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. 2011 Aug;25(3):229-44.
doi: 10.1055/s-0031-1281493.

Sex Reassignment Surgery in the Female-to-Male Transsexual

Stan J Monstrey, Peter Ceulemans, Piet Hoebeke

Sex Reassignment Surgery in the Female-to-Male Transsexual

Stan J Monstrey et al. Semin Plast Surg. 2011 Aug.

Abstract

In female-to-male transsexuals, the operative procedures are usually performed in different stages: first the subcutaneous mastectomy which is often combined with a hysterectomy-ovarectomy (endoscopically assisted). The next operative procedure consists of the genital transformation and includes a vaginectomy, a reconstruction of the horizontal part of the urethra, a scrotoplasty and a penile reconstruction usually with a radial forearm flap (or an alternative). After about one year, penile (erection) prosthesis and testicular prostheses can be implanted when sensation has returned to the tip of the penis. The authors provide a state-of-the-art overview of the different gender reassignment surgery procedures that can be performed in a female-to-male transsexual.

Keywords: Genital surgery; gender reassignment surgery; phalloplasty; subcutaneous mastectomy; transsexual.

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Figures

Figure 1
Figure 1
(A,B) Result of long-term “breast binding.”
Figure 2
Figure 2
Algorithm for choosing appropriate subcutaneous mastectomy technique.
Figure 3
Figure 3
Semicircular technique. (A) Incisions and scar; (B) preoperative; (C) postoperative.
Figure 4
Figure 4
Transareolar technique. (A,B) Incisions and scar; (C) preoperative; (D) postoperative.
Figure 5
Figure 5
Concentric circular technique. (A) incisions; (B) preoperative; (C) postoperative.
Figure 6
Figure 6
Extended concentric circular technique. (A) Incisions and scar; (B) preoperative preoperative; (C) postoperative.
Figure 7
Figure 7
Free nipple graft technique. (A) Incisions and scar; (B) preoperative; (C) postoperative.
Figure 8
Figure 8
(A–D) Phallic reconstruction with the radial forearm flap: creation of a tube (urethra) within a tube (penis).
Figure 9
Figure 9
(A–C) Late postoperative results of radial forearm phalloplasties.
Figure 10
Figure 10
(A,B) Aspect of the donor site after a phalloplasty with a radial forearm flap.
Figure 11
Figure 11
Reconstruction of a lateral looking scrotum with two transposition flaps: (A) before and (B) after implantation of testicular prostheses.
Figure 12
Figure 12
(A,B) Phalloplasty after implantation of an erection prosthesis.
Figure 13
Figure 13
Results of a metoidioplasty procedure.
Figure 14
Figure 14
Penile reconstruction with a pedicled anterolateral thigh flap. (A) Preoperative and (B) postoperative results.
See this image and copyright information in PMC

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