FTM Surgery | Top & Bottom Surgery Options

For those under the female-to-male (FTM) transgender umbrella, they can experience something called “dysphoria”. NHS. The UK defines dysphoria as, “a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity. This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life.” Due to the intense feelings that dysphoria can cause, many seek medical intervention to alleviate that pain, including pursuing top surgery and bottom surgery. Let us learn more about these types of surgeries, shall we?

FTM Top surgery, or in medical terms “subcutaneous mastectomy”, has many different kinds of procedures depending on the size of one’s chest. The Buttonhole Technique is an ideal FTM surgery for those who want a focus on nipple/areola size, positioning, feeling, and color. Another type of FTM surgery is Double Incision, which is the most popular procedure and is best for individuals who have a larger chest. For this surgery, the skin is cut open along two incisions, at the top and bottom of the pectoral muscle. Another common FTM surgery is Inverted-T which is also known as T-Anchor. This surgery is also ideal for large-chested people who hope to keep the most feeling possible in the nipple/areola region. 

A procedure that is popular with those who have a smaller chest size is Peri-Areolar. During this surgery, due to the nipple stalk and nerves not having been severed the feeling is generally maintained. Another FTM surgery that works well for those with a smaller chest is Keyhole, sensation is also maintained through this procedure as well. The final FTM surgery available is Minimal Scar, which is ideal for those with a small chest size and good skin elasticity. This is not as common as a procedure as the others and topsurgery.net describes it as, “Developed by Dr. Elliot Jacobs, Minimal Scar Top Surgery involves only small incisions on the side of the chest and partway around the areola. This minimally-invasive procedure leaves nearly invisible scars after healing, and nipple sensation is retained, making it an excellent choice for the right patient.”

FTM surgery that involves one’s genitalia is known as bottom surgery. There are two main types: phalloplasty or metoidioplasty. A phalloplasty is the construction or reconstruction of a penis that involves more than one surgery to gain the desired result. The goal of a phalloplasty FTM surgery is to build a cosmetically appealing penis of decent size that has sensations and is able to release urine in a standing position. During the procedure the surgeon removed a flap of skin from a donor region on the patient’s body, it is used to make the urethra and the shaft of the penis. Donor sites can include one’s radial forearm, anterior lateral thigh, abdominal, or musculocutaneous latissimus dorsi (back muscles underneath the arm). 

The second option for FTM surgery in regards to genitalia is metoidioplasty also known as meta. According to healthline.com metoidioplasty is, “a term used to describe surgical procedures that work with your existing genital tissue to form what is called a neophallus, or new penis. It can be performed on anyone with significant clitoral growth from the use of testosterone. Most doctors recommend being on testosterone therapy for one to two years before having metoidioplasty.” Within metoidioplasty, there are several ways to go about it such as simple release, full, ring, and centurion. Simple release, also known as simple meta, consists of only releasing the clitoris and not altering the vagina. The full metoidioplasty is releasing the clitoris and using a skin graft to create a urethra connecting to the neophallus. With the centurion metoidioplasty, no skin grafts are taken; instead, the labia is used to surround the released clitoris to give it more girth. As technology improves we are bound to see newer and better FTM surgery options in the near future.

For transgender individuals who cannot afford FTM surgery at this time, there are devices that can help alleviate dysphoria. For one’s chest, there are different types of binders available to flatten and give a sculpted masculine look. GC2B, Underworks, and TransTape tend to be the top site for the best binding methods available. You can get various designs, colors, sizes, and more. As for prostheses to alleviate bottom dysphoria, there are several types as well. You will find the best of the best at Axolom.com for stand-to-pee devices, packing, and even play. Axolom offers their three-in-one STP with pleasure ridges with a variety that allows each customer to find their best fit. These FTM surgery alternatives allow you to customize based on circumcision preferences, skin tones, size, and more! With all these items available for a female-to-male transgender individual there is hope for better day-to-day life without dysphoria constantly looming overhead. There is hope thanks to those who have fought for these options being available to the amazing transgender people who deserve the right to live their life to the fullest.