Male to Female (MTF) Surgical FAQ and Checklist – Part 2

This is a male-to-female (MTF) surgical FAQ by Dr. Harold Reed. The piece is the second of a four-part series on the procedure.

See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 4

6. How long does it take to heal?

You can leave Bay Harbor Islands as a rule on your 7th post-operative day, and return to an office environment in about 1 to 2 weeks after that.

Please no penetrating sex for a good eight weeks following surgery or until delayed wound healing is complete.

Premature sex can be very traumatic and may open up incision lines and can incite inflammation and infection, so exercise all due caution and gentility.

7. Establishing a physician contact to follow you… 

In your home town is very important, although usually small problems can be sorted out with E-mail photos.  You should do this before you come to Miami and provide us their name and contact number before you have surgery.   Phone service to me is available virtually 24/7.

8. Do you require prior hair removal? 

Definitely yes. Please confer with us about the areas that need to be done. Essentially you will require complete removal of any hairs on the shaft, and a ring or path around the base of the penis 1 inch wide. If you wish to be pretty, then also have removed any hairs on the scrotum under the "shadow" of the penis down to and around the anal verge. This is optional. Removal of any other pubic hair is also purely optional.

Ideally electrolysis to include all above mentioned areas should be "first pass" completed 3 months before surgery. This allows enough time for a secondary pass 1 month later as some hair follicles may regenerate.

Laser hair removal is OK also. The skill of your licensed technician is more important than the method is used.

For those with blond or light hairs, please mention Meladyne, an FDA approved cream which is reputed to darken hairs. Regretfully the experience has been mixed, so confer with your technician.

Try to get your electrolysis completed a good month before surgery so your tissues have a chance to recover.

9. Also would like to know what your scheduling backlog is like?

Presuming you have fulfilled the WPATH criteria, we are available every month for the balance of this year.

10. How soon may I have penetrating sex?

Although you could have penetrating sex within 6 to 8 weeks following vaginoplasty, as you understand, a refinement labiaplasty will be offered about 3 months later.

Your rites of passage include the obligation to insert a vaginal stent or tutor 3 times a day for 20 minutes for 6 months. You'll be amazed how in most cases you can pick up an extra inch and a half of depth.  (See FAQ # 13). Safe sex is course an alternative way.

Douching is encouraged starting a week after your vaginoplasty.

11. Will I need a PAPS test and pelvic exams annually following my surgery?

Perhaps this question has been answered best by Dr. Anne Lawrence (see her full paper)

Essentially she concludes "cytology examinations (Pap smears) probably have limited value following vaginoplasty. MTF transsexuals should receive annual pelvic examinations following vaginoplasty, but there no evidence to suggest that they would benefit from vaginal cytological screening in most cases. However, if the glans penis has been retained as a neo-cervix, cytological examination of the neo-cervix is a reasonable practice."

12. Will I be able to feel the pleasure of intercourse as a woman does when I have had the operation?

Yes, if there has been a careful preservation of the neurovascular bundle and creation of a clitoris from glanular tissue, orgasm will most likely continue. We are very fussy about this aspect of surgery. Appearance, function, and pleasure are all interrelated.

13. Is there some way that my vagina can always be moist like 100% ...all day long?

Yes, this may be accomplished by inversion of a urethral strip as a part of the vaginal vault or extension of an opened urethra to the base of the clitoris. This provides a natural way to achieve moisture as well as lubrication during sex. Please see "photographic examples" on our web-site.   Patients who simply have penile skin inversion fare quite well also, and we are starting to re-think whether the extra time and somewhat enhanced potential for complications makes urethral strip inclusion really worthwhile.

14. Do you also provide a surgery in which I will obtain breasts? 

Yes, our all inclusive fee is $5,000 for saline implants.
Silicones are $6000. Please see our photographic examples on our web-site.

While some doctors do both procedures at the same time, I think that may be a little too adventuresome and would caution you to stage that either as an independent procedure or reserve breast augmentation for the time of your labiaplasty.  As you know, estrogen therapy will feminize your breasts.

For some MTF patients, that end point is a good resting place.
It has been recommended that you be on hormone therapy for at least 24 months before insertion of breast implants.

We use the Tebbetts' formula to determine the appropriate size. That is large breast prostheses can only be put in if there is enough home grown breast tissue to cover.  Also please keep in mind, very large breasts, natural or prosthetic, are prone to droop in 6 years or so, and you'll be back on the table for a lift.  These incision lines as contrasted with a small initial incision are not all that pretty.

15. Do you perform tracheal shaves?

Tracheal shave surgery is performed by others.

16. Can you make a man have sex organs that can reproduce offspring and go through a period every month?

Perhaps in the future.

Uterine transplants have been done in New York Downtown Hospital on natal women and in Gothenburg, Sweden
Tap in to research this subject or view

When or how soon this exciting, new technology will be applied to transsexual patients is uncertain.

This is a male-to-female (MTF) surgical FAQ by Dr. Harold Reed. The piece is the second of a four-part series on the procedure.

See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 1
See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 3
See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 4


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