Male to Female GRS
SEX REASSIGNMENT SURGERY
Criteria for Approval of Sex Reassignment Surgery:
- Patients must be 18 years of age and if under 20 years of age, parental consent is required.
- Patient must be diagnosed with at least one of the following disorders:
- Gender Identity disorder, gender dysphoria, or associated conditions and receive an approval from two different Psychiatrists who should certify that the person has Gender Identity disorder and is in a sound frame of mind to take a decision for Gender reassignment surgery.
- Patient is required to have lived full-time in the cross-gender role for at least one year.
Male to Female Gender Reassignment Surgery / Feminization surgery:
A) Bottom Surgery includes:
- Penis amputation (Penectomy) and Orchiectomy (removal of testes)
- Vaginoplasty (partially removing the penis; and creating a vagina, clitoris and labia) or Using Sigmoid Colon
- Labiaplasty after SRS which involves the reconstruction of Labia.
B) Feminizing Augmentation Mammoplasty (Breast enhancement/ Silicone implant/ Fat transfer etc.)
C) Facial feminization surgery
D) Tracheal shave
E) Voice feminization surgery
MALE TO FEMALE GENDER REASSIGNEMENT SURGERY (BOTTOM SURGERY)
PENECTOMY & ORCHIECTOMY
Amputation of the penis and removal of the testes is a prerequisite to change the gender from Male to Female. These are done surgically.
Male to female vaginoplasty is a Gender Reassignment surgery that transforms male genitals to an aesthetic and functional vagina. During a vaginoplasty surgery, the surgeon creates both the outer and inner vagina by using skin and tissue from the penis and scrotum. This is called Penile inversion technique.
The other method of Vaginal reconstruction is by using sigmoid colon (a part of Large Intestine). In this surgery, the abdomen is operated on. The sigmoid colon segment taken on with blood supply, the remaining sigmoid colon joined to each other, the segment to be used for Vagina is brought down and sutured.
With our qualified Surgeon, our patients can expect normal urination, sexual drive and minimal scarring.
It is the creation or revision of the labia following Male to Female SRS / GRS surgery which involves surgically constructing a labia majora or labia minora out of the existing tissue. These are refining surgeries for the beautification
A simple orchiectomy is surgical removal of the testes which is most commonly performed as a part of Sex Reassignment Surgery for transgender women.
VOICE FEMINIZATION SURGERY
Voice Feminization Surgery is a procedure to raise the pitch of the voice or make it sound higher.
Surgery changes the length, size or tightness of the vocal cords which is permanent. These are done by specialized Endoscopic Surgeons.
It is recommended to have voice therapy pre- and post-surgery.
The surgery usually takes about 1-2 hours and is done as a day care procedure under General anaesthesia.
The patient can resume work after 7 days and exercise after 4 weeks.
FACIAL FEMINIZATION SURGERY(FFS)
Facial Feminization surgery is a highly sophisticated surgery. The exact procedures required for the transformation of the facial features from male facial features to the female facial features requires a lot of personalized discussion and planning. Sometimes facial profiling may be required.
It does mean thus, the procedures may be less and simple in some patients and more and complicated in some, depending on the preoperative contour.
The Surgeries involve:
Feminine Brow line creation / Reconstruction
This includes two types of techniques:
Surgery on the bones of the skull
Work on the soft tissue that covers the bone.
Bone reconstruction in FFS is based on the differences between the average male and female skull.
The Soft tissue work is less invasive
Forehead surgeries includes the following procedures:
Brow shaving or osteoplastic bone surgery to recontour the forehead bone
Trimming down the upper edge of the eye sockets to remove brow bossing.
Forehead implant to round out a flat forehead.
A recessed hairline is associated with an aging look and masculine features.
Advancing the hairline yields a more youthful and feminine appearance.
Brow lifting: Tightening the skin on the forehead and raising of eyebrows.
Nose reshaping / reconstruction:
To change the appearance of the nose, surgical changes to the nose in FFS can include-
Micro-fat grafting / fillers or dermal-fat grafting:
Surgical procedure works on to reduce the size of the laryngeal prominence also known as the Adam’s apple.
The outcome is a smoother neck with a less prominent Adam’s apple.
Mandibular shave Surgery
Those patients who have a broad angle of Mandible or jaw line may require mandibular angle shave or jaw shave surgery. In this surgery, the pointed jaw bone, the outer surface of the jaw, is removed.
Additional Botulinum toxin injection to the masseter muscles may be required to make a V- shaped jawline
Female faces have high cheekbones. These can be achieved by either fat injection or fillers injection or by Malar implants which are put through intra oral incision.
POSSIBLE COMPLICATIONS OF NECK / FACE SURGERY:
- Adverse reaction to anaesthesia
- Blood clots
- Excessive bleeding
- Wound infection
- Slow healing
- Numbness (mostly temporary)
- Scar problems.
Fortunately, these side effects are not very common and hardly any patient has had any major issues
Words of wisdom:
It is very important to go step for these surgeries after meticulous planning and discussion. Please try and visualize yourself in the new face as much as possible and discuss extensively with the doctor.
FEMINIZING AUGMENTATION MAMMOPLASTY / BREAST AUGMENTATION IN TRANSGENDERS/ SILICONE IMPLANT:
Estrogen can significantly change breast size and shape in some MtFs. While breast growth starts soon after taking estrogen, it is slow and gradual, and takes two or more years for breasts to reach their maximum size.
If you can take hormones, it is recommended that you wait at least 12 months, to give your breasts time to develop with hormones. Hormones will help your nipples grow, and will also stretch out the skin of your chest so you can have a more natural looking implant.
In this way the Implants look more natural if they are used to augment existing breasts, rather than implanted into a flat chest.
In some cases, if hormones are contraindicated medically or if the patient chooses not to have hormones, still the implants can be done with a smaller size that will look balanced with the size of the nipples.
Breast surgery can be done as a single standalone surgery or in combination with genital surgery to avoid a repeat of general anaesthesia.
SITES FOR AUGMENTATION INSERTION:
- Periareolar – around the areola
- Transaxillary – in the armpit
- Inframammary – Incision under the breast.
POINTS TO BE DISCUSSED WITH THE SURGEON:
- Type of breast implant
- Shape of the implant
- Texture of the silicone shell
- Placement of the implant
- Size of the implant – 100 cc to 1000 cc
RISKS & POSSIBLE COMPLICATIONS IN TRANSGENDER BREAST AUGMENTATION.
These surgeries are generally simple and usually no major problems occur. But at times some problems may happen
- Reaction to anaesthesia
- Wound infection
- Scarring issues
- Problem with the implant: leakage, rupture, infection, capsule contracture etc
- Less or more intense sensation in the nipples.
Post operative swelling and pain generally improves in a few days’ time and one is fit to resume duties in a few days. The doctor will counsel you regarding the do’s and don’ts.
BODY FEMINIZING SURGERIES like lipo-sculpting may be required in some patients.
Along with this the mannerisms and voice tutorials may also be required for a good result