Metaiodoplasty

Metoidioplasty is a procedure used to obtain a more masculine appearance of the genitals.

Dr. Brassard consults with each of his patients individually to determine the best surgical technique to use according to their needs, current anatomy of their genitals, and desired results.

Several needs and desires can guide you in your choice to undergo metoidioplasty, an alternative surgery to phalloplasty.

In order to meet the needs and expectations of our clientele, GRS Montréal performs different metoidioplasty techniques. However, each of these techniques generally consists of: 

  • The creation of a penis through the lengthening of the clitoris (metoidioplasty);
  • The possibility of lengthening the urethra (neourethra);
  • The possibility of closing the vaginal cavity (vaginectomy). *An hysterectomy including removal of the cervix must be performed at least 6 months before a vaginectomy;
  • The creation of a scrotum (scrotoplasty and the insertion of testicular implants) or a bifid scrotum (insertion of the testicular implants into the labia majora of the vulva).

The team at GRS Montréal constructs your masculine genitals using existing genital tissues. This way, all techniques performed allow for the achievement of optimal aesthetic results.

Due to multiple factors that are unique to each individual, aesthetic and functional results vary from patient to patient. Be assured that our surgical team works with each patient individually to achieve the best results possible. In order to optimize the results of your surgery, your surgical team asks the following from you:

  • healthy weight without excessive accumulation of fat in the pubic region;
  • an intact genital skin: genital skin with a significant degree of laxity cannot be used during the procedure;
  • a hypertrophy of the clitoris.

 


 The various proposed surgical techniques


Metoidioplasty WITHOUT lengthening of the urethra 

Expected and desired results:

  • A masculine appearance of the genitals by lengthening the clitoris, which forms the penis;
  • An erogenous, erectile organ, with the possibility of sexual pleasure, but without the possibility of penetration.

Limits of the surgical technique:

  • Does not allow for urination while standing since the urethra remains in its current location;
  • Does not allow for sexual relations with penetration.

The 3 possibilities:

Metaiodoplasty without vaginectomy

Metaiodoplasty and testicular implants

Metaiodoplasty with vaginectomy and with or without testicular implants

Highlight of the surgical technique:

Lengthening of the clitoris by completely releasing the clitoral ligaments.

Highlight of the surgical technique:

  1. Lengthening of the clitoris by completely releasing the clitoral ligaments;
  2. Insertion of testicular implants in the labia majora to obtain the appearance of a bifid scrotum.

Highlight of the surgical technique:

  1. Lengthening of the clitoris by completely releasing the clitoral ligaments;
  2. Closure of the vaginal cavity;
  3. *Optional: Insertion of testicular implants in the labia majora to obtain the appearance of a bifid scrotum.

 

The surgical procedure, your stay and convalescence
 
Average length of the procedure
Admission to the CMC
Anesthesia
Hospitalization
Convalescence at Asclépiade
Average lenght of convalescence at home
Return to physical activities and sports
Metaiodoplasty without vaginectomy
1 hour The day of the procedure Regional or General

2 nights postoperatively

None 3 weeks 6 weeks
Metaiodoplasty with testicular implants
1 to 1.25 hours The day of the procedure Regional or General

2 nights postoperatively

None 3 weeks 6 to 8 weeks
Metaiodoplasty with vaginectomy with or without testicular implants
1.5 to 2 hours The day of the procedure Regional or General

2 nights postoperatively

6 days 4 weeks 6 to 8 weeks
Medical follow-ups and appointments: Asclépiade provides personalized postoperative follow-ups to all patients. You will be getting a follow-up appointment with your surgeon one month after your surgery. If you cannot come to your appointment, your attending physician can follow-up with our surgeons by contacting the Asclépiade.

 

Metaiodoplasty WITH lengthening of the urethra 

Expected and desired results:

  • A masculine appearance of the genitals thanks to:
    • lengthening of the clitoris, which forms the penis;
    • lengthening of the urethra to the tip of the penis;
    • a scrotum with a more natural appearance for a metoidioplasty with scrotoplasty, otherwise a scrotum with a bifid appearance for a metoidioplasty without scrotoplasty.
  • Ability to urinate standing up;
  • An erogenous, erectile organ, with the possibility of sexual pleasure.

 Limits of the surgical technique: 

  • Does not allow for sexual relations with penetration.

The 3 possibilities:

Metaiodoplasty by mucosal graft or ring flap, vaginectomy and testicular implants

Metaiodoplasty by mucosal graft or ring flap, without vaginectomy and with testicular implants

Metaiodoplasty by mucosal graft or ring flap, vaginectomy and scrotoplasty

Highlights of the surgical technique:

  1. Removal of the vaginal mucosa and closure of the vagina (vaginectomy);
  2. Complete release of the clitoral ligaments and the ventral cord for maximal lengthening of the clitoris;
  3. Use of the skin of the labia minora added to a vaginal mucosal graft to lengthen the urethra. The urethra is extended from the biological urinary meatus to the tip of the penis;
  4. Insertion of testicular implants in the labia majora to obtain the appearance of a bifid scrotum. Testicular implants will be located higher up, a considerable advantage.

 

Highlights of the surgical technique:

  1. Complete release of the clitoral ligaments and the ventral cord for maximal lengthening of the clitoris;
  2. Use of the skin of the labia minora added to a vaginal mucosal graft to lengthen the urethra. The urethra is extended from the biological urinary meatus to the tip of the penis;
  3. Insertion of testicular implants in the labia majora to obtain the appearance of a bifid scrotum. The testicular implants will be located in an anterior position to the genitals, a considerable advantage.   
    *Testicular implants may be inserted 6 months after metaiodoplasty surgery during a secondary surgical procedure.

Highlights of the surgical technique:

  1. Removal of the vaginal mucosa and closure of the vagina (vaginectomy);
  2. Complete release of the clitoral ligaments and the ventral cord for maximal lengthening of the clitoris;
  3. Use of the skin of the labia minora added to a vaginal mucosal graft to lengthen the urethra. The urethra is extended from the biological urinary meatus to the tip of the penis;
  4. Construction of the scrotum between the thighs. It can be located higher in patients who have enough skin and if this skin is sufficiently elastic. Otherwise, the position of the scrotum will be located lower (between the legs);  
  5. * Testicular implants will be inserted 6 months after metaiodoplasty surgery during a secondary surgical procedure. Because the scrotum is located in a lower position, the testicular implants have a tendency to take a position one in front of the other rather than one next to the other.

  *The choice of a mucosal graft or ring flap is decided by the surgeon in the operating room and in accordance with your anatomy. Your surgeon works to obtain maximum elongation of your penis while minimizing the risk of complications like urethral fistula.   

 

The surgical procedure, your stay and convalescence
 
Average length of the procedure
Admission to the CMC
Anesthesia
Hospitalization
Average lenght of convalescence at Asclépiade
Average lenght of convalescence at home
Return to physical activities and sports
Metaiodoplasty by mucosal graft or ring flap, vaginectomy and testicular implants
2 hours The day of the procedure Regional or General

2 nights postoperatively

6 days 4 to 6 weeks 6 weeks
Metaiodoplasty by mucosal graft or ring flap, without vaginectomy and with testicular implants
2 hours The day of the procedure Regional or General

2 nights postoperatively

None 4 to 6 weeks 6 weeks
Metaiodoplasty by mucosal graft or ring flap, vaginectomy and scrotoplasty
2 hours The day of the procedure Regional or General

2 nights postoperatively

6 days 4 to 6 weeks 6 weeks

Medical follow-ups and appointments: Asclépiade provides personalized postoperative follow-ups to all patients. You will be getting a follow-up appointment with your surgeon one month after your surgery. If you cannot come to your appointment, your attending physician can follow-up with our surgeons by contacting the Asclépiade.

Postoperative care:

During your convalescence, you will be provided with the document Information and Postoperative Care – Metaiodoplasty. This document contains your surgeon’s instructions and will serve as a guide.

Download the document Information and Postoperative Care – Metaiodoplasty.

 

Click here to consult our table comparing the different surgical techniques for metaiodoplasty offered by GRS Montréal.