What is Bottom Surgery

The goal of transfeminine bottom surgery is to transform the male genitalia and reconstruct it into that of a female. Transfeminine bottom surgery is typically performed as a multiple stage procedure. There are many techniques used to perform bottom surgery, and the most appropriate technique for you will depend on your surgeon's preference as well as your personal goals.


Cost may include:

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Following your transfeminine bottom surgery, gauze or bandages may be applied to your incisions. A conformer will be placed inside the new vagina to help the tissues heal into proper position.

You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

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Healing will continue for several weeks as swelling decreases. Your plastic surgeon will place you on a regimen of dilating your vagina after surgery. Continue to follow your plastic surgeon's instructions and attend follow-up visits as scheduled.


The final results of transfeminine bottom surgery can help alleviate the feelings of gender dysphoria that some individuals may experience.

Over time, the new vagina will settle into position and the scar lines will improve, although they'll never disappear completely. There are trade-offs, but most transwomen feel these are small compared to the large improvement in their quality of life and the ability to look and feel like a woman.

The prostate gland is not removed from your body during the procedure. Although the amount of prostate growth as a result of estrogen therapy is small, the risk of developing prostate cancer is not zero. Careful monitoring of prostate health through exam is essential to your long-term health.

When you go home, if you experience shortness of breath, chest pains, or unusual heartbeats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.


The decision to have transfeminine bottom surgery is extremely personal. You'll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Many individuals view this procedure as a necessary step toward alleviating their gender dysphoria.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedures you will undergo and any risks or potential complications.

The possible risks of transfeminine bottom surgery include, but are not limited to, bleeding, infection, poor healing of incisions, hematoma, nerve injury, stenosis of the vagina, inadequate depth of the vagina, injury to the urinary tract, abnormal connections between the urethra and the skin, painful intercourse and anesthesia risks.


During your transfeminine bottom surgery consultation be prepared to discuss:

Your surgeon will also:

Be sure to ask your plastic surgeon questions. It’s very important to understand all aspects of your bottom surgery. To help, we have prepared a checklist of questions to ask your plastic surgeon that you can take with you to your consultation.

It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.


In preparing for transfeminine bottom surgery, you may be asked to:

Transfeminine bottom surgery is typically performed in a hospital setting, and will likely use general anesthesia. Some follow-up procedures may be performed on an outpatient basis, and local anesthesia with sedation may be used. These decisions will be based on the requirements of your specific procedure and in consideration of your preferences and your doctor’s best judgment.

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Words to know:

A process to maintain the opening of the vagina.
General anesthesia
Drugs and/or gases used during an operation to relieve pain and alter consciousness.
Blood pooling beneath the skin.
A procedure whereby the scrotal skin is used to create the labia majora.
A procedure to remove the testicles.

Questions to Ask

Use this checklist as a guide during your transfeminine bottom surgery consultation:

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