Ultra Aesthetics

Ravinder Jarial, D.O.

MTF Bottom Surgery

MTF Bottom Surgery West Palm Beach

Bottom surgery – otherwise known as gender reassignment surgery or sex confirmation surgery – is, for many patients, the last step in their transition. The physical appearance and function of the genitals is surgically altered to align with the patient’s gender identity – the reasons for which don’t require much introduction.

Bottom surgery is broadly split into two categories: male-to-female and female-to-male.


Male-to-female bottom surgery is perhaps the more commonly pursued of the two and, at Ultra Aesthetics, Dr. Jarial offers a couple of different surgical procedures:


    This is the creation of a vaginal canal, and it can be done in a few different ways:

  • Penile inversion – when the skin of the foreskin and penis is turned inside out to create the vagina and scrotal tissue to create both labia – all of which are fully sensitive due to the tissue used. The downside of this method is a lack of lubrication in the newly created vaginal wall.
  • Rectosigmoid vaginoplasty – when intestinal tissue is used to form the vaginal wall. Sometimes performed in conjunction with a penile inversion, this surgery is most useful for transgender women who began hormone therapy before puberty (and so didn’t develop full male genitalia).
  • Non-penile inversion – when scrotal tissue is used to create the vagina and the labia majora, and penile tissue is used to create the labia minora.

After a vaginoplasty at Ultra Aesthetics, three to six nights are typically required in a Florida hospital, followed by seven to ten days of close outpatient monitoring. It will take at least six weeks before you’ll be able to return to work or strenuous activity. A catheter is required for the first week, after which your altered urethra should be functional. 

Dilation is usually required after any type of vaginoplasty to achieve the desired depth and width – Dr. Jarial will help you schedule this into your everyday life. Scarring is typically well hidden in the naturally wrinkly tissue of the labia and with pubic hair.

What should I expect after my male-to-female bottom surgery?

Labiaplasty is the creation of both labia when performed separately from vaginoplasty, and/or the revision and reshaping of previously created labia. This step in male-to-female bottom surgery may not be necessary for all patients (especially those who have had a one-step vaginoplasty) but can improve the aesthetics of the vagina. Downtime for this procedure is minimal – swelling peaks in the first two to three days and subsides from there.

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410 Evernia St., Ste. 109, West Palm Beach, FL