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Transmasculine Bottom Surgery

What is Transmasculine Bottom Surgery?

Transmasculine bottom surgery, formerly known as FTM bottom surgery, includes a combination of gender affirming procedures to transform the female genitalia into male genitalia. Transmasculine patients can choose to undergo a vaginectomy followed by a procedure to create a phallus through one of numerous techniques. Through a procedure known as phalloplasty, surgeons are able to create a penis using skin taken from other parts of the patient’s body.  Other procedures are available to create the crown of the penis as well as a scrotum for a fully masculine presenting lower body.

Crane Center surgeons are specialists in bottom surgery, with experience performing hundreds of successful procedures. Your surgeon will consult with you to determine the right combination of procedures to achieve your desired result.

Transmasculine Bottom Surgery Procedures

The Crane Center specializes in transmasculine bottom surgery procedures including multiple techniques for metoidioplasty and phalloplasty. Explore the list below and select any procedure to learn about the different options available.


This procedure creates an entirely new penis using donor skin taken from other parts of the patient’s body. Skin can be grafted from either the forearm (RFF Phalloplasty), the thigh area (ALT Phalloplasty) or the lower back.


Rather than creating a whole new penis, this procedure uses the patient’s existing clitoris to create a masculine presenting phallus. Metoidioplasty offers an excellent alternative to the more complex phalloplasty procedure.


This surgical procedure creates the look of a circumcised penis. A crown is added after phalloplasty for a more aesthetically typical phallus. In addition, the Crane Center has developed the procedure known as a Glans Implant to better maintain the coronal ridge over time.


This procedure, done in multiple stages, creates the look of a scrotum and testicles. The scrotum is created first, using nearby donor tissue, followed by the insertion of testicular implants once the patient has healed.


A gender affirming vaginectomy is a procedure that removes the vaginal canal and creates a flat perineum, usually performed in combination with either a phalloplasty or metoidioplasty procedure but also available as a stand-alone procedure for non-binary individuals.


A hysterectomy is the surgical removal of the uterus. Patients can choose to undergo the removal of both the uterus and ovaries prior to the phalloplasty or metoidioplasty procedures. This can aid in the success of these procedures and also reduce the future risk of uterine cancer.


Urethroplasty, or urethral lengthening, is a procedure performed with metoidioplasty or phalloplasty to extend the urethral tube the full length of the newly created phallus. This popular procedure makes it possible for transmasculine individuals to urinate while standing.

Penile Implant Placement

In this optional procedure, performed in conjunction with phalloplasty, a penile implant can be inserted into the newly created phallus to allow for transmasculine individuals to engage in penetrative intercourse.

We acknowledge that terminology regarding transgender identities is evolving. We are committed to staying informed and using accurate terminology and inclusive language as determined by the individual themself.

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