What Is Bottom Surgery?

Bottom surgery creates harmony with a person’s gender identity while improving self-confidence and self-image. Each patient will have different goals for their transition, and the team at ART Surgical will create a highly personalized set of procedures to achieve the most seamless and satisfying outcome for this step of male-to-female gender affirmation.

Individuals who continue with bottom surgery typically report feeling an improvement in their overall mental health and self esteem, marked by a reduction in depression, anxiety and suicidality. Furthermore, patients also often report feeling more comfortable with their sex partners and in healthcare settings. While the physical implications of these changes are significant, we have seen amazing and inspiring changes to our patients’ confidence and outlook on their lives.

What to Expect from Bottom Surgery

Bottom surgery refers to the work done to change the patient’s lower body, which can include a variety of procedures, such as a vulvoplasty/minimal-depth vaginoplasty/zero-depth vaginoplasty, vaginoplasty, phallus-preserving vaginoplasty, or labiaplasty/vaginal revision. At ART Surgical, we offer vulvoplasties, which utilize penile tissues to create a functional adult vulva. We now have variations on this procedure to meet your goals and what you envision.

Penile Inversion

During penile inversion, the surgeon cuts the area between the rectum and the urethra, which forms a tunnel that becomes the neo-vagina. The surgeon lines the inside of the tunnel with skin from either the scrotum, the penis, or both. While vulvoplasties create a fully-functional adult vulva, there are plenty of patients who might not wish to undergo the creation of a vaginal canal. In some instances, this might be because the patient is uninterested in penetrative intercourse or would like to avoid the potential risk of complications involving the urinary tract or rectal canal.

Zero-Depth Vaginoplasty

Zero-depth vaginoplasty involves utilizing the tissues from the penis and scrotum to create a fully-functional adult vulva without creating a vaginal canal. This non-standard gender affirmation surgery enables a person to enjoy the physical appearance of their choosing without undergoing unwanted internal adjustments.

Minimal-Depth Vaginoplasty

Minimal-depth vaginoplasty is a very similar procedure in which a very shallow vaginal canal is constructed and can be more appropriate for some patients. During your consultation, we’ll help you decide which option might be best for you and your desired goals.

Overall, the surgical methods of vaginoplasty include sculpting a clitoris from the head of the penis. With this procedure, a vaginal vault is created between the urethra and the rectum; this is the same location as a cis woman’s pelvic floor. The vaginal lining comes from the patient’s penile skin. An orchiectomy is performed to create the labia majora, while a section from the glans penis is used to create the clitoris. Meanwhile, scrotal skin is employed to help construct the labia. This process retains the prostate to avoid urethral structure and preserve erogenous sensations.

Bottom Surgery Recovery Period

The ART Surgical team will assist you in determining which highly personalized set of procedures is right for you to deliver a seamless and satisfying outcome. Bottom surgical procedures are considered major surgery, and it will take some time for your body to heal afterward. The amount of recovery time you need depends on the type of surgery you had. All patients are unique, and it will generally take six weeks for most of the healing to occur. Nearly all patients return to their usual activities within three months.

We look forward to connecting with you to discuss your questions to make you feel at ease. If you have any questions about bottom surgery, don’t hesitate to contact us. Give us a call, click (415) 680-1120, or fill out the form below to schedule a consultation.

Please make sure to answer all the questions before submission
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Bottom Surgery FAQs

Q: What does bottom surgery refer to in male to female transition?

A: Bottom surgery is a broad term used to describe surgical procedures that alter the genitals to align with an individual’s gender identity. In the context of male to female transition, it typically refers to procedures such as vaginoplasty or orchiectomy (testicle removal).

Q: Are there any non-surgical options to achieve desired feminine genital appearance without undergoing vaginoplasty?

A: While vaginoplasty is the primary surgical option for achieving feminine genital appearance, there are non-surgical options available, such as hormone therapy, that can help in achieving desired changes in the genital area. However, these non-surgical options may have limitations.

Q: How much Is bottom surgery with insurance

A: The cost of bottom surgery with insurance can vary significantly depending on your insurance provider, policy coverage, and the specific procedures involved in the surgery. In general, you can expect total costs of $6,400 to $24,900 for FTM bottom surgery and around $25,000 for MTF bottom surgery. However, these are only estimates. It’s essential to contact your insurance company directly to understand the details of your coverage and the extent to which gender-affirming procedures, such as vaginoplasty, phalloplasty, or other related surgeries, are covered.