Plastic and Sex Change Surgery Info

Sex Change Surgery photos, procedure before and after


Dear Blog Readers, I just found this article on sex reassignment pictures, here are some photos of before and after sex change surgery , sex reassignment and sex change operation from female to male and male to female as well as some homosexual sex surgery and here are some more pictures of before and after transsexual surgery. During sex change surgery operation in the operation theater, the picture clearly shows that how they can proceed right from the initial steps in vagina, implanting penis and after the penis implantation pictures.

Sex Change Surgery photos, procedure before and after
sex change surgery photos

see more picture here >>>>

Below, there are real pictures of sex change surgery (SRS) male to female transsexual picture that I actually took from some other sources in terms of my blog viewers to make them graceful while they are desperately looking for information and how does it look like after the vagine converted into real penis, some also asked about do they still able to release sperm. Well, for this reason I am still researching to gain more genuine information and will be posting shortly. Now what they have been expecting to find out about sex change surgery either sex change surgery from male to female or female to male by transsexual surgery operation. 

 I got this info page from http://www.symposion.com/ and I thought it would be helpful to my visitors who're here looking for information and pictures of sex change surgery. So I made it my blog post.                                                 

Beginnings of Sex Reassignment Surgery in Japan

By Takamatsu Ako, M.D., Harashina Takao, M.D., Inoue Yoshiharu, M.D., Kinoshita Katsuyuki, M.D.**, Ishihara Osamu, M.D.**, Uchijima Yutaka, M.D.* **Department of Plastic and Reconstructive Surgery, Gynecology*, Urology**, Saitama Medical Center, Saitama Medical School, Japan

Abstract 
The first sex reassignment surgery (SRS) performed officially in Japan - for a female-to-male (FtM) person in 1998 and for a male-to-female (MtF) person in 1999 - are reported. For the FtM, two-stage conversion was applied. In the first operation, salpingo-oophorectomy, hysterectomy, colpectomy, metoidioplasty, and mastectomy were performed. A free flap phalloplasty with the deltoid flap is planned as the second stage. For the MtF, one-stage neovaginoplasty was performed by penile skin inversion technique with sensate pedicled neoclitoplasty.

Introduction
Japan, which is considered to be one of the world's most advanced countries in terms of its economy, technology, industry, and medicine, has long been in the dark ages regarding people who suffer from gender dysphoria. In July 1996, the Ethics Committee of Saitama Medical School submitted a report, at our request, on surgical treatment for transsexual patients. The report acknowledges that transsexualism exists and that treating transsexual patients can be regarded as a justifiable medical activity. The report was made public by mass media. In 1997, the medical guidelines for transgender persons were issued by the Japanese Society of Psychiatry and Neurology, with some modifications of the Standards of Care of the Harry Benjamin International Gender Dysphoria Association. We organized a medical team composed of psychiatrists, a sexologist, endocrinologists, gynecologists, urologists, and plastic surgeons.
This is a report of the first sex reassignment surgeries (SRSs) officially performed in Japan: one for a FtM person in 1998 and one for a MtF person in 1999. Diagnosis, preparatory psychotherapy, and hormonal therapy were carried out according to the above-mentioned guidelines.
Methods
SRS for a Female-to-Male Transsexual
  In the first operation, regarded as the first stage in the two-stage conversion, bilateral salpingo-oophorectomy, hysterectomy, colpectomy, metoidioplasty, and mastectomy were performed. Please click on the picture to enlarge how they perform female to male gender change surgery.

 
sex change surgery procedure from female to male
sex change surgery procedure from female to male

First, the gynecologists performed a transabdominal oophoro-hysterectomy. Then they began to elevate the anterior vaginal flap through the abdominal approach. The elevation was completed transvaginally, just to the dorsal part of the urethral orifice, by plastic surgeons. The vaginal mucosa was resected, and colpocleisis was accomplished. After the abdominal wall was closed, we performed a metoidioplasty, as advocated by Hage (1996). By resection of the chordee, the clitoral shaft was released and abdominally advanced. The neourethra was constructed by suturing the vestibular skin, the vaginal mucosal flap and the labial flap around the urethral catheter in a watertight fashion (Figures 1, 2). A suprapubic cystostomy was performed and the urethral catheter was removed.
Figure 1 Figure 2

For the bilateral mastectomy, we used a modification of the concentric-circle periareoral de-epithelization technique reported by Davidson (1979). Resection of the breast gland and reduction of the nipple were performed by the transareolar approach described by Pitanguy (1966) and Hage and Bloem (1995) (Figures 3, 4).Figure 3 Figure 4
SRS gender reassignment picture photos
SRS assignment picture
after transform to male from female rare picture
after transform to male from female rare picture

see more picture here

 The estimated blood loss was 740 ml, and the total operating time was 6 hours. The postoperative course was completely uneventful. The suprapubic catheter was left in place for 7 days. The total hospital stay was 14 days.

We are planning a free-flap phalloplasty as the second stage of the conversion. The patient desires the phalloplasty but at this time cannot afford the necessary fee which will amount to 2,500,000 yen (US$25,000).

SRS for a Male-to-Female Transsexual


A one-stage operation was performed in June 1999. The operative technique involved the following procedures: bilateral orchiectomy and penectomy followed by vaginoplasty, clitoroplasty, and vulvoplasty.

 
For the vaginoplasty, we employed a modification of the abdominally pedicled penile-skin-inversion technique added by a triangular perineal skin flap (Karim, Hage and Mulder, 1996). A dorsally based triangular perineal flap measuring about 10 cm long and 4 cm wide was used to line the posterior wall of the neovagina and widen the introitus (Figure 5). The testes were isolated and then removed with a double ligation of the spermatic cord at the level of the external inguinal rings. The skin of the penile shaft was mobilized from the corpora up to the level of the corona. A circumcising skin incision was made at the corona, completely denuding the penis of its skin and leaving the glans penis attached to the corpora. in figure 5 its shows that after cutting the penis off and converted into the vagina as we seen in the pictures. It seems very real and not much difference if you see on the before and after sex change photo.

  male to female sex change before and after picture transgender vaginal surgery before and after
male to female sex change before and after picture

Figure 6

The dorsal part of the glans penis was used as a clitoris. Sensate pedicled neoclitoplasty using the reduced glans, which remained attached to its dorsal penile neurovascular pedicle, was performed (Brown, 1976). The corpora cavernosa were resected to prevent postoperative pain due to erection of the remaining corpora tissues.

A neovaginal cavity was created by dissection between the two layers of Denonvillier's fascia using a laparoscope placed in the abdomen as a guide. The created neovaginal depth was approximately 10 cm.
sex change surgery overall picture for male to female transformation rare picture
sex change surgery overall picture for male to female transformation rare picture
The lower abdominal skin flap was dissected to about the level of the umbilicus, and this advancement of the flap in the inferior and posterior direction made it possible for the base of the penile skin tube to overlie the introitus of the neovagina. The perineal triangular flap was sutured to the posterior wall of the penile skin tube and the widened tube was then inverted to line the neovaginal cavity. The skin flap was incised in the middle and the urethra was brought out through the buttonhole and amputated at the urogenital diaphragm level. The urethral stump and neurovascular pedicled neoclitoris were sutured to the skin with interrupted sutures. A soft, individually selected urethane mold, placed in a condom, was inserted into the neovagina, and the mold was securely sutured to the perineum to prevent prolapse (Figure 7).

The estimated blood loss was 760 ml and no transfusion was necessary. The postoperative course was uneventful and the patient was discharged on the eighth postoperative day. She wore the dilating stent every day for 3 months postoperatively; nevertheless, the neovagina decreased in depth to 6 cm and in diameter to two fingers' width. The neoclitoris was found to have returned to a normal level of sensation (Figure 8). The patient has returned to her previous occupation.



Discussion We believe that most FtM transsexuals desire closure of the vagina. However, we recognize the different view of some surgeons who consider the risk benefit to be rather high. Their reasoning is that most patients are not necessarily aware of the presence of the vagina because of decreased discharge after hysterectomy and atrophied mucosa due to long-term hormone therapy. We have found vaginectomy to be technically difficult and bloody and autotransfusion has a valuable place here. We have also found the vaginas of the Japanese FtM transsexuals we have examined to be very narrow compared with those we have observed elsewhere, so we have chosen to do transabdominal hysterectomies. The other advantage of the transabdominal approach is that the partial elevation of a sufficient size of the anterior vaginal flap and vaginectomy can be carried out from above, under direct vision.  
In SRS for MtF transsexuals, we employed a laparoscope to assist in dissecting the vaginal cavity. Its light can help avoid injury to the prostate and rectum and can provide a direct view of the vaginal cavity up to the peritoneum.

We are planning a free-flap phalloplasty as the second stage of the FtM SRS (Figure 10). We have experienced 13 cases of deltoid flap and 5 cases of forearm-flap phalloplasties in non- transsexual patients during the past 15 years (Figure 11). These techniques always result in extensive scarring of the donor area. Our first choice of donor site for phallic construction is the deltoid flap (Harashina et al.,1990) because it results in less morbidity in the donor site, is a true sensory flap, has hairless skin, and is less likely to result in atrophy of the neophallus. 

However, this technique may be technically more difficult than that with the forearm flap, and it may be impossible to make a roll on obese patients. We think the deltoid flap is especially suitable for Japanese FtM patients because they generally are not obese. In fact, they usually try to reduce their weight so that they will not be regarded as females.


At the time of writing this paper, we have performed six SRSs: one for MtF and five for FtM. Four of the five FtM patients had already undergone mastectomies elsewhere. The SRSs were performed at the Gender Clinic of Saitama Medical Center, which was the only provider of transgender-specific health services in Japan as of March 2000. In total, over 400 clients have visited our clinic since the first patient arrived in 1992, and about 100 new gender dysphoric clients have been seen each year. Sixty percent of them seek SRS. While there are many candidates, we take our time before performing surgery because there are very few psychiatric specialists in this field in Japan and we must apply for permission from our ethics committee in each case.

Conclusion

The first SRS operation in Japan was affirmatively reported all over the country and there was actually no public criticism. The operation was an historic turning point for the proper understanding of Gender Identity Disorder in our country.

We are just on the starting line. Many issues remain to be resolved in promoting the welfare of our patients. Whereas public interest is steadily increasing and some acknowledgement of SRS seems to have become established, there is still no policy regarding health insurance and legislation for those who have undergone the procedure. SRS is not covered by National Health Insurance, and postoperative persons cannot yet change any of their documents. Our team is still the only practising gender surgery team in Japan, although two other teams are now being organized. Despite these difficulties, the role of SRS, performed justifiably, is becoming more prominent in the treatment of transsexualism in Japan.


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References

Brown, J. (1976) Creation of a functional clitoris and aesthetically pleasing introitus in sex conversion. In Marchac, D. (Ed.), Transactions of the 6th International Congress of Plastic and Reconstructive Surgery. Paris: Masson, pp. 654-655.

Davidson, B. A. (1979) Concentric circle operation for massive gynecomastia to excise the redundant skin. Plastic and Reconstructive Surgery, 63: 350-354.

Hage, J.J. (1996) Metoidioplasty: An alternative phalloplasty technique in transsexuals. Plastic and Reconstructive Surgery, 97: 161-167.

Hage, J. J., Bloem J.J.A.M. (1995) Chest wall contouring for female-to-male transsexuals: Amsterdam experience. Annals of Plastic Surgery, 34: 59-66.

Harashina T., Inoue T., et al. (1990) Reconstruction of penis with free deltoid flap. British Journal of Plastic Surgery, 43: 217-222.

Karim, R.B., Hage J. J., and Mulder J. W. (1996) Neovaginoplasty in male transsexuals: Review of surgical techniques and recommendations regarding their eligibility. Annals of Plastic Surgery, 37: 669-675.

Pitanguy, I. (1966) Transareolar incision for gynecomastia. Plastic and Reconstructive Surgery, 38: 414-419.


Acknowledgement

We are very much grateful to Doctor Joris J. Hage in the Netherlands for his valuable help in order to accomplishing this task.

Male to Female (M2F) Transgender's story (Krissy's Story)

I was born at Ryde Memorial Hospital, Sydney in March 1963 and pronounced a boy, My mother, Nancy, was a process worker and also worked in milk bars and TAFE cafeterias. Dad's name is Hilton and he was a supervisor for Goodyear Tyre and a storeman for Kmat. They are both retired now and mum does a lot of volunteer work for the Red Cross. My two brothers were older than I was and I also had one older and one younger sister. When I transitioned their reaction was mixed but these days the whole family lives in Queensland and is very close. If we can't see each other for a while the phone lines run hot.
      When I was in my teens, both my friend Denielle and I were lucky that our families supported us. We were ostracised by many trannies in Kings Cross because we still lived with our families and they had lost theirs. I guess they couldn't stand being reminded of that. I did get to know quite a few of them and became a 'Clayton's friend for when no-one else was around. That was the way it was: 'You're there--I am here! Don't talk to me untill after so and so has gone...'
      As a kid I don't remember particularly thinking that I was a girl but I liked girls games and toys-- not boy stuff. Our neighbours all seemed to know that I was different, probably because I was always helping them around the house and in the garden. I didn't have any trouble with the kids in our street either. The bashing started at infant school. I was so terrified, I would lose control of my bowels and urine and hide in the closet. The bashing continued through primary school and it was there that I started smoking cigarettes of course. I used sex as a tool and become a 'teacher's pet' so that I could stay behind after class--but no teacher ever touched me in a sexual way.
     I think I got a reputation for being tough (probably because of the smoking) and people started to leave me alone. My second oldest brother had been involved with a few bashings of his own. He had bashed two teachers, and he would just walk out of school, so people began to assume that I had the same violent nature. Mum took me to see Dr Wallman, our family GP, and asked him to send me to a psychiatrist but he refused. He had done that with a set of twins previously, one of whom had said that he wanted to be a girl, and six months after they had seen the psychiatrist they were dead. They both suicided--even the one who hadn't thought he was a girl.
      The challenges really brought home to me how different I was to them and I didn't cope very well. My brother's reputation had preceded me once again and sex was another 'thing' that I used to keep the bastards away from me. I don't think Dr Wallmart knew what to do with me but he knew that I was on the edge and probably figured that a live kid on drugs was better than a dead kid on nothing--so he prescribed Valium for me. The result was that I spent most of my time at high school in a drug-induced daze. Fairly predictably, I tried to overdose on Valium (which obviously didn't n work) and ended up taking a year off. Eventually I couldn't stand it any more and left school completely.
      For a long time I thought I was gay and I had a lot of trouble trying to come to terms with that idea. My ambition when I was a kid was to be a singer and glamour girl--I loved sequins and feathers and all that. What I ended up doing was working on a machine in a factory that make plastic bags and I hated it. I really went off the rails for a while and both Danielle and I flirted with prostitution.
      Then a couple of gay guys and I went to Kings Cross to see a show at Les Girls, where I saw transsexual performers such as Carlotta and Toye de Wilde. It was a revelation. I had no idea that a boy could become a girl and the minute I saw them I thought, 'That's me!' I managed to talk to a couple of the girls, which was just as well because there was no information available that was of any help to me. They told me about a doctor in Sydney I could see-- and that was the beginning of my transition.
      I told my parents, who were totally confused and blamed themselves, They just didn't understand what was happening, but then, neither did I. Eventually they met a couple of my tranny friends, including Danielle, and tried really hard to adapt to the situation. Meanwhile I received a great deal of support from Seahorse in Sydney and my friend, Noeline. If course I used to dress up in my glad rags and go out for the boring into you--it was 'wicked' and 'scandalous'. I got the impression that everyone expected me to stop carrying on under their noses, go away for my gender reassignment operation and not come back until after 'everything' was done.
      I had my operation at the Masada Hospital, Melbourne in 1989 and remember saying, 'Thank God that's over'--now I can get on with the rest of my life'. Mum went to Melbourne with me. When dad rang up to see how I was he said, 'Well, I might have lost a son but now I have another daughter', which I thought was really nice. No-one can ever be entirely happy with being regarded as a guinea pig but I was reasonably pleased with the way I was treated at the hospital; I was certainly happy with the outcome of the operation. After that, I touched base with reality and grew up. I did Year 10 at Meadowbank TAFE under the name of Kristine, which I thought was pretty cook and it saved a lot of arguments later when I had to present my qualifications. No prospective employee have insisted on seeing my high school results so far but I often wonder what the expression on their faces would be like if they read that Kristine attended an 'all boys' school.
      It would be wonderful if school records, trade papers and apprenticeship papers etc. could be changed to reflect the true indedtity of a person, particularly if the documents were made gender neutral (the Queensland University of Technology will now change the name and gender status for transgender students). I never did become a glamorous singer but, unlike many trnasgenders after transition, I managed to earn a living by doing house cleaning, working as a process worker and supervisor, andI also acquired a forklift operator's licence.
     I would like to adopt children but have never tried to do anything about it because the laws are too defined and unbending even for those who are considered to be suitable candidates. in 1999 several law reforms relating to industrial relations, domestic violence and property law were passed by the Queensland Parliament in order to bring De-facto and same-sex relationships into line with conditions covering heterosexual married couples in these areas.
      
I couldn't help wondering where that left me as a woman--a boy who, with the help of the medical profession, grew into a woman. And what about the girls, who, again with the help of the medical profession, grew into men. Are we male or female? That depends on which government department you deal with and what state you live in. Federally we aren't too badly off. The federal government has acknowledged our change of gender (after all the surgery has been complete of course) provided we produce a letter from doctor dear that the surgery is irreversible. Documents attesting to that fact fly across the country at such a rate they burn up by the time they arrive at their destination.
      In the State of Queensland, particularly, we faced a great many challenges. We couldn't be issued with a new birth certificate reflecting our change of gender and we couldn't marry the partner of our choice. I could have married a female-to-male(F2M) transsexual legally but, although I was in a long-term relationship with my male partner, that relationship was not recognized for what it was because we were considered to be a same-sex couple. Transgender people to have a Bill, an Act of Parliament of amendments to legislation already in place, to clarify where we stood in the community.
      Where do we, as a community, draw the line or set the boundaries? Who decides who is transgender, homosexual, heterosexual, bisexual and so on--do we let the politicians do it? Many people in our community identify with homosexuals, male-to-female (M2F) people attracted to women, female-to-male (F2M) attracted to men. Is a M2F attracted to men gay because she has a vagina and her partner has a penis? Is a F2M attracted to women gay because he has a penis and she has a vagina?
      Regardless of whether you are a F2M or a M2F, what is between you legs at birth currently decides your future worth to the community as a whole. Society has an absurd curiosity about genitalia and this is reflected every day in just about every form of documentation we are required to sign. The big question is (whether you are pre-op, post-op or no-op) who are we? Where do we fit in? Our legal status is in limbo depending on which state, government department or person you deal with. In addition to that, we must cope with neighbours and people who, on an everyday basis, often refer to you as Ms or Mr based solely on the sound of you voice or appearance.
      My preference would be do do away with the word 'transgender' completely and go straight from male to female. A few words added to legislation, or a small alteration here and there to existing legislation, would eliminate so many of the obstacles we face that prevent us from living worthwhile and fulfilling lives. What other section of the community is compelled to undergo the most intensive, intrusive and exhaustive medical testing and analyses over many years to ensure that they are sane people? How many of you have been forced to prove you sanity? How many other members of society are forced to put in as much time, effort, and money just to conform to the ideas of genitalia-correct people who believe that we have somehow been given the wrong bodies to begin with.

We do it because we are different -- very different. We are forced through endless psychological, medical, psychiatric, religious and peep pressures to fit in. Nearly forty-five per cent of transgenders forfeit their lives through suicide because they can't cope with that kind of constant pressure. In the end---this is the way we are. Society has decided how we will look, act and talk, A parade of people with different hats decides who 'passes' and who doesn't. Because society has decided all this for us, I believe it is up to society to protect us, nurture us, and be there when we need them---but this is not the case at the moment.
      The way we deal with society's assumptions is in our own hands and in the hands of the well-intentioned people who believe in us. All I want is to be an active and participating member of the world at large---not relegated to the outskirts of society for the entertainment of those who see us as men in dresses on stage; or as a sex change; or as a prostitute for men and women to fulfil their sexual fantasies.
      I don't want to see my transgender friends drown in alcohol or choke on their own vomit through talking drugs because they don't measure up to a community's expectations---and there have been quite a few. I don't want to be hidden away in bed-sits or isolated to wait for the deep sleep to end the pain. I don't want to be an 'in your face' type either. I want to be able to get married and adopt my future husband's children, if any. I also want to be able to love, care for and protect the children of friends and family, who in their last will testament have given me the guardianship of their child. I want to be able to live, love and work in an environment where I am protected from vilification, harassment, and discrimination of any kind.
      It should be mentioned  here that there are some truly wonderful people working within the system trying to right these wrongs---none more so than those who tried to change things in Queensland where transgendered and inter-sexed people had no protection under state law at all in many areas. Like members of the transgender community, those who sought to help us continually had their hopes for improvement stomped on for years because we were not politically palatable or the climate was not considered right for a change.

Epilogue

Change eventually came to Queensland! in March 2003 the Queensland Government passed amendments to the anti-discrimination Act to include GENDER IDENTITY (the medical term). This has released the tension and grustration of being (legally at least) treated as a non-human.
      With that protection comes the responsibility of living in a diverse cultural community. Although the law now protects us, education relating to the dynamics of gender identity still has a long way to go. I will always assist whenever and whereever I can to put a human face on this issue.

      Personally, I look forward to a future where I can live a full and productive life, stay healthy, gain some financial stability---and never have to was my face again.

Source : Transgenders and intersexuals by May, Lois