What is the difference between phalloplasty and metoidioplasty?
Metoidioplasty releases and reshapes the clitoris, which has grown on testosterone, into a small penis. Phalloplasty builds a larger penis from a skin flap, usually taken from the forearm or thigh. Metoidioplasty is generally a smaller operation with a shorter recovery; phalloplasty usually involves several stages and more possible complications.
Is phalloplasty done in one operation?
Usually not. Phalloplasty is normally carried out in two or more stages, months apart, so each stage can heal before the next. Later stages may include urethral work, shaping the tip of the penis and, if wanted, erectile or testicular implants. Your surgeon will confirm how many stages and trips your plan involves.
Can I have FTM bottom surgery in Turkey from the UK?
Yes. Our licensed agency helps trans men and non-binary people from the UK, Europe and the USA plan phalloplasty or metoidioplasty with partner plastic surgeons in Istanbul. We arrange a free online consultation, a written quote, your hotel, transfers and interpreter support, then stay in touch after you return home.
What are phalloplasty and metoidioplasty?
Phalloplasty and metoidioplasty are the two main types of FTM bottom surgery. Both aim to create a penis that feels right to you, and both can be combined with related procedures such as lengthening the urethra so you can pass urine standing up, creating a scrotum (scrotoplasty) or removing the vagina (vaginectomy). Not everyone wants every step.
Operations are performed by experienced partner plastic surgeons in Istanbul. Neda Deniz Health Tourism Agency Ltd. is authorised by the Turkish Ministry of Health. Our team coordinates your care from the first message to aftercare. You can find chest, facial and voice options on our female to male surgeries page.
Who is FTM bottom surgery for?
The NHS lists surgery as one of the treatments adults with gender incongruence may choose. The WPATH Standards of Care, Version 8 (SOC8) describe general criteria surgeons use for genital surgery, including:
- an assessment by a qualified health professional confirming marked and sustained gender incongruence;
- the capacity to give informed consent;
- any other physical or mental health conditions being reasonably well managed;
- a period of stable hormone therapy before surgery, unless hormones are not wanted or not medically suitable.
Requirements differ between surgeons. Many ask for around 12 months of testosterone, which matters especially for metoidioplasty because it relies on clitoral growth. Some surgeons also ask for a hysterectomy before or alongside certain stages, and permanent hair removal on the donor site before phalloplasty. We confirm exactly what your surgeon needs during your free consultation.
Phalloplasty techniques
- Radial forearm free flap (RFF). Skin, fat, blood vessels and a nerve are taken from the inner forearm and connected at the groin using microsurgery. This flap is thin and flexible, which helps when building a urethra inside the penis. It leaves a visible scar on the forearm, which is covered with a skin graft.
- Anterolateral thigh flap (ALT). Tissue is taken from the outer thigh. The forearm is left untouched, but the flap may be thicker depending on your body, and sensation and urethral options differ.
Metoidioplasty techniques
- Simple metoidioplasty releases the ligament holding the clitoris in place so it sits further forward and appears longer. The urethra is not changed.
- Extended (full) metoidioplasty adds urethral lengthening so you may be able to pass urine standing up, and is often combined with scrotoplasty and vaginectomy.
Phalloplasty vs metoidioplasty
| Compared | Metoidioplasty | Phalloplasty |
|---|---|---|
| Tissue used | Your own clitoral tissue, enlarged by testosterone | A skin flap from the forearm (RFF) or thigh (ALT) |
| Size | Smaller; depends on clitoral growth | Larger; planned with your surgeon |
| Number of operations | Often one, sometimes a second | Usually two or more stages |
| Standing to urinate | Possible with urethral lengthening | Possible with urethral lengthening |
| Penetrative sex | Usually not possible | Possible with an erectile implant at a later stage |
| Sensation | Erogenous sensation usually kept | Depends on nerve connection; develops over months |
| Donor-site scar | None | Forearm or thigh scar |
Some people start with metoidioplasty and decide on phalloplasty later. If that might be your path, tell your surgeon early, because it can affect how the first operation is planned.
Your journey with Neda Agency
- First message. Contact us on WhatsApp or through our form, and we answer your questions honestly.
- Free online consultation. We share your medical history, hormone and assessment documents with a partner surgeon, who reviews your suitability and options.
- Written quote. You receive a written quote setting out each stage and what is included.
- Planning your trip. We book your hotel and arrange airport, hotel and hospital transfers, with interpreter support.
- In Istanbul. Pre-operative tests, meeting your surgeon, surgery, your hospital stay and check-ups.
- Flying home. Your surgeon confirms when it is safe to fly.
- Aftercare and next stages. We stay in touch at home and help plan any further stage.
Phalloplasty usually means more than one trip to Istanbul, while metoidioplasty is often completed in one or two operations. There is no fixed number of days for either: your surgeon will confirm your stay and the gap between stages.
Recovery and possible risks
As a general guide, lower surgery takes around six to twelve weeks before most people return to normal routines, and full healing takes longer, especially across several phalloplasty stages. You will usually have a catheter for a period after surgery, need to rest, and avoid heavy lifting and exercise. After phalloplasty, the donor site on your arm or thigh also needs care.
FTM bottom surgery is complex, and clinical sources describe complications such as:
- urethral problems, including narrowing (stricture), a leak or opening along the urethra (fistula), dribbling or urinary tract infections;
- bleeding, infection or wound-healing problems;
- in phalloplasty, partial or total loss of the flap if its blood supply fails, and donor-site scarring or stiffness;
- problems with implants, if used, which may need replacing over time;
- results that need further surgery to refine.
Urethral complications are more common after urethral lengthening and are often treatable, sometimes with another operation. Your surgeon will explain your individual risks before you consent.
How much does phalloplasty or metoidioplasty cost in Turkey?
Prices depend on technique and stages; contact us for an itemised quote. For phalloplasty, ask for every stage to be priced separately so you can see the full picture. When you compare quotes, check that each one itemises:
- surgeon’s and anaesthetist’s fees for each stage;
- hospital stay, nursing care and medication;
- pre-operative blood tests and checks;
- catheter supplies and dressings;
- hotel accommodation during recovery;
- airport, hotel and hospital transfers;
- interpreter support and check-ups in Istanbul;
- remote follow-up after you return home.
Our surgery cost guide explains how to compare quotes line by line; it focuses on top surgery, but the same checklist applies here.
Why patients choose Turkey
Patients often choose Turkey for surgeons experienced in gender-affirming procedures, hospitals working to Ministry of Health standards, and costs that are often lower than private treatment at home because of exchange rates. One team organising transfers, accommodation and translation matters even more when a plan involves several trips. See our overview of transgender surgery in Turkey or read Neda’s story.
Phalloplasty and metoidioplasty: frequently asked questions
Can I have metoidioplasty without testosterone?
It is uncommon, because metoidioplasty relies on clitoral growth from testosterone. Requirements differ between surgeons, and we confirm yours during the consultation.
Will I be able to urinate standing up?
Possibly, if urethral lengthening is part of your surgery. It is one of the most common goals, but it also carries most of the urinary risks, so discuss it carefully with your surgeon.
Can I have phalloplasty after metoidioplasty?
Yes, many surgeons offer this. Mention it early so your first operation can be planned with it in mind.
Do I need top surgery first?
No, but many patients start with top surgery. The order of your surgeries is a personal and medical decision made with your surgeon.
Talk to us about FTM bottom surgery
Neda is a patient advisor, not a surgeon. Neda shares lived experience and coordinates your journey, but all medical decisions, including eligibility, technique, the number of stages and how long you stay, are made by your surgeon. The information on this page is general and does not replace medical advice.
If you are considering phalloplasty or metoidioplasty in Turkey, book a free online consultation or message us on WhatsApp using the button on this page, or reach us through our contact page.
Sources
- NHS – Gender dysphoria and incongruence
- WPATH – Standards of Care for the Health of Transgender and Gender Diverse People, Version 8
- HealthTürkiye – official health tourism portal of the Republic of Türkiye Ministry of Health
- Cleveland Clinic – Phalloplasty: procedure, risks, benefits and recovery
- ECU Health – Metoidioplasty: surgery and aftercare