Masculinizing surgery, also called FTM surgery, offers two methods for creating a penis: one is phalloplasty, and another is metoidioplasty, often referred to as phallo and meta. While both of these procedures create a penis, the difference between phalloplasty vs metoidioplasty varies in sensitivity, aesthetics and function. A metoidioplasty is considered the procedure that releases natal erectile tissues, sometimes also known as the clitoris, from the surrounding ligaments to appear more prominent as a penis. A phalloplasty procedure creates a penis larger than with the metoidioplasty from the flap of skin from the thigh or forearm. Both procedures have different aspects that can be personalised, such as whether they include urethral lengthening and vaginectomy to facilitate urination while standing. We will get to know the differences for a better understanding of which procedure best fits the goals.
Needs and goals: motives for choosing different types of surgery
- Nonbinary and transmasculine individuals can sometimes feel a sense of incongruence with natal genitalia, this is referred to as bottom dysphoria. Some patients express that these feelings are distressing in moments while using the bathroom or during intimacy.
- When it comes to which procedure is best for you, the patients are encouraged by specialists to think about what brings them gender dysphoria and what changes would bring them gender euphoria.
Procedure details about metoidioplasty
- This procedure involves the release of erectile tissue from the surrounding ligaments. An incision is made at the base of the glans, and the surrounding skin is pulled back. The labia minora can be removed completely. A simple procedure ends at this stage, giving a forward and prominent position to the penis on the body.
- A procedure with primary urethral lengthening will extend the urethra so it ends at the penile shaft. This allows the patients to urinate while standing.
- The recovery process is shorter than phalloplasty. This procedure cannot create penile length and girth; some patients are satisfied with this, but some patients desire more. Having metoidioplasty does not include the possibility of getting phalloplasty in future.
- Due to BMI requirements, patients who want phalloplasty will begin with metoidioplasty at the initial stage of gender surgery while working on reducing weight.
Procedure details: phalloplasty
This is a multistage procedure; the stages depend on the goals and type of phalloplasty chosen to undergo. At the start, the penis is constructed using a skin flap from the thigh or forearm. These procedures are known as radial forearm free flap and anterolateral thigh flap. Patients who choose phalloplasty can undergo the additional procedures either during the initial stage of surgery or in the last stage.
Choosing between both of the procedures
When considering phalloplasty vs metoidioplasty, various factors come into play, and the factors include:
- Urinate standing up
- Sensitivity
- Penis length
- BMI limitation
- Scar visibility
- Smoking history
- Insurance and costs
Recovery from both procedures
From bottom surgery, recovery can be challenging. For most patients, a key factor in choosing between phalloplasty and metoidioplasty is the intensity of the recovery process and the number of surgeries performed to achieve the desired goal. The following factors are considered for recovery while making the decision of which procedure is appropriate:
- Physical and emotional impact
- Engaging in sexual activity
- Cost and insurance coverage
FAQ’S
What is the difference between phalloplasty and metoidioplasty?
The key difference between both the procedures is that metoidioplasty releases natal erectile tissue from the surrounding ligaments and in phalloplasty a large penis is constructed as compared to metoidioplasty.
How do the appearance and size compare?
Thebpenis constructed in phalloplasty ranges from 4 to 8 inches, and in metoidioplasty it ranges from 1 to 3 inches.
After surgery, are patients able to pee in a standing position?
Yes, after both surgeries, patients are able to pee in a standing position.
How does sexual sensation work?
Sensory nerves are preserved by metoidioplasty, and during phalloplasty, sensation is developed; the neophallus develops and grows with time, depending on the nerves grafted.
How many stages are involved in both surgical procedures?
Stages involved in metoidioplasty are single, but in phalloplasty, multiple stages are involved.
Which procedure is better?
The choice depends on the personal goals regarding ability to penetrate, size, desire to avoid scars, risk tolerance and surgical complexity.
