Female to male operation (FTM SRS)
CRITERIA FOR ELIGIBILITY FOR SRS
If you consider having a surgical procedure for gender reassignment, you must meet the following criteria.
To be eligible for G.R.S., one must, first of all, answer to the criteria of the « Standards of Care of the Harry Benjamin International Gender Dysphoria Associations, Inc. ».
That is :
« Hormonal sex reassignment recommended by a clinical behavioral scientist.
Two letters are required for surgery :
A . Two separate letters of recommendation from mental health professionals who work alone without colleagues experienced with gender identity disorders are required for surgery and :
1. If the first letter is from a person with a master’s degree, the second letter should be from a psychiatrist or a clinical psychologist. Those who can be expected to adequately evaluate co-morbid psychiatric conditions.
2. If the first letter is from the patient’s psychotherapist, the second letter should be from a person who has only played an evaluative role for the patient. Each letter writer, however, is expected to cover the same seven elements.
B. One letter with two signatures is acceptable if the mental health professionals conduct their tasks and periodically report on these processes to a team of other mental health professionnals and nonpsychiatric physicians.
The patient has the responsibility to see that the behavioral scientists have the necessary qualifications mentioned above and that they are clearly stated in the recommendation. Also most important is the fact that one of these recommendations has been made by a scientist who has followed the patient for at least six months.
CHEST MASCULINIZATION
Subcutaneous mastectomy is the reduction of breast volume to a male appearing chest. It is performed under general anesthesia through a semicircular U shape incision located at the junction of normal skin and areolar skin. The incision leaves minimal scarring.
Liposuccion can be used to help during the procedure if necessary, but alone it can never remove enough breast tissue to achieve an optimal result. Surgery lasts 90 to 120 minutes.
1. Before and after subcutaneous mastectomy.
Subcutaneous mastectomy never needs to be done through long transverse and conventional mastectomy or mastopexy incisions. Even if there is significant skin laxity or excess, we still use a minimal incision (u-shape) at the junction of the areola with the skin. After surgery, natural skin retraction occurs and can correct the residual skin laxity. If it persists after 9 to 12 months, we prefer to correct the remaining problem under local anesthesia. This way you will get the least scarring, most probably a circular scar around the areola or a keyhole type of scar.
2. Scar location on the chest after subcutaneous mastectomy without (a) and with (b-c) skin laxity removal.
To improve a subcutaneous mastectomy result you should know that upper body training before and after surgery are highly suggested and also the fact that excess weight should be kept to a minimum.
CLITORIS RELEASE
Clitoris release is a procedure that will masculinize the external genitals by the release of the clitoris attachments (ventral choudae). This makes the glans of the clitoris move forward. Testicular implants can be put inside the labia majoras. It will not allow intercourse nor urination standing because the urethra opening is left untouched . The vaginal cavity is left intact. This procedure can be done under local anesthesia at the office and lasts 2 hours.
METAIDOIOPLASTY
Testosterone (male hormone) stimulation of your external genitals may have produced a pleasing change and you want to enhance this male transformation . Metaidoioplasty achieves this goal and also allows : urination while standing, preservation of sensation to the enlarged clitoris, removal of the vaginal cavity and creation of a scrotal sac. It will not allow intercourse. It crate a small penis. It is done under general anesthesia and lasts 3 to 4 hours.
The principles of the technique are based on embryology : every female genital structure has its male counterpart and the metaidoioplasty uses local tissue to transform the female structure into it’s corresponding male part. The technique releases your actual clitoris to get it longer, uses the labia minora to form the urethra inside the penis, moves your labia majora to form the scrotum. Part of the vaginal mucosa is used as a flap to construct the urethra and the rest is discarded and the cavity definitely closed.
Testicular implants are put inside the scrotal sac after six months under local anesthesia. It is an in-office procedure and is not done during the metaidoioplasty because of a high risk of extrusion. Only when the metaidoioplasty is well healed are the implants put inside.
MASCULINIZATION COSMETIC PROCEDURES
Masculinization cosmetic procedures are not frequently necessary in the Female to Male patient because of all the obvious secondary sexual characteristics that testosterone create.
However in the hope of improving muscle definition, calf and pectoral implants can be chosen. The silicone implants are put through an axilla (armpit) incision under the muscle for pectoral augmentation. For calf augmentation, usually one implant per leg is put through a behind-the-knee incision above the exesting calf muscle. Other cosmetic procedures apply very well to the Female to Male patient and should be considered with caution and based on an individual need and surgical indication.
PHALLOPLASTY
A phalloplasty is the construction of male external genitalia (phallus). Locoregional flaps from the groin and abdomen have been used for many years and are the predecessors of the state-of-the-art free flap phalloplasty. They allow only phallic volume and lenght. Sensation is not possible and it is a lenghty process (multi-stage). We do not perform these flaps because they offer less than optimal result and in our opinion, do not fulfill the basic goals and needs of Gender Reassignment Surgery. You will be best served by a free forearm flap phalloplasty if you seek the following objectives: genitalia that allows one to urinate while standing, a phallus with erogenous and protective sensation that grants intercourse and pleasing aesthetics.
Functional male sexual organs are constructed in a two or three-stage procedure.
FIRST STAGE
The first stage is a five to six hour procedure done by two surgical teams.
Free flap phalloplasty
1. Forearm skin is elevated.
2. Construction of the penis around a catheter.
Your non-dominant forearm skin, along with its sensory nerves, veins and arteries, is taken to construct the urethra, glans and penis shaft. The vaginal cavity is obstructed, the labia majora are used to construct the scrotum. The nerves responsible for clitoris sensation are preserved and after being connected, they will grow gradually into your new penis. Yet, we have not seen one patient who lost his capacity of orgasms after a phalloplasty.
3. Penis is connected in its proper location.
SEEKING IMPROVEMENT AFTER F TO M PROCEDURES
You had an F to M procedure and may be unsatisfied of the results. Cosmetic and functional problems related to female to male procedures can be corrected.
For example a lack of definitions of structures on the constructed genitalia is sometimes present. Diverse modifications care be made under local or general anesthesia. Usually patients send us a list of the problems they want to get rid of along with pictures. Then a discussion with the surgeon can be fruitful in making recommendations.
Attachment of the penis is done by connecting the two urethras, clitoris nerves to the new penis nerves and the artery and veins to the groin area. Your stay at the hospital will last 5 days, after which you will spend two more weeks at the house of convalescence.
SECOND AND THIRD STAGE
When protective sensation of the penis has recovered, approximately 9 months after the first stage, testicular implants and implants to obtain rigidity (erection) on demand are inserted.
The MENTOR ALPHA II IMPLANT is modified to fit your neophallus. It is activated with a remote pump valve mechanism in the groin area. This second stage is done under general anesthesia and lasts 75 minutes. Testicular implants are put inside under local anesthesia and this is done at the office.
November 12th, 2009 at 2:51 pm
I am interested in Hysterectomy and Metioplasty (clitoris release)and Scotoplasty. I am 24 years old and have lived as a full male since 2004. I want to know what your cost is for these surgeries.
January 14th, 2010 at 2:31 pm
Hello,
My fiancé was born female and is Transgendered. He does not feel the need for the entire procedure, was wondering if you could only perform the Subcutaneous mastectomy on him. If so what would be the price range, and would the same it need the same requirements (the two doctor’s notes, etc.)
Thank you very much for your time,
Melody
April 11th, 2010 at 9:20 am
How much is the sugery,and how often would u be able to have intercourse.
June 10th, 2010 at 3:34 pm
my message is i need help with who i am .i all ways
want to be a man,my first question is can this surgery
be coverd by my insurance? ican not to pay my next bill please help me. my cell is 760 500-0292
i try every thing but i keep run in to dead end
if you are in las veags i will drive there to see the doctor. thank you i be waiting for your reply
June 24th, 2010 at 3:10 am
HI
I have had a hysterectomy/mastectomy 13 to 14 years a go
I all so have been on hormones for that long i am 59
and would like to have the rest done so that i can feel
hole. I would like the full cost of the fest and how long i would have to stay to get it all done.
Pleas get back to me i relly wont this done
Thank you shaun Mair
December 30th, 2010 at 8:42 pm
ive been wanting to get this transition done for a long time, but im not the smartest person when it comes to finding out information on it. im also lacking in the financial department and am curious if they have financial plans for the not so wealthy people? can you tell me more about the phalloplasty?
January 4th, 2011 at 3:21 pm
bonjour,
Je suis transsexuel FTM, hormoné depuis 16 mois suivi par un psychiatre et un endocrinologue (en équipe non officielle). Suis en ald, et je pense savoir qu’il ya moyen de faire la phalloplastie avec le dr Brassard.
Comment ça se passe, je vis en France sur Paris.
January 20th, 2011 at 10:26 am
Hello and ty for your time. I was born female but totaly born in the wrong body. I am looking to do total top surgery as i havent found very many total bottom surgeries giving the effects desired. My question is do you do Sculpting of the upper body after the removal of the breast. I dont want the flat sunken look and am trying to find a Dr that does sculpting as a more muscular yet not hulk look. Just something on with a muscle look and also the small six pack look. Is this possible for you to do? If so i would like to find out the cost and how long the procedure takes. What you would need from me as i am taking harmones now and seeing a pshy. also. I have lived the majority of my life as a man and am so ready to have my body, mind and soul be one. Thank you for any help you can give me and i look forward to having you do this procdure if possible. Again ty.
February 24th, 2011 at 3:08 pm
please visit our website http://www.grsmontreal.com
February 24th, 2011 at 3:09 pm
svp contacter suzanne 514-288-2097
March 28th, 2011 at 3:53 pm
hi.i am girl.26 old.so i want remove my chest.u can tell me about opration.who many charges.and who many takes days.and it is possible in u.k.?
April 4th, 2011 at 3:19 pm
Yes we do mastectomy operation, for info about prices.. please contact info@grsmontreal.com
April 4th, 2011 at 3:22 pm
Svp contactez Suzanne au : info@grsmontreal.com
April 4th, 2011 at 3:23 pm
You should definitely contact the WPATH .. http://www.wpath.org , they can help you in many ways
thanks
April 4th, 2011 at 3:28 pm
Hello
you need to verify with your insurance for that matter
We are located in Montreal Canada
thanks for your inquiry
April 14th, 2011 at 9:55 am
HI
I would like more information on full cost of the
(PHALLOPLASTY)Free Forearm Flap with this Procedure
well allow me to Urination while standing and well
have Sensation so as i can have intercourse. and
The full cost of this Surgery in US Dollars.I am
ready to have this done if you would kindly get
Back to me as soon as you can Thank You So Much
Shaun Mair
May 4th, 2011 at 7:46 pm
Do you serve patients from the US? What is the cost for double mastectomy and also hysterectomy and phalloplasty?
May 14th, 2011 at 10:26 am
Its the same account with celebreties always getting too much plastic surgery, I would like they could go for a more natural look.
September 8th, 2011 at 5:43 pm
I moved from Vancouver. I need to know what are the chances to get chest surgery ( removal of breasts) How much will it cost? How soon can this be done? I meet all the requirements and then some. Please help me with some answers. Thanks so much Alexander
0
September 18th, 2011 at 6:03 pm
please contact our office for prices
thanks
5142882097
September 28th, 2011 at 12:43 pm
I live in Ontario and was wondering if there is a place that I can get this done in Ontario, my other question is what is the cost, I am very set on getting this surgery done will anyone else know about this surgery??Could you please let me know all the details a quickly as you can. Thank you for your time.
September 29th, 2011 at 12:35 pm
I am looking to become a male as I was born in the wrong body at the moment I am a female do you have information on this operation, my voice is deep and I was also wondering if any doctor in Ontario can do this surgery?? Cause I want to become a male thank you for your time
October 2nd, 2011 at 8:05 am
What is the total price of this whole surgery? what is the approximate percentage of success? how long does it need in total? thank you
October 3rd, 2011 at 1:28 pm
Hi I was born female and feel like I’m in the wrong body since 2000 and I want to know how much will the surgery cost and where can I go to get it and also can my insurance cost the price…Thank
October 13th, 2011 at 2:55 pm
hi i need to find out if any insurances pay for my sex change surgery can you please help me some im a transgender im a female and i want to be a male my insides is a male my outsides is a women
October 23rd, 2011 at 7:57 am
There is different operation… but unfortunately .. no one in Ontario does the surgery… you are welcome to come and see us in montreal
November 21st, 2011 at 5:39 am
hi I live in scotland united kingdom I have been transitioning for 3 years on hormones for 2 and a half years post top surgery 14mnths an interested in having a simple release how do I go about or can I have the procedure done in your country scotland can only offer me phallo which I do not want can you help?
November 25th, 2011 at 2:24 pm
yes .. we can help you
please call our office for more details about the surgery or email
info@grsmontreal.com
November 26th, 2011 at 3:33 pm
Hi,I do not know how to go about before I can have a sex change from female to male and I live in Vancouver.
I had my breast removed 15yrs back in Malaysia and I had to go through 2 psychiatrist before the doctor do it.
I looked exactly like a male and I am married to my wife.
I would like how to go about and how much it will cost.
Thank you.
December 4th, 2011 at 9:20 am
Hi !
it can be paid by the province of BC… please contact Suzanne our secretary for more information info@grsmontreal.com
thanks