however you are,
you are equally
valid, justified, and beautiful
Our Gender-Affirming Surgeries
Reconstructive Surgical Arts offers a variety of gender-affirming bottom surgeries. Gender identity is independent of our genitals. For this reason, surgeries are listed in no particular order. If you click on the hyperlink for each surgery, you will find a brief video description. There is also an image gallery of our work that can be reached at the home screen.
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An orchiectomy involves removal of the testes. This is an outpatient procedure under anesthesia in which both gonads are removed from a small incision on the skin. This can be done at the same or separate time as a vaginoplasty. An orchiectomy does not create a barrier to a vaginoplasty in another setting.
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A scrotectomy is a scrotum removal surgery. This is generally performed in patients with natal male genitalia, along with an orchiectomy. Patients who elect to have this generally do not desire to pursue further bottom surgery. For those who do desire a future vaginoplasty, this procedure is not recommended. It removes skin that would generally be used at the time of a vaginoplasty in the future.
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Dr. McClung performs a penile inversion vaginoplasty, which is the most common type of vaginoplasty performed in the world. This procedure involves creating the vulva (external genitals), vaginal canal, clitoris, and labia using your existing genital tissue. The urethra is shortened and placed in a lower position below the clitoris. Permanent hair removal is required prior to a vaginoplasty
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The technical name for a zero depth vaginoplasty is a vulvaplasty. In this procedure, the vulva (external genitals) is made, but there is no canal. This means that no penetrative intercourse is possible. In general, individuals who select this procedure do so for one of the following reasons:
1. No desire for penetrative vaginal intercourse,
2. Desire to avoid dilations which are required with a full depth vaginoplasty, or
3. High medical risk for canal dissection (Crohn’s disease, rectal cancer, prostate cancer, etc).
The recovery process for the vulvaplasty is faster and the risk is lower. No hair removal is required for this procedure.
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As previously stated, genitals do not define our gender. Many groups of patients select this procedure, including women and gender non-conforming individuals. A penile sparing vaginoplasty maintains the penis but creates a vaginal canal. A PSV is slightly more of a bespoke procedure. Some patients will want to only have a canal created, and otherwise keep their natal genitals intact. Others will want to use the scrotum to create labia. Others will request a urine stream diverted to come out by the canal, instead of the tip of the phallus.
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Also known as meta surgery. A metoidioplasty involves the release of the hormonally enlarged clitoris to make a penis. The penis is small, and the average length varies between 4-6 cm. Other components of a meta include removal of the vagina (vaginectomy), urethral lengthening, and creation of a scrotum (scrotoplasty). In order to prevent infection and erosion of implants through the skin, testicular implants are generally placed 3-6 months later. A meta will generally allow the patient the option of standing to void, without the “commitment” of a phalloplasty.
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A simple release is only one component of a meta surgery, which is the release of a hormonally enlarged clitoris. The vaginal canal is left intact, and a scrotum is not made. This is an outpatient procedure with a rapid recovery time. We find different groups of patients select this procedure, including men and gender non-conforming individuals.
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A phalloplasty involves moving tissue from another location of the body to the genital region in order to create a larger sized penis, relative to what can be obtained with a meta surgery. Options for “donor site” are radial forearm, outside of the thigh (ALT), or the back (latissimus dorsi). In general, the radial forearm allows for better nerve connection (and hence sensation), blood supply, and appropriate girth relative to the other flaps. As with a meta, a vaginectomy, urethral lengthening and scrotoplasty are done at the same time. Glans shaping (glansplasty), testicular implant insertion, and penile implant insertion are generally done after the healing from the initial surgery. Penile implant insertion allows the penis to have erectile function and for patients to have penetrative intercourse.
Dr. McClung works closely with Dr. Santosh Kale to perform these gender-affirming surgeries.
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Gender nullification surgery involves removal of natal external genitals in order to create a smooth transition between the lower abdomen and the area between the leg. In other words, the patient is rendered free of external genitals. The urethra will often need to be modified to create this smooth appearance. If desired, a nullification can be done in a way to create a hidden focus for orgasmic function.
