An Update on the Surgical Treatment for Transgender Patients.
BACKGROUND
As gender dysphoria is becoming increasingly accepted in the general population, the number of patients seeking gender reassignment surgery is increasing. Although not every patient with gender dysphoria requires surgery, medical practitioners taking care of these individuals should be aware of the different surgical options.


OBJECTIVE
To review current gender reassignment surgical techniques and update the clinician.


METHODS
A review of the literature was performed focusing on the most recent techniques of gender reassignment surgery.


METHODS
Main outcomes included a historical review of gender confirmation surgery leading to the techniques of choice in different divisions. For the vaginal lining, penile-scrotal skin flaps remain the technique of choice, and the gold standard for a phalloplasty remains the radial forearm flap.


RESULTS
Surgical techniques for male-to-female gender reassignment consist of facial feminization surgery, voice surgery, breast augmentation, orchiectomy, and vaginoplasty. Female-to-male gender reassignment surgery includes facial masculinization surgery, subcutaneous mastectomy, and phalloplasty procedures.


CONCLUSIONS
Penile-scrotal skin flaps remain the technique of choice for the vaginal lining, although indications for a vaginoplasty with intestinal transfer are becoming more common. The gold standard for a phalloplasty remains the free radial forearm flap.
Department of Plastic Surgery, Ghent University Hospital, Gent, Belgium.
Britt
B
Colebunders
Department of Plastic Surgery, Ghent University Hospital, Gent, Belgium.
Sam
S
Brondeel
Department of Plastic Surgery, Ghent University Hospital, Gent, Belgium.
Salvatore
S
D'Arpa
Department of Urology, Ghent University Hospital, Gent, Belgium.
Piet
P
Hoebeke
Department of Plastic Surgery, Ghent University Hospital, Gent, Belgium. Electronic address: stan.monstrey@ugent.be.
Stan
S
Monstrey
Gender Dysphoria; Gender Reassignment Surgery; Transsexualism