Metoidioplasty
Female-to-Male Ring Flap Metoidioplasty
Notice: Adult Content
This page contains post-operative pictures of genitals. This page is not work safe.Overview
Ring Flap Metoidioplasty is a technique developed in Japan by Dr. Ako Takamatsu, M.D., Ph.D. Dr Takamatsu is a female plastic surgeon who is currently the sole surgeon offering Gender Confirmation Surgery (GCS) in Japan. Dr. Takamatsu was hosted by Papillon Center in July of 2008 to exchange ideas on GCS and as a result, Dr. McGinn is now offering Ring Flap Metoidioplasty. This surgery utilizes a flap of skin from the vagina along with the labia minora to create a urethral extention. The clitoral chordee is also released in this procedure. The result is a lengthened phallus with added girth and the ability to urinate while standing. This procedure has a particular advantage over buccal mucosa urethral lengthening in that it does not require a second operative site to harvest the oral mucosa. This eliminates problems such as poor mouth healing and decreased saliva production. Another advantage of this procedure is that it may be converted to a free flap phalloplasty if the patient’s goals change at a later date.Scrotoplasty, testicular implants, mons liposuction and phallus repositioning are also available, but must be performed as a second surgery due to the delicate nature of urethral lengthening procedures.
The cost for Metoidioplasty is $15,500 USD (Approx. 12,300 EUR*), $1,000 of which is due when a surgery date is scheduled. This price includes transportation to the hospital, the hospital stay, operating room fees, anesthesia fees, complimentary Myofascial or Reiki therapy, and hospital blood tests. There is a choice of two hospitals: DSI of Bucks County in Bensalem, and Doylestown Hospital, both located just north of Philadelphia, Pennsylvania.
For financial or health insurance assistance, please visit our Financing and Health Insurance section.
Requirements
Papillon Center follows the World Professional Association for Transgender Health (WPATH) guidelines for transgender surgery. Two letters of recommendation are required before surgery. These letters can be from: psychologists, therapists, psychiatrists, sexologists or counselors that have been in regular contact with you and have experience dealing with transgender issues. The letters should be in the format described by the Standards of Care. Papillon Center can work with patients that have insufficient recommendations. On-going therapy and support is preferable both before and after surgery. Patients should have also completed their "real-life test" as well as be on an approved contra-hormone therapy (CHT) regimen. The reason for these requirements is a compassionate one: we want you to have an understanding about what changes you will go through before they are irreversible.
Please see Therapy Letter Requirements for an indepth overview of surgery recommendation letter requirements.
The metoidioplasty surgery is not a minor surgery. It is necessary that the body and mind be in optimal health. Smoking and obesity will increase your chance for complications. Smoking cessation is mandatory one month prior to surgery (as well as six months following surgery). It is also required that body mass index (BMI) be less then 28. Some medications will need to be stopped before surgery. They can generally be continued several days after surgery. Dr. McGinn does not require cessation of testosterone contra-hormone therapy (CHT).Initial Consultation
A consultation is required to setup a surgery date. It is preferable that it takes place in person; however, Papillon Center will make phone consult accommodations for individuals on a case by case basis. The cost for the consultation is $150 USD.The procedure is outlined, including risks, complications, and possible outcomes. Health is also taken into consideration, especially the topics of sexuality, nutrition, body mass, and smoking. Sexual health is of particular concern as sexual re-education tends to take a substantial role in the recovery of sexual function after surgery.
Dr. McGinn will go over past surgical results, including pictures, as well as expectations and limitations. It is important to be honest and ask questions about subjects that you do not understand.
