Clitoroplasty

Clitoroplasty is a surgical operation, which is done to reform, cut down or recreates the clitoris. It is widely performed on those with congenital adrenal hyperplasia (CAH) resulting in clitoral enlargement, gender-affirming surgery in transgender people (masculinizing or feminizing situations), or posttraumatic or complication of female genital cutting (FGM) or other medical reasons. The objective is to bring about normal appearance, functionality, and sensation.

Clitoroplasty surgery

Clitoroplasty surgery is the surgery done to re-shape, decrease, reconstruct or make better the clitoris without loss of sensation and function. It is usually performed on people with clitoral enlargement (CAH), intersex cases, gender affirming requests, cases of trauma, or following female genital cutting (FGM). This is aimed at attaining natural look, preserving sexual sensation and enhancing physical and psychological comfort.

Types of Clitoroplasty Surgery

Feminized Clitoroplasty (Reduction of Clitoral Size)

Performed to remove clitoris enlargement because of:

• Congenital adrenal hyperplasia 
• Intersex variations
• Cosmetic concerns

Focus:

• Reduce size
• Preserve nerve supply
• Rebuild natural structure.

Masculinizing Clitoroplasty (Clitoral Lengthening - a part of Metoidioplasty)

• Done on transgender men as part of bottom surgery.

Focus:

• Release clitoral ligaments
• Lengthen clitoris
• Form a small phallic object.
• Lengthen urethra optionally.

Post-FGM/Trauma Reconstructive Clitoroplasty

Conducted on behalf of people with:

• Female genital mutilation
• Trauma injuries
• Scar tissue formation

Focus:

• Remove scar tissue
• Restore clitoral structure
• Improve sensation
• Enhance sex and psycho-emotional health.

Benefits of Clitoroplasty

• Better cosmetic appearance.
• Sense preservation and improvement.
• Lessening of pain or suffering.
• Improved sexual function
• Wellbeing and psychological confidence.
• Treatment of deformities of congenital or trauma origin.

Clitoroplasty procedure

Clitoroplasty is surgery to decrease, restructure or lengthen the clitoris and maintain nerve activity and sex sensation. The procedure needed depends on whether the nature is feminizing, masculinizing or reconstructive. 

Preparation

• Preoperative Work-up: Laboratory evaluation, imaging as indicated, and medical clearance
• Anaesthesia: General anaesthesia or Local anaesthesia with sedation may be used for some cases
• Position: The patient is placed in the lithotomy, or supine, position. 
• Genital area antiseptic cleaning.

Feminizing Clitoroplasty (Clitoral reduction)

Used in congenital adrenal hyperplasia (CAH) or clitoral hypertrophy: 

• Uncovering of clitoris by using a soft pull-down of the clitoral hood.
• Localization of neurovascular bundle to avoid loss of sensation.
• Atrophy of the erectile tissue (partial excision of the corporal tissue)
• Restoring the size of the clitoral glans to a normal size
• Urethra repositioning the clitoral hood to cover glans.
• Fine absorbable suture with closure.

Masculinizing Clitoroplasty (Clitoral Lengthening – in Transgender Men)

Carried out as a metoidioplastic procedure:

• Release of the suspensory ligament to lengthen clitoris.
• Releasing tissue around to maximally protrude.
• Straightening the clitoris
• Standing urination with optional urethral lengthening.
• Shaping into a small phallus
• Suturing and dressing

Reconstructive Clitoroplasty (Post-FGM/Trauma)

• Incision over scar tissue
• Lysis of adhesions and fibrotic tissue.
• Detection of available clitoral tissue.
• Rebuilding of clitoral glans.
• Remodelling of tissue around it.
• Closure and dressing

Postoperative Care

• Dressing: To avoid infection and preserve tissues.
• Pain management: Analgesics (oral or IV).
• Hygiene: Clean and dry environment.
• Activity restriction: 2-4 week of no exertion.
• Follow-up: To observe progress and to remove sutures, as indicated. Once weekly. 

Duration

• Surgery: 1-3 hours depending on difficulty.
• Hospitalization: Day or night.

Recovery

• Swelling & mild pain for 1–2 weeks
• Most daily activities: 1–2 weeks
• Sexual activity: 6–12 weeks
• Full healing: up to 3 months

Factors Affecting Clitoroplasty cost

The price of clitoroplasty surgery is subject to very wide variations based upon a number of medical, surgical, and logistic factors. Some of the key determinants are given below:

Type of Clitoroplasty

• Feminization Clitoroplasty (Reduction): It is not as involved, and is usually done when it is congenital or cosmetic.
• Masculinizing Clitoroplasty (Lengthening/Metoidioplasty): More complex, especially if urethral lengthening is being done. 
• Reconstructive Clitoroplasty (Post-FGM/Trauma): This depends on the amount of scar tissue and scale of reconstruction.
• More complicated operations tend to be more expensive as there is a longer surgery and specialized methods.

Surgeon’s Expertise

• Specialist surgeons in genital reconstruction or gender-affirming surgery are more expensive.
• The quality of its results and cost is affected by the surgeon's experience. 

Hospital or Clinic

• Metro cities have top-tier hospitals that are usually expensive.
• Hospitals that are expected to be more expensive are those that have specialized facilities.
• Location is a factor affecting anaesthesia, ICU and room charges.

Anaesthesia & Operating Room Charges

• General anaesthesia is the norm; in some cases the local anaesthesia + sedation can be applied.
• The costs of operating rooms are equipment, instruments, and surgical staff charges.

Preoperative Investigations

• Blood tests, imaging (ultrasound, MRI in complicated cases)
• Hormonal tests whether CAH or intersex exists.
• The total cost is increased by preoperative assessment charges.

Combined Procedures

Clitoroplasty is occasionally used together with:

• Labiaplasty
• Vaginoplasty
• Phalloplasty or Metoidioplasty.
• Blended processes play a very big role in adding cost.

Postoperative Care

• Stay at hospital, drugs, and dressings.
• Follow-ups, suture extraction, and complications.
• Physical therapy or sexual counselling (where necessary).

Geographic Location

• The prices are city and country-specific:
• It is usually more expensive in big cities like. 
• For small towns or rural areas, lower fees might be offered. 

Best hospital for clitoroplasty India

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Conclusion

Clitoroplasty is a specialized, effective and safe surgical operation that is aimed at reshaping, reducing, reconstructing or lengthening the clitoris and maintaining the nerve functions and sexual sensation. It is commonly performed for:

• Feminizing reasons (reduction of the clitoris due to congenital reasons)
• Masculinizing (transgender males lengthening of their clitoris to males)
• Reconstructive (after traumas or after genital mutilation or after genital mutilation restoration) purposes.

The nerve-sparing methods of today are such that sexual function, sensation and aesthetic appearance are maintained. The success will be based on expert skills of the surgeon, hospital facilities, and patient-related factors. When carefully planned preoperative, operative and postoperative treatment, clitoroplasty has the potential to greatly enhance physical comfort, sexual functioning and psychological well-being, so it makes it a very effective procedure in the case of eligible patients.

Clitoroplasty surgery India GetWellGo

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• Complete transparency
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• Language Support
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• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
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FAQ

Is operative treatment painful?

• The procedure is performed under anaesthesia and hence there is no pain during the procedure. The patient can have mild to moderate pain and swelling after the surgery which is treatable. 

Will there be an impact of clitoroplasty on sexual sensation?

• The point of nerve-sparing techniques in modern times is to save sensation. Some of them can cause temporary numbness, and the majority of patients have normal sexual functioning.

Is the surgery reversible?

• Plastic surgery is irreversible.
• Reconstructive surgery enhances the appearance and functionality yet it is not able to replace the original tissue completely.

What is the duration of the operation?

• 1-3 hours, according to the complexity and type of clitoroplasty.