MTF Surgery
At the Center for Cosmetic and Reconstructive Surgery (CCRS), we believe that everyone deserves to feel at home in their own skin and to look in the mirror and see the person they know they are. We know that aligning your physical appearance with your true self is about much more than aesthetics—it’s a deeply personal journey of self-discovery, self-affirmation, and, ultimately, self-celebration. For many, this journey is as emotional as it is transformative, and we’re here to walk alongside you, every step of the way, offering not only our expertise but also our understanding and support.
Our MTF (male-to-female) procedures are carefully tailored to honor each individual’s unique path. From the first consultation to the final result, our compassionate and highly skilled team works with you to create the feminine contours and features that help you feel truly, authentically yourself. We view this as a collaborative, creative process—one where precision and artistry come together to craft a natural, graceful result.
Throughout your time with us, your comfort, safety, and privacy are paramount. We know these elements matter profoundly when undergoing such meaningful transformations. It’s our privilege to be part of this journey with you, and we’re dedicated to helping you feel seen, valued, and celebrated as you take these transformative steps.
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MTF SURGERIES @ CCRS
Welcome to our Gender Care Clinic at CCRS! We are dedicated to providing comprehensive care and support for individuals seeking gender transition or gender-affirming treatment. Our team of healthcare professionals is committed to providing high-quality, compassionate care to help you achieve your gender-affirming goals. MTF surgery is a complex and highly individualized process that requires extensive pre-operative planning and evaluation. It is important for individuals seeking MTF surgery to work with a qualified and experienced surgeon who understands the unique needs and concerns of the transgender community.
Lets talk about Gender Reassignment Surgeries
MTF surgeries
Dr.Sameer Karkhanis | Welcome to CCRS
The Road to MTF Transformation
Age Requirement
The individual must be at least 18 years old to consent to SRS legally. For those under 18, parental consent is generally required for any gender-affirming procedures.
Psychiatric Evaluation and Mental Health Certification
A thorough psychiatric assessment is required to confirm the diagnosis of Gender Dysphoria, as per the guidelines of the World Professional Association for Transgender Health (WPATH).
The individual must obtain a mental health certificate from a qualified mental health professional, usually a psychiatrist, affirming that they have been diagnosed with Gender Dysphoria and are mentally prepared for SRS.
This assessment typically involves counseling sessions to evaluate the individual’s understanding of the surgery and its implications.
Hormone Therapy
Although not a strict legal requirement in all cases, most surgeons and medical guidelines recommend that individuals undergo hormone therapy for at least 1–2 years before SRS.
Hormone therapy helps the individual experience some physical changes, allowing them to further affirm their gender identity. It also provides time to assess the person’s readiness and commitment to transition
"Real-Life Test"
Individuals are often encouraged, though not legally required, to live in their identified gender role for a minimum of 1 year before undergoing SRS. This practice, commonly known as the “real-life test,” allows the person to experience life in their affirmed gender role and helps assess their comfort level.
Legal Documentation and Consent
The individual must provide informed written consent before undergoing SRS. This includes understanding the risks, benefits, and irreversible nature of the surgery.
While a Gender Dysphoria diagnosis from a mental health professional often serves as a basis for moving forward, some surgeons or institutions may also require a second opinion.
Depending on the state, individuals may need to submit legal documents affirming their chosen gender identity. In cases where legal recognition of gender has been obtained (such as a gender identity certificate or updated identification), these documents can be useful in the process but are not strictly mandatory.
Affirmative Consent for Surgery
A legal declaration may be required, especially for irreversible surgeries, to ensure the individual is fully aware of the implications. This is part of informed consent to ensure clarity around the permanence of SRS.
Financial Preparation
Since SRS is typically not covered by health insurance in India, individuals should be prepared to handle the financial costs.
Different hospitals and clinics have varying requirements regarding documentation and medical assessments, so it’s essential to consult with the facility performing the surgery for any additional requirements.
Post operative plan
A follow-up and care plan should be in place, which may include regular consultations with mental health professionals, hormone therapy adjustments, and physical rehabilitation if necessary. This plan, though not legally mandated, is often required by medical institutions to ensure post-surgery recovery and support.
The MTF Procedures
At the Center for Cosmetic and Reconstructive Surgery (CCRS), our MTF (male-to-female) procedures are designed to help you align your body with your identity. With skilled surgeons and personalized care, we provide a range of options to create natural, feminine features that feel authentically you.
BREAST AUGMENTATION
Breast augmentation is about helping you achieve the feminine silhouette that feels authentic to you. Using implants, our surgeons create a fuller chest that matches your proportions and vision. With a range of implant types and sizes, we work with you to choose an option that feels just right—whether you want subtle curves or a more pronounced shape. The result is a natural, balanced enhancement tailored specifically for you.
FACIAL FEMINIZATION SURGERY (FFS)
Facial Feminization Surgery reshapes masculine features to create softer, more traditionally feminine contours. Each procedure is thoughtfully tailored—whether it’s smoothing the brow, refining the jaw, enhancing the cheeks, or reshaping the nose. Our approach is not one-size-fits-all; instead, we work to highlight your unique beauty, crafting a harmonious balance that feels true to who you are.
BODY FEMIISATION SURGERY
Body Feminization Surgery is designed to help you achieve a more traditionally feminine silhouette. By sculpting areas like the waist, hips, and buttocks, our surgeons enhance curves and soften angles to reflect a graceful, feminine shape. Through liposuction and fat transfer techniques, we work to create natural-looking contours that leave you feeling confident and comfortable in your body.
TRACHEAL SHAVE
A tracheal shave, or Adam’s apple reduction, reduces the prominence of the thyroid cartilage to create a smoother neck profile. This procedure is delicate yet impactful, softening the neck’s appearance and contributing to a more traditionally feminine look without affecting your vocal function. It’s a small but meaningful change that helps you feel more aligned with your femininity.
ORCHIECTOMY
Orchiectomy, the removal of the testicles, is often part of a comprehensive MTF transition plan. This procedure reduces testosterone levels, supporting the feminization process without the need for hormone blockers. Performed in a supportive, understanding environment, orchiectomy is a step that can ease both the physical and emotional aspects of your journey, helping you move closer to your long-term goals with peace of mind.
HAIRLINE ADVANCEMENT
Hairline advancement in MTF surgery is a procedure that brings the hairline forward, creating a softer, more traditionally feminine forehead. By reducing the height of the forehead and reshaping the hairline, this technique helps achieve a rounded, natural look that aligns with the patient’s gender identity. It’s often combined with other facial feminization procedures for balanced results.
LASER HAIR REMOVAL
Laser Hair Removal (LHR) is an essential step in many MTF transitions, offering smoother, hair-free skin that aligns with a feminine appearance. At CCRS, our advanced LHR treatments focus on long-lasting results, providing comfort and confidence for your unique transition journey.
BOTTOM MTF Procedures
Our bottom MTF (male-to-female) procedures at CCRS are carefully crafted to help you feel at home in your body. With options for creating both functional and aesthetic results, our skilled team ensures each procedure aligns with your unique needs, comfort, and identity.
PENILE INVERSION VAGINOPLASTY
The most common technique, penile inversion uses the penile skin to create the vaginal canal. The scrotal skin can also be used to enhance vaginal depth and lining. This method provides a functional and sensitive vagina with minimal scarring.
PERITONEAL VAGINOPLASTY
In this technique, a portion of the peritoneal lining (from the abdominal cavity) is used to create the vaginal canal. This approach offers natural lubrication and reduces the need for dilation. It’s particularly beneficial for those with limited penile and scrotal tissue.
INTESTINAL VAGINOPLASTY
For patients who need additional tissue or prefer a naturally lubricated vagina, part of the sigmoid colon (a section of the large intestine) can be used to construct the vaginal canal. This procedure provides good depth and moisture, though it’s typically more complex than other methods.
ZERO DEPTH VAGINOPLASTY
Designed for those who do not require a vaginal canal, this procedure creates only the external genitalia, including the labia and clitoris, without creating a full-depth canal. This option offers a faster recovery, avoids dilation requirements, and provides a feminine appearance for individuals prioritizing external aesthetics.
Consultation
Meet the skilled professionals behind our transformative treatments. Each of our specialist doctors brings extensive experience and a commitment to excellence, ensuring personalized care and exceptional results.
Sameer Karkhanis, MD
Board-Certified Mumbai Plastic Surgeon
Chief Plastic Surgeon & the Director at CCRS is a qualified Aesthetic Plastic and Reconstructive Surgeon. He is Board Certified, with the qualification of DNB Plastic Surgery (Diplomate of National Board). He is an active member of the International Society of Aesthetic Plastic Surgery.
FAQs
Our dedicated team of professionals provides top-notch surgical services in a modern, comfortable environment. Explore our gallery to see the advanced facilities and compassionate care that set us apart in the field of surgery.
Like all types of surgery, gender-confirmation procedures carry risk. That’s why we thoroughly evaluate your health before planning surgery. Our experienced team follows best practices when it comes to your safety.
The length of your journey depends on your individual needs and choices. Along with surgical procedures, you might also have hormone therapy, voice therapy, and counseling. It’s up to you where to start and when you feel you’ve met your goals.
In addition to a comprehensive understanding of the procedures, hormones, and other risks involved in these types of operations, there are other steps which must be accomplished before surgery is performed. Necessary steps may include mental health evaluation, clear and consistent documentation of gender dysphoria, and “real life” test.
With the advance SRS technique we use now, it doesn’t really matter the penile skin availability. We can get skin graft from other area of your body to create the desired depth. Normally, we will use penile skin with scrotal skin graft first and if they are not sufficient, we can opt for abdominal skin graft. From our experience, our patients who have limited penile skin, can get a good depth from this technique which has less risks than Sigmoid Colon SRS.
During the first year post-op, you need to do dilation 2-3 times a day. After one year, you may do it less to maintain vaginal width and depth.
Quality of life appears to improve after gender-affirming surgery. One 2017 study found that surgical satisfaction ranged from 94 percent to 100 percent. Since there are many steps and sometimes uncomfortable surgeries involved, this number supports the benefits of SRS for those who feel it is their best choice.
Gender reassignment (confirmation) surgery is more common in transgender men (42 to 54%) than transgender women (28%). Top (chest gender confirmation) surgery is performed approximately twice as often as bottom (genital) surgery. In studies that assessed transgender men and women as an aggregate, top surgery accounts for 8 to 25% and bottom surgery accounts for 4 to 13%.
For transgender individuals desiring sex reassignment surgery, hormone therapy (HT), also called hormone replacement therapy (HRT), involves taking estrogen for a male to female transition. Hormone therapy may be used before, during, and after the surgical transition to another gender. The purpose of hormone therapy is to change the physical appearance into that of the desired gender.
The feminizing effects of estrogen may appear after the first couple of doses, although it may be several years before a person is satisfactorily transitioned. This is especially true of breast development.
Surgery is delayed until at least one year after the start of hormone therapy and at least two years after the first mental health evaluation. Once the surgical procedures begin, the amount of time until completion is variable depending on the number of procedures desired, recovery time, and more.
Most often, surgeries involved in sex reassignment surgery are broken down into those that occur above the belt (top surgery) and those below the belt (bottom surgery). Not everyone undergoes all of these surgeries, so our experienced surgeon will have a thorough discussion with you to get the best solutions for your SRS journey.
When the operation begins, we will try to create the vaginal cavity as deep as possible but we have to consider patient’s safety as well. Therefore, our limit is at peritoneal reflection (It is a point of an “apron” that covers internal organs such as intestines etc.), going farther than this point can be harmful to your body. Normally the distance between vaginal opening and peritoneal reflection is around 5 to 7 inches. After creating the vaginal cavity, we will use penile skin+scrotal skin graft as vaginal cavity wall. The depth of the neovagina you will get depend on various factors:
▪ The distance from vaginal opening to peritoneal reflection
▪ Skin graft quality: there is possibility that the graft is failed and shrunk and may lose depth after surgery.
▪ Dilation: It is the most important post-op care. All SRS patients have to do it correctly and regularly especially during the first year post-op and lifetime. Failure in dilation can create vaginal stenosis and finally losing depth.
Even Though you have sex regularly, it cannot be counted as dilation. Patient must use a rigid dilator to enlarge the vaginal cavity and give a small pressure when reach the end to maintain the depth.
