+66 (0) 2 715 0111
consult@pai.co.th
Metoidioplasty
Understanding Trans Men and Gender-Affirming Surgery
A trans man is someone who was assigned female at birth but has a male gender identity. Many trans men choose to undergo gender-affirming surgery to align their physical bodies with their identified gender. One important step in this process can be metoidioplasty, a type of female-to-male (FtM) bottom surgery.
Before metoidioplasty, patients usually need to:
Metoidioplasty often involves creating a neophallus from the hormonally enlarged clitoris, enabling standing urination and preserving sexual sensation. This surgery is commonly performed alongside a vaginectomy (closure of the vaginal canal), although the closure is sometimes optional depending on patient preference.
Overview of Female-to-Male (FtM) Gender-Affirming Surgeries
FtM surgeries generally involve four main procedures:
Most trans men who opt for metoidioplasty also undergo a vaginectomy to close the vaginal canal at the same time.
What is Metoidioplasty?
Metoidioplasty is a female-to-male bottom surgery where the hormonally enlarged clitoris is surgically transformed into a small penis (neophallus). This procedure allows for:
How Metoidioplasty Works: Procedure Overview and Surgical Options
Metoidioplasty, sometimes referred to as a “clitoral release” or “clitoral free-up”, involves surgically freeing the hormonally enlarged clitoris from surrounding tissues to create a small neophallus. This is done by cutting the ligament that holds the clitoris in place under the pubic bone, and removing or modifying nearby tissue. The result is a penis-like structure that allows for standing urination and preserves sexual sensation.
Additional Procedures with Metoidioplasty
Metoidioplasty can be performed alongside other procedures, often during the same surgical session, including:
- Vaginectomy (removal or closure of the vaginal canal)
- Hysterectomy and oophorectomy (removal of the uterus and ovaries)
- Top surgery (bilateral mastectomy to create a masculine chest)
This combined approach may reduce the need for multiple hospital visits and anesthesia sessions, depending on the patient’s health and goals.
Testicular Implants: Why They’re Often Delayed
Testicular implants (also called ball implants) are usually recommended in a separate surgery, often around 10 months after metoidioplasty. This delay allows time for:
- Skin tissue to expand and become more elastic, improving results
- Reduction of post-surgical infection risk
- Proper healing of the genital region
Placing implants too early can lead to complications, so patience is key for optimal long-term results.
Managing Expectations: What Metoidioplasty Can and Cannot Do
It’s important that patients are realistic about what metoidioplasty and related reconstructive procedures can achieve. While the surgery creates a small phallus with preserved sensation and the ability to urinate standing, it does not produce the same size or function as a cisgender male penis.
Leading surgeons like Assoc. Prof. Preecha Tiewtranon, MD, Dr. Burin Wangjiraniran, and Dr. Sutin Khounsongserm — experts in cosmetic and reconstructive surgery — emphasize the importance of open and honest communication. Thorough consultations with board-certified professionals help ensure that goals, risks, and results are clearly understood.
Future Options: Phalloplasty After Metoidioplasty
If a patient later decides they want a longer phallus, they can pursue phalloplasty — often using abdominal skin grafts. This staged approach, beginning with metoidioplasty, gives patients more control over their transition timeline and outcomes.
Read more trans man procedures and more cosmetic procedures at Preecha Aesthetic Institute.
Best Candidates for Metoidioplasty at PAI (Preecha Aesthetic Institute)
At PAI (Preecha Aesthetic Institute), we follow internationally recognized clinical standards such as the WPATH Standards of Care, HBIGDA, and Asia PATH guidelines to ensure safe, ethical, and affirming care for all patients seeking gender-affirming surgery.
These guidelines help assess eligibility for metoidioplasty based on mental health, physical readiness, and long-term well-being — with the ultimate goal of achieving lasting personal comfort with the gendered self, and maximizing psychological health and self-fulfillment.
Package is included with Metoidioplasty :
Preecha Aesthetic Institute (PAI) is the first multidisciplinary Aesthetic and Reconstructive center also best well known the pioneer in Sex Reassignment Surgery (Male to Female and Female to Male) Thailand since 1980. The center has the most advanced 10 consultation rooms, 6 operation rooms (local anesthesia), equipment to any leading Aesthetic Plastic Surgery completed with recovery rooms and the internationally accepted standard of hygienic system.
All cases under general anesthesia, PAI's using two major private International Standard Hospitals affiliated - JCI accredited, for healthcare promoting center located in Bangkok under the philosophy of "World class quality with Thai hospitality", private patient rooms, 230 beds, modern medical technology, equipment and hospital receiving accreditation for high-quality.
Preecha Aesthetic Institute
Affiliated Hospital
Affiliated Hospital
Dr.Preecha Tiewtranon MD, Dr.Burin Wangjiraniran MD FRCST and Dr.Sutin Khobunsongserm MD (Board of Plastic & Reconstructive Surgery, Thailand).
Your questions will be direct answers from PAI's doctors.
All surgery carries risks but can minimize by closely following your surgeon’s advice on follow up care during the healing process. It is important that you are realistic about what cosmetic surgery, reconstructive surgery and treatments can and cannot do. Possibility risks are included rare wound complications, urethral strictures and urethral fistulas. Your doctor is in the best position to address these issues and for that reason frank and open dialogue is recommended to avoid any misunderstanding.
After 12 months metoidioplasty.
Metoidioplasty. While stand up to urinate at a toilet.
Metoidioplasty. After one year.
Metoidioplasty + Closed Vagina. After 12 days and After one year.
1. Write your question, interest at consult us in program form
2. Via email consult@pai.co.th
2.1 list your expectations or procedure that you are interest and give us your detail as possible
2.2 email to us
2.3 We will get back to you shortly after receive your question with recommendation from specialize surgeon
Once you know your planning date for surgery. Here is the next step:
1. Consultation with us via email for details and procedure
2. Plan your available date to be surgery and departure from Bangkok
3. We will confirm you for surgery date
4. You may start to book your airline ticket
5. We will confirm you all detail and hotel booking, if require
6. For transportation to be pick up from the airport, we can do for you as optional
During direct consultation with our surgeon – the surgeon will evaluate your general health status and any pre - existing health conditions or risk factors such as examine and take measurements, take photographs, discuss your options and recommend a course of treatment and discuss likely outcomes of Metoidioplasty and any risks or potential complications
Preparation to Metoidioplasty (a small penis)
Package is include with Metoidioplasty
Metoidioplasty Surgical Dates
Day 0 - Arrival date (check in hotel)
Day 1 - Consultation and Prepare for Laboratory Testing
Day 2 - Medical Health checks
Day 3 to Day 5 - Check out hotel. Surgery date (2 nights in hospital) and 3 days in hospital private room after surgery
Day 5 - Discharge from Hospital
Day 5 to 17 – Stay in hotel for recovery period and follow up on doctor appointments
Day 7-10 – Stitches removal
Day 17 - Final checkup and prepare for letter fit to fly and issue for a new letter with gender name change
Day 17 - Safe to fly
Things should bring from home.
Metoidioplasty - The procedure is perform by cutting the ligament that holds the clitoris in place under the pubic bone, as well as cutting away some of the surrounding tissue, the surgeon is able to create a small phallus from the elongated clitoris.
This is why metoidioplasty is sometimes referred to as a "clitoral free-up" or "clitoris release" (the clitoris is freed from some of its surrounding tissue and brought forward on the body) in a manner that makes it appear like a small penis.
In order to further enhance the result, fat deposit from those areas may be remove from the pubic mound and skin and pull upward to bring the phallus even farther forward. Metoidioplasty surgery is involving a urethral lengthening procedure to allow the patient to urinate through the penis while standing.
Under General Anesthesia : 3 - 4 hours
Post operative recovery :
Recovery from metoidioplasty (Female to Male surgery) may be differently from everyone. But most commonly are
Surgery Schedule (required at least seventeen days in Bangkok for Metoidioplasty)
Day 0 - Arrival date (check in hotel)
Day 1 - Consultation and Prepare for Laboratory Testing
Day 2 - Medical Health checks
Day 3 to Day 5 - Check out hotel. Surgery (2 nights in hospital) 3 days in hospital private room after surgery
Day 5 - Discharge from Hospital
Day 5 to 17 - Stay in hotel for recovery period and follow up on doctor appointments
Day 7 to Day 10 - Stitches removal
Day 17 - Final checkup and prepare for letter fit to fly and issue for a new letter with gender name change
Day 17 - Safe to fly
Recovery Timeline Metoidioplasty
Recovery times for Metoidioplasty surgery may take from 4 to 8 weeks. The patient won't be able to do any strenuous activity or lift heavy objects for at least a four weeks after surgery. Any activities should wait until the surgery site has fully healed before having sexual intercourse. Fully healing can take up to 8 -12 months.
For local’s patient - You may resume to work after ten to fourteen days surgery but must avoid heavy lifting object over the head or fast movement during four to six weeks after surgery date. Stitches are remove seven days to ten days after surgery date.
For international patient - Plan to be in Bangkok at least seventeen days all together. Stitches will remove seven to ten days after surgery date. You may resume to work two weeks but must avoid heavy lifting object over the head or fast movement during four to six weeks after surgery date.
◊ Any bruising and swelling will usually dissipate within 3 to 8 months after metoidioplasty FtM surgery.
3 - 4 Hours
General Anesthesia
21 days
6 weeks
8 - 12 months
1 - 2 month (s)
is called Bottom surgery in a manner that makes it appear like a small penis.
Schedule Appointment Consultation / Surgery / Question Metoidioplasty Female to Male at Preecha Aesthetic Institute.
Once you know your planning date for surgery
Trip's planning :
PAI (Preecha Aesthetic Institute)
898/1 Sukumvit 55 Wattana, Bangkok
10110 Thailand
Tel: +662-715-0111
Fax: +662-715-0113
Email: consult@pai.co.th
The driver will be waiting for you at door number 4 (Meeting point) after exit from customs. The driver will stand by with your name and PAI logo. [Suvarnabhumi International Airport (BKK)]
Hotels are under cooperate and nearby PAI, starting from 50 USD to 100 USD. Rates are quoted in THB, USD/net/included of taxes and service charges. All non-commissionable rate. VISA/Master card is accepted.
Thai, Chinese, Japanese, Italian, Spanish, French, German, Turkish and other languages upon request.
PAI can issue the letter to clarify with your local Embassy or Passport.
Cost of living meal per day is 15-20 USD.
The payment can be prepared in Cash by US dollar, Euro, Japanese Yen, Hong Kong Dollar, Singapore Dollar, Australia dollar. If using credit cards (VISA/Master card), the hospital will charged 3% for international transaction fee. This is only for surgery fees. Hotels are not charged for international transaction fee. An extra charged for HIV is 50% from total cost.
Australia, Austria, Belgium ,Brazil ,Bahrain , Brunei Darussalam ,Canada, Denmark ,Finland ,France, Germany ,Greece ,Hong Kong ,Iceland ,Indonesia ,Ireland ,Israel ,Italy ,Japan ,South Korea ,Kuwait ,Luxembourg , Malaysia ,Monaco ,Netherlands ,New Zealand ,Norway ,Oman ,Peru ,Philippines ,Portugal , Qatar , Singapore ,Spain ,South Africa ,Sweden ,Switzerland ,Turkey ,United Arab Emirates, United Kingdom ,United States of America ,Vietnam.
Please present the supporting documents confirming the scheduled operation upon request. Please do not carry any unnecessary drugs or dangerous objects in your luggage.
A: For FtM surgery, you should take testosterone or contact therapy in your country at least one year with written proof of therapist or psychiatrist letter. There is still two more request by THAI's psychiatrist, which will refer to hospital while direct consultation.
A: Base on your general information, you are looking good and a good candidate for metoidioplasty. However, please also fill out your medical form or contact us via email for more information.
A: No. The reason is you should do hysterectomy removal before metoidioplasty or together with metoidioplasty, if also consider closed vagina.
A: Metoidioplasty must be with closed vagina. If no closed vagina, there are many chance of infections / complications such as metoid leakage, urethral leakage and etc.
A: You can consider metoidioplasty without vaginectomy, if you have already removed hysterectomy and ovaries. But most importantly must be in good health conditions.
A: Yes. Hysterectomy + Ovary Removal, Metoidioplasty and close vagina can be perform at the same trip. But require longer recovery periods in Bangkok Thailand. If all will be perform at the same trip. You must be in Bangkok at least 3-4 weeks all together. However, if you don't want to stay long in Bangkok. You may first consider hysterectomy + ovary removal to perform in your country and then wait at least 3 months to come to Preecha Aesthetic (PAI) for metoidioplasty + closed vagina. If just metoidioplasty + closed vagina, you may plan to be in Bangkok for 2 weeks all together.
A: Yes. We are all communicate in English comfortably.
A: On average Metoidioplasty (FtM surgery) recovery time at least two weeks before able resume daily activities and work (desk job). If heavy lifting or standing or walking all times, these may recommend to wait at least three to four weeks after surgery date.
A: You must be with us at least 17 days all together included before & after surgery. You must stay in Bangkok at least 14 days as minimum requirement after surgery date.
A: Metoidioplasty is performed in one stage. Exclude testicle implant must be wait at least 8 months.
A: Yes.
A: Yes. We do accept referral letters from a registered therapist. However, under Thai medical law (GID regulations), the referral must still be confirmed by two Thai psychiatrists in Thailand. Our clinic will organize these psychiatric evaluations at the hospital for you, making the process as smooth as possible.
Write your question, interest at consult us in program form
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