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They are two completely different techniques that provide different results in several ways and not in all patients the surgeon can practice one or the other technique. To perform a metoidioplasty, there must be a previous hypertrophy of the clitoris so that the length to be achieved is acceptable. In the case of not having hypertrophy or being a patient who wants a significant length of his penis, we should practice a phalloplasty.
Logically, there is a difference between both techniques, both in risks and in the results obtained.
Metoidioplasty has fewer risks since it is a single intervention and erogenous and tactile sensitivity is achieved.
n the case of phalloplasty there is a little more risk since it is a more complex and longer technique. By performing this technique, greater penile length and greater penetration capacity are achieved, but the sensitivity can be affected because although we rebuild the nerves, it is frequent that complete erogenous and tactile sensitivity is not achieved.
It is necessary for the surgeon to carry out a complete evaluation of the patient to determine the appropriate technique.
The fact that the patient can have sexual intercourse depends on several factors, mainly on the technique practiced. In the case of metoidioplasty, it depends a lot on the previous hypertrophy of the clitoris, if it is important, there are patients in a small percentage that get to have erections and even penetration capacity.
In the case of phalloplasty, the patient will be able to have sexual intercourse but a second intervention is necessary to place a prosthesis and achieve erectivity in the penis.
Yes. In the case of metoidioplasty, the sensitivity is not altered. In the case of phalloplasty, although the sensitivity may be in other different points of the anatomy of a CIS man's biological penis, there is both erogenous and tactile sensitivity to achieve orgasm.
When a trans person undergoes a masculinization mammoplasty, the goal is not to remove all the breast tissue, because removing it completely would leave only the skin attached to the muscle from the clavicle to the lower chest and from the armpit to the sternum, It would look like an oncological surgery showing a lousy morphological result.
Therefore we have to think that after a masculinization mammoplasty, there are remains of breast tissue. Based on the fact that a CIS man can have breast cancer in 1% of cases of this type of cancer, we must be aware that a trans man can also have it. It is not frequent, but whenever a nodule appears or any alteration in the operated breast, you should consult a professional.
Yes, the patient will probably have to continue with his usual hormonal treatment for life, even after having undergone genital reconstruction surgery, whatever the technique practiced.
The nature of a trans man's penis is different from that of a CIS man's biological penis, so there is no need for systematic monitoring with a urology specialist. It is necessary to go to this specialist if a urethral fistula occurs, in which case the patient must follow a joint treatment between the urologist and his surgeon.