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WhatsApp UsMost patients who walk into my OPD for this surgery have already spent two, three, sometimes eight years on the internet. They've watched every YouTube video. They know what RFF stands for. They can pronounce "metoidioplasty" better than half the doctors I know. What they haven't been able to find is somebody, in their own state, who will sit across the table from them, look them in the eye, and say plainly, "Yes, this is possible. Here is exactly what we'll do. Here is what it will cost. Here is what your body will look like. Here is what it will feel like. And here is what could go wrong."
You are not the first person from Vijayawada, Visakhapatnam, Warangal, Hyderabad, Bhubaneswar, Bengaluru, or Dubai to come here for this. You will not be the last. And — this matters — you do not have to fly to Bangkok or Mumbai to be treated by someone who has done this work for years and trained the surgeons who now run gender clinics in the metros. You can come here.
FTM stands for Female-to-Male, a term traditionally used to describe a transgender person who was assigned female at birth and identifies as male. The term transgender man is often preferred. In medical and plastic surgery contexts, FTM commonly refers to gender-affirming treatments for transgender men. Common FTM procedures - FTM top surgery: Chest masculinization to create a flatter, more masculine chest. - FTM genital reconstruction: Procedures such as metoidioplasty or phalloplasty. - Hysterectomy: Removal of the uterus, if desired and medically appropriate. - Oophorectomy: Removal of the ovaries, if desired and medically appropriate. Not every transgender man chooses surgery, and the procedures selected depend on individual goals and medical circumstances.
Anatomy & Surgical Foundations
- In female-to-male (FTM) gender-affirming surgery, the anatomy and structural foundation refer to the underlying chest wall, skin, breast tissue, fat distribution, nerves, blood vessels, and supporting structures that influence surgical planning and outcomes. For a plastic surgery website, this section can focus on chest masculinization (FTM top surgery), with a separate discussion of genital reconstruction where relevant.
- 1. Surgical Precision & Symmetry Chest wall and pectoral muscles The pectoralis major muscle forms the principal muscular contour of the anterior chest. Its shape, position, and attachments influence a masculine chest appearance. Breast tissue and subcutaneous fat Glandular tissue, fatty tissue, and skin determine chest volume and contour. Their distribution influences tissue removal, skin management, and the need for contour refinement. Nipple–areola complex (NAC) The nipple and surrounding areola contribute to chest appearance and sensation. Their size, position, blood supply, and nerve connections matter when planning repositioning or grafting. Skeletal framework The sternum, ribs, clavicles, and overall thoracic dimensions establish the chest's underlying shape. Surgery primarily modifies soft tissues and does not ordinarily change this skeletal framework.
- 2. Structural factors that influence surgical planning Chest size and skin excess Influence the choice of incision pattern and skin-removal approach Skin elasticity Affects skin redraping and the potential for residual laxity Breast tissue distribution Influences contour and tissue-removal planning Nipple position and size Guide the desired masculine chest appearance Blood supply and nerve anatomy Affect nipple viability and the potential to preserve sensation Chest-wall width and asymmetry Influence the final contour and symmetry expectations Previous scars May affect tissue mobility, blood supply, and incision planning
- 3. How anatomy relates to FTM top surgery Periareolar techniques: May be appropriate for selected patients with smaller chests and limited skin excess. Double-incision techniques: Often considered when there is greater tissue volume or excess skin; nipple grafting may be used when indicated. Contour refinement: May be needed to address lateral chest fullness, residual tissue, or asymmetry.
Phalloplasty is a surgical procedure to construct or reconstruct a penis. It is one of the genital gender-affirming surgeries available to transgender men and some other individuals who want penile reconstruction. It may also be performed following trauma, cancer surgery, or congenital conditions. In female-to-male (FTM) gender-affirming care, phalloplasty typically uses tissue from another part of the body to create a penile structure.
Anatomy & Surgical Foundations
- Stage 1 Flap design, neophallus creation, urethral lengthening, transfer to groin, nerve and vessel anastomosis
- Stage 2 Glansplasty (shaping of the tip), scrotoplasty (creation of scrotum from labial tissue), and vaginectomy
- Stage 3 Testicular implants
- Stage 4 Penile (erectile) implant — inflatable or semi-rigid
If you only read this table, you'll know more than most patients walking into their first consultation.
| Question | Quick Answer |
|---|---|
| What is FTM Surgery? | A planned set of gender-affirming surgeries that brings a transgender man's body in line with his identity — chest masculinization (top surgery), genital reconstruction (bottom surgery: metoidioplasty or phalloplasty), and removal of female reproductive organs (hysterectomy/oophorectomy). |
| Who is it for? | Adults 18+ in India, with a persistent and well-documented gender dysphoria diagnosis, in stable physical and mental health, and able to give informed consent. WPATH SOC 8 currently requires one letter from a qualified mental health professional. |
| What procedures are offered at Pratap Hospital, and what do they cost? | • Top surgery (double incision/keyhole/ periareolar/buttonhole) — ₹1.5 to 4.5 lakh • Metoidioplasty — ₹3.5 to 6 lakh • Phalloplasty (RFF/ALT/MLD) — ₹6 to 12 lakh, done in stages • Hysterectomy + oophorectomy — ₹1.5 to 2.5 lakh • Add-ons (scrotoplasty, vaginectomy, urethral lengthening, glansplasty, testicular/penile implants) — priced per stage |
| How long is FTM surgery recovery? | Top surgery: Back to desk work in 2 weeks, full activity in 6–8 weeks. Bottom surgery: Staged — 1 to 2 weeks in hospital and 3 to 6 months for full recovery between stages. |
| Why choose Vijayawada for FTM surgery? | Same techniques and outcomes as a Mumbai or Bengaluru centre, at roughly 40–60% of the cost — with full privacy, hostel-style attached recovery rooms for outstation patients, and Central Government recognition you won't find at most private hospitals |
| Is FTM surgery covered by insurance in India? | Ayushman Bharat TG Plus offers up to ₹5 lakh per year for transgender persons holding a National Portal ID card. Our team handles the paperwork end-to-end. |
FTM top surgery, also called chest masculinization surgery, is a gender-affirming procedure that reshapes the chest to create a flatter, more masculine contour. Candidacy depends on the patient's health, goals, anatomy, readiness, and ability to safely undergo surgery.
✓ Good Candidates
- Gender-related goals: The patient desires a flatter, more masculine chest and understands the expected changes.Gender-related goals: The patient desires a flatter, more masculine chest and understands the expected changes.
- Medical fitness: General health is suitable for anesthesia and surgery, with medical conditions appropriately managed.
- Stable chest anatomy: Chest size and skin characteristics have been assessed to guide technique selection.
- Informed decision-making: The patient understands the benefits, scars, recovery, limitations, and possible complications.
- Realistic expectations: The patient understands that perfect symmetry, invisible scars, and preservation of all nipple sensation cannot be guaranteed.
- Support and aftercare: The patient can access postoperative care and follow recovery instructions.
✕ When to Wait or Reconsider
- Active infection or skin infection near the surgical site
- Uncontrolled diabetes or significant medical instability
- Unrealistic expectations or uncertainty about the desired outcome
- Significant untreated psychological distress affecting consent or recovery
- Pregnancy or another condition affecting anesthesia and surgical timing
Mastectomy
Pre-op: Arrive at the hospital the previous evening. Blood tests, ECG, anesthesia review, and detailed marking on your chest while standing (this is critical — chest shape changes when lying down). Surgery: 2 hours under general anesthesia Hospital stay: Usually 1 night; 2 if you live alone or come from far away. Drains: Two soft suction drains, removed at the clinic on days 5–7. Compression vest: Worn 24/7 for 4–6 weeks (we provide it). First shower: Day 3 (sponge bath) / Day 7 (proper shower). Return to desk work: 10–14 days. Lifting heavy / gym chest exercises: No earlier than 8 weeks.
Metoidioplasty and Phalloplasty
A neopenis is constructed using a tissue flap from another part of the body — most commonly the forearm (RFF), thigh (ALT), or back (MLD). The flap brings its own skin, blood vessels, and nerves, which are then microsurgically connected at the groin Phalloplasty isn't one surgery. At Pratap Hospital, we plan it in 3 to 5 stages, with 3 to 6 months between each: You can stop at any stage. Many patients are satisfied after Stage 2. Penile implants are done last because they require the neophallus to have fully developed protective sensation — usually 9 to 12 months after Stage 1.
| Timeline | Expected Sensation | Activity Allowed | Garment Care |
|---|---|---|---|
| Day 0 – 2 | Tightness & mild swelling | Light walking indoors, rest in elevated posture | Compression garment worn 24x7 |
| Day 3 – 7 | Peak swelling subsiding | Desk work from home, gentle walks | Garment 24x7; dressings checked |
| Week 2 – 3 | 60% swelling resolved | Return to office, driving, social visits | Garment during daytime/evenings |
| Week 4 – 6 | 85% final shape visible | Gym, yoga, swimming cleared after review | Garment discontinued |
| Month 3 – 6 | Final refined contours | Unrestricted activity and swimwear | Scar mature and flattened |
| Timeline | Expected Sensation | Activity Allowed | Garment Care |
|---|---|---|---|
| Day 0 – 3 | ICU-level monitoring of flap perfusion. Bed rest. Catheter in. | ||
| Day 4–7 | Step-down. Sitting up, gentle walking with help. | ||
| Day 7–10 | Discharge home or to the attached recovery suite. Catheter usually still in. | ||
| Week 2–4 | Catheter remains. Sponge baths. Outpatient flap reviews. | ||
| Week 6–8 | Catheter removed in stages. First standing urination — a major day. Donor site (forearm/thigh) skin graft maturing. | ||
| Month 6 | Most functions return. Eligible to plan Stage 2. |
We believe in complete pricing transparency with no hidden theatre or consumable surprises.
| Procedure Variant | Cost in Vijayawada (₹) | Cost in Mumbai / Bangalore (₹) | What It Includes |
|---|---|---|---|
| Top surgery (DI-FNG) | ₹2,00,000 – 3,50,000 | ₹1,75,000 – ₹2,75,000 | Surgery, anaesthesia, 1 night stay, drains, vest, 6-week follow-up |
| Top surgery (Periareolar / Keyhole) | ₹1,75,000 – 3,00,000 | ₹3,00,000 – ₹4,50,000 | Surgery, anesthesia, 1 night stay, garment kit, 1-year follow-up |
| Buttonhole top surgery | ₹2,25,000 – 3,75,000 | ₹4,00,000 – ₹6,50,000 | Comprehensive cervicofacial redraping, private suite care |
| Hysterectomy + Oophorectomy | ₹1,50,000 – 2,50,000 | ₹3,00,000 – ₹4,50,000 | Including scrotoplasty if combined |
| Phalloplasty Stage 1 (RFF/ALT/MLD) | ₹4,00,000 – 6,50,000 | ₹10,00,000+ | Flap, microsurgery, 7–10 day stay |
| Phalloplasty Stage 2 (glansplasty, scrotoplasty, vaginectomy) | ₹1,50,000 – 2,50,000 | ₹2,75,000 – ₹3,75,000 | |
| Testicular implants | ₹80,000 – 1,50,000 | ₹1,75,000 – ₹2,75,000 | |
| Penile (erectile) implant | ₹2,50,000 – 4,50,000 | ₹3,75,000 – ₹4,75,000 | Implant + procedure; varies by inflatable vs semi-rigid |
| Full phalloplasty journey (all stages) | ₹8,00,000 – 12,00,000 | 15,00,000+ | Across 12–24 months |
Want a personalized quote for your specific anatomy?
Get My Itemized Quote1. Can I have FTM surgery in India without being on testosterone?
Yes — for top surgery, WPATH SOC 8 does not require prior hormone therapy. Many patients have top surgery before starting T, especially if T isn't accessible yet or they're undecided. For bottom surgery, we strongly recommend at least 12 months of testosterone first — bottom growth from T meaningfully improves metoidioplasty outcomes and contributes useful tissue for phalloplasty planning.
2. What is the minimum age for FTM surgery in India?
18 years for any genital surgery or hysterectomy, per Indian medical and legal standards. Top surgery in carefully selected 17-year-olds with strong family support, clear long-standing dysphoria, and psychiatric clearance is occasionally considered at established centers. We follow a conservative approach — there is no harm in waiting until 18.
3. How long do I need to stay in Vijayawada for FTM surgery?
For top surgery alone — 7 to 10 days total (1 night in hospital, then 5–7 days for drains and first dressing change). For hysterectomy — 4 to 5 days. For Stage 1 phalloplasty — 3 to 4 weeks ideally, as we'd like to see the flap stabilize and the catheter come out under our supervision. We help arrange affordable attached recovery accommodation for outstation and overseas patients.
4. Will my insurance in India cover FTM surgery?
Possibly. The Ayushman Bharat TG Plus scheme covers up to ₹5 lakh per year for transgender persons holding a National Portal ID card. Some private insurers cover hysterectomy and top surgery if classified as medically necessary under gender dysphoria; bottom surgery coverage is rarer. We have a dedicated insurance coordinator who handles the paperwork for you — bring your policy document and TG card to the consultation.
5. Can I get pregnant after FTM surgery?
If you retain your uterus and ovaries (no hysterectomy or oophorectomy), then biologically, yes — pregnancy is theoretically possible, though testosterone usually suppresses ovulation. Once a hysterectomy + oophorectomy is done, a biological pregnancy is no longer possible. If having biological children matters to you, we refer you for egg preservation before any irreversible steps. Adoption and surrogacy remain options at any stage.
6. Will my scars from FTM surgery be visible?
After top surgery — yes, in some technique combinations, but scars typically fade significantly over 12 months, and most patients are comfortable shirtless within a year. With periareolar or keyhole techniques, scars are minimal. With double incision, scars run horizontally and often pass for routine surgical or muscular lines. After phalloplasty, the donor site scar (forearm with RFF, thigh with ALT) is permanent and visible; thigh and back scars are easily hidden under clothing
7. How is bottom surgery (phalloplasty) different from metoidioplasty?
Metoidioplasty uses the testosterone-enlarged clitoral tissue to create a small phallus (4–7 cm) with full natural sensation, faster recovery, lower cost, and natural erection — but generally without penetrative ability. Phalloplasty constructs a full-sized neophallus (12–16 cm) from a tissue flap (forearm, thigh, or back), with the option of urethral lengthening for standing urination and a penile implant for penetrative sex, but is done in stages over 12–24 months with higher complication rates. There's no "better" — there's only what fits your body, your priorities, and your life
8. What if I'm coming from outside India for FTM surgery in Vijayawada?
We routinely treat patients from the US, UK, Australia, the Gulf, and Southeast Asia. We provide a complete medical visa support letter, airport pickup, accommodation coordination, and a dedicated international patient coordinator who speaks English, Telugu, Hindi, and basic Arabic. Many overseas patients do a single trip for top surgery (10 days) and a longer trip for phalloplasty Stage 1 (3–4 weeks). Email us your scans, history, and dates — we plan everything before you board the flight
9. Is FTM surgery reversible?
Top surgery is essentially irreversible — chest tissue removal is permanent. Hysterectomy and oophorectomy are permanent. Bottom surgery is permanent. This is why our pre-operative process is deliberate, multi-visit, and counselor-supported. We want you to be certain. Patients who undergo proper screening have regret rates of 1–2% globally, among the lowest of any major surgery.
10. Why should I choose Pratap Hospital Vijayawada over a Mumbai or Bangkok clinic?
Three answers, in order: First — Dr Pratap is MCh-trained at Safdarjung Hospital, Delhi (All India 2nd rank), with 15+ years of operating experience, including microsurgical work that phalloplasty demands. Second — Pratap Hospital is Andhra Pradesh's only Central Government–approved Gender Affirmation Surgery centre, which is an institutional recognition you don't find in most private clinics. Third — you get metro-grade results at 40–60% of metro prices, in your own state, in a culturally familiar setting, with no language barrier and full privacy. The surgeons running gender practices in some metros are Dr Pratap's former students.
"At 52, I hated how my neck looked in photos at family functions. Dr. Pratap performed a neck lift and lipo. The result looks completely natural — friends tell me I look refreshed and energetic."
