Top Surgery

Top Surgery – What Is It?

The term “top surgery” refers to any surgical procedure that involves cutting or shaping the external genitalia (genitals) of one person and placing them into another person’s body. For example, a male with female genitals would have their own internal reproductive organs removed and then placed inside a woman’s body. A transgender individual may undergo top surgery to change their gender identity from male to female.

There are many different kinds of top surgeries. Some procedures involve removing part of the internal reproductive system such as ovaries, testicles, uterus, fallopian tubes and/or vas deferens. Other procedures involve altering the external genitalia such as vaginoplasty, labial reduction, clitoral hooding and penile inversion.

Some procedures require no physical changes at all; these include hysterectomies and mastectomies.

Some surgeons perform both types of top surgeries simultaneously while others only do one type of surgery first before performing the other type. There are also some surgeons who specialize in one kind of top surgery or none at all.

Some girls and women experience complications that require a second round of surgery. Others don’t have any problems at all. It’s important to know what to expect during the healing process and recovery time.

In addition, there are certain things that should be avoided following these procedures.

What Are the Different Types of Top Surgeries?

There are various types of top surgeries for male to female transgender patients. Each one requires different prep work, recovery time and can offer various results.

Reduction Groin (Vasovasostomy) – This surgery involves cutting away excess tissue from the genitals and stitching the skin back together to make new holes for the urine and genitalia. Most MTF patients choose this form of surgery because it preserves the nerves that are important for sexual sensation.

Penile Inversion (Sigmoid Colon Reinforcement) – One of the oldest and most common types of top surgeries, this procedure involves the removal of the testicles and most of the penile skin. The skin is then turned inside out and sewn to the vaginal cavity, providing internal organs with a new home. A prescription for hormones is required to add structure to the tissue and promote growth.

Vaginoplasty – A very complex procedure that is often the last resort for many MTF patients. The surgeon takes a skin graft of about eight inches of the patient’s colon and turns it inside out to create a vaginal canal. Hormones aren’t needed with this surgery since the skin used in the graft will shrink over time in response to lower levels of estrogen.

What Are the Different Types of Top Surgeries for Non-binary Patients?

There are several types of top surgeries for non-binary patients. Each procedure offers different results and healing times.

Hysterectomy (Complete or Partial) – One of the more common procedures, this surgery involves the removal of all or some of a person’s internal reproductive organs. A complete hysterectomy involves the removal of both ovaries and both Fallopian tubes. A partial hysterectomy involves removing only one ovary and one Fallopian tube.

Mastectomies (Both or One) – A mastectomy involves the removal of both of a patient’s cancerous or non-cancerous tissue. For FTMs, this can involve chest reconstruction as well.

Salpingo Oopherectomy – This form of surgery involves the removal of both ovaries and Fallopian tubes through small incisions in the stomach. The procedure can be done with a laparoscopy or a mini-laparotomy.

Thorough Knowledge is Powerful

As you can see, there are several types of top surgeries offered for MTF patients. You may not need to have any revisions or second surgeries after the initial procedure. However, it’s vital that you know your options before going into the procedure so you can make an educated decision about your own body.

Sources & references used in this article:

Plastic surgery classics: characteristics of 50 top-cited articles in four plastic surgery journals since 1946 by MPJ Loonen, JJ Hage, M Kon – Plastic and reconstructive surgery, 2008 – journals.lww.com

Top 10 reasons for endoscopic maxillary sinus surgery failure by WJ Richtsmeier – The Laryngoscope, 2001 – Wiley Online Library

The top 100 classic papers in lumbar spine surgery by J Steinberger, B Skovrlj, JM Caridi, SK Cho – Spine, 2015 – journals.lww.com