Metoidioplasty offers natural erectile capabilities and more sensation, but much smaller size; in contrast, phalloplasty offers larger size and more functionality for intercourse, but the penis cannot become erect on its own and is not as sensitive. Genital reconstruction Genital reconstructive surgeries GRS use either the clitoris, which is enlarged by androgenic hormones Metoidioplasty , or rely on free tissue grafts from the arm, the thigh or belly and an erectile prostheses Phalloplasty. In addition, there is less denervation damage to the nerves supplying the skin of the chest wall with a peri-areolar mastectomy, and less time is required for sensation to return. The goal of the SCM in a FTM transsexual patient is to create an aesthetically pleasing male chest, which includes removal of breast tissue and excess skin, reduction and proper positioning of the nipple and areola, obliteration of the inframammary fold, and minimization of chest-wall scars. In addition to the difference in penis size, one other way that metoidioplasty and phalloplasty differ is that metoidioplasty retains more of the original nerve pathways, which may yield greater potential for orgasm post-surgery. That's one reason why fewer women choose to have surgery on their genitals, Bowers said. While the rates of endometrial and cervical cancer are overall higher than ovarian cancer, and these malignancies occur in younger people, it is still highly unlikely that this question will ever be definitively answered. Fred Ettner, a physician in Evanston, Ill. If desired, the urethra can be lengthened and routed through the newly formed penis. While the rates of endometrial and cervical cancer are overall higher than ovarian cancer, and these malignancies occur in younger people, it is still highly unlikely that this question will ever be definitively answered. Under the standards of care adopted by the World Professional Association for Transgender Health WPATH , the first step usually is meeting with a mental health professional for a diagnosis and psychotherapy. By some doctors, the surgery is done in two steps, first the contents of the breast are removed through either a cut inside the areola or around it, and then let the skin retract for about a year, where in a second surgery the excess skin is removed. Bowers said that only two of the 1, people she has operated on have wanted to go back to their old bodies. How many people have sex reassignment surgery? Archives of Sexual Behavior, 22, For female to male sex reassignment surgery, there are different types of surgery that can be performed, depending on the patient's expectation.