Gender dysphoria should not be left untreated. Modern surgical techniques allow us to offer many options for those who wish to achieve a partial or complete gender transition. These procedures involve the face, breast, genitals and body. The safest way to perform these is to undergo the recommended steps as proposed from WPATH prior to surgery, which means having completed the psychiatric evaluation and even the minimum 1 year of real life experience.
Male to female surgery
Feminization of the male breast is performed in a similar way as the breast augmentation, using tear drop shaped implants, which are selected according to the individual anatomical specifications of the chest and the personal wishes. Another aspect of the feminization the re-positioning of the nipple, which has to brought medially and higher, as in the female breast. All these possibilities are decided after thorough discussion and examination during the consultation.
Facial feminization surgery
The male face is in many aspects very different from the female, mostly due to the differences of the bony structure. Our goal here is to eliminate these differences, combining a series of procedures such as rhinoplasty, chin reduction, cheek implants, brow lift, eye socket elevation, Adam’s apple reduction etc. All these procedures allow us to create a female appearance of the face, without distortion of the personal characteristics.
Since fat allocation is different between male and female, modern techniques such as Bodyjet liposuction/fat grafting allow us to alter the body contour, feminizing areas such as the buttocks, extremities and abdomen. The results are permanent, since fat grafts behave as living tissue. This means gaining or loosing weight will maintain the new analogy of the body.
Male to female Genital surgery
Penile inversion is the most common technique used to transform the genitals from male to female. We perform a modification of this technique, where urethral tissue covers part of the vaginal wall, thus ensuring natural lubrication and a wider neovagina. The glans is trimmed and part of it is used to create the clitoris, while another part sustains the bottom of the vaginal wall. This way sensation of the new clitoris is ensured.
Female to male surgery
Removal of the the female breast in terms of a mastectomy is crucial in female to male surgery, since it allows one to integrate better. The technique we use is a modification of the breast reduction, where the nipples retain their sensation and blood supply. The scar is placed obliquely, beneath the lower rim of the pectoral muscle. The aesthetic result is superior compared to other techniques, while being a low risk procedure.
Using a combination of liposuction and fat grafting, the analogies of the body are altered, reducing feminine curves of the hip, buttocks etc.
From our experience, using the radial flap to create a penis is a procedure with high complication rate and morbidity of the donor area. Aesthetically equal results can be achieved using the ALT flap (anterior lateral thigh flap) as a pedicled flap, leaving a fine scar on the thigh and reducing microsurgical complications of the radial flap.