTM bottom surgery.

The following are the most critical aspects of FTM bottom surgery:

The Different Types of FTM Bottom Surgery

Surgery team in operating room doing FTM Bottom Surgery

The two most common types of FTM bottom surgery are metoidioplasty and phalloplasty.


In metoidioplasty, the surgeon removes the clitoris and creates a neo-penis. The plastic surgeon makes the penis using skin flaps and fat from the clitoris. The doctor may also generate a scrotum to hold testicles in place.

One downside is that the procedure is long, complicated, and expensive. It needs an expert to minimize any sorts of complications.


In this procedure, surgeons make a new penis out of skin and tissue from other body parts. They use components from the thigh or abdomen to create a penis.

Although phalloplasty has been successful in many patients with penile concerns, it has setbacks. The new penis may not have a successful erection.

Besides, because the surgeon takes skin grafts from an area not used for sexual function, they will take longer to heal.

Recovery From FTM Bottom Surgery

Having a realistic expectation about recovery time after FTM bottom surgery is essential. You must stay in bed after FTM bottom surgery for roughly five days. You need at least a few weeks of rest before starting to ease back into activity.

This is to keep an eye on the blood flow and ensure the artificial penis doesn’t hang down and stretch the blood vessels too much.

The doctor needs to support the phallus with a sling while it heals completely. One catheter will come out of the new urethra, and the other will come from above the pubic bone—these will drain your bladder for six weeks following surgery. But, patients must avoid pulling the catheters at all costs.

Meanwhile, the recovery period varies from person to person. It depends on how much activity you were doing beforehand and how active your new life will be. And for the scar to completely heal, you may need a scar revision.

Some people can return to work after a week. Some start running, swimming, and other forms of exercise and light activity. More demanding jobs should have more time, two weeks or more.


What Does FTM Bottom Surgery Mean?

Bottom surgery is a plastic surgeon’s procedure for transgender men who wish to alter their genitalia. 

What Are the Other Names for FTM Bottom Surgery?

Other names for FTM bottom surgery include:

  • Gender confirmation surgery
  • Transgender surgery
  • Sex reassignment surgery
  • Gender-affirming surgery
  • Gender reassignment surgery

Any Risks From FTM Bottom Surgery?

Just a few of the potential risks with transgender bottom surgery include:

  • Injuries to the urinary tract
  • Abnormal connections between the urethra and the skin
  • Bleeding
  • Infection
  • Poor wound healing
  • Hematoma
  • Nerve injury
  • Inadequate vaginal depth
  • Pain during erections

How Large Can a Metoidioplasty Get?

A metoidioplasty typically yields a penis that measures 4 to 10 centimeters (cm) in length. Penetrative sex might not be possible due to the size. A person may choose to get a phalloplasty following a metoidioplasty if this causes them concern.

With  Phalloplasty, Is It Possible to Get Hard?

A phalloplasty leads to a larger penis than a metoidioplasty. But this neo-penis cannot stand up by itself.

What Are the Costs and Affordability of FTM Bottom Surgery?

The cost of bottom surgery varies depending on where you live and your chosen procedure. Historically, neither government healthcare nor health insurance has provided coverage for FTM. However, some insurance companies are starting to pay for FTM from specific surgeons.

So, depending on the surgeon and the number of surgeries, out-of-pocket expenses for FTM often range from $20,000 to $50,000.

How Long Does It Take to Completely Recover After Bottom Surgery?

A transgender girl recovering after her FTM Bottom Surgery

FTM post-op bottom surgery recovery takes three to six days in the hospital. You’ll need another seven to 10 days of strict outpatient observation. After your surgery, you should take around six weeks off from work or intense activity.

Is Phalloplasty Realistic?

Although the procedure is technical, patients can constantly urinate while standing and feel satisfied. Most people call this a trustworthy method for generating a penis and scrotum that appear regular.