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bottom surgery

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Bottom Surgery

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Urethral Lengthening

Bottom Surgery

    Bottom Surgery: Healed

    Vuvloplasty Healed

    Vuvloplasty Healed

    Vaginoplasty Peritoneal Pull Through Healed

    Vaginoplasty Peritoneal Pull Through Healed

    Peritoneal Pull Through Ports Healed

    Peritoneal Pull Through Ports Healed

    Abdominal Flap Phalloplasty and Donor Site Healed

    Abdominal Flap Phalloplasty and Donor Site Healed

    Radial Forearm Flap Phalloplasty Healed

    Radial Forearm Flap Phalloplasty Healed

    Radial Forearm Flap Donor Site (forearm) healed

    Radial Forearm Flap Phalloplasty Donor Site healed

    Anterolateral Thigh Flap Phalloplasty and Donor Site Healed

    Anterolateral Thigh Flap Phalloplasty and Donor Site Healed

    These posters are based on the practices and techniques of Dr. Shubham Gupta, Director of the Surgical Gender Affirmation Program at University Hospitals in Cleveland, Ohio. I had the privilege to shadow Dr. Gupta and his team in the operating room for 7 surgeries, and in the office during post-operative follow-up appointments. I documented their practices with detailed sketches and photographs to create the final posters. 


    I observed for 50 + hours in the OR to research this project. 

    urethral lengthening for phalloplasty

    Split-thickness skin

    The split-thickness graft requires a layer of skin from a donor site, like the thigh, and is made into a tube within the phallus. 

    Pedicled labia minora

    The pedicled labia minora flap reconfigures the labia minora to create a tube within the phallus. 

    Vaginal mucosa

    The vaginal mucosa flap takes a portion of the lining of the vagina to create the tube. This is inserted into the future phallus donor site to be harvested in a future surgery. 

    Created for:

    Novel techniques for urethral lengthening as part of gender-affirming phalloplasty 

    By Xu, Alex J.; Tabei, Sajjad Seyed; Khouri, Joseph S.; Mishra, Kirtishri; Chen, Mang; Gupta, Shubham submission to the International Journal of Reconstructive Urology.


    See the publication here: 

    https://journals.lww.com/ijoru/fulltext/2025/07000/novel_techniques_for_urethral_lengthening_as_part.7.as

    Drafting a medical illustration - details coming soon

    Resources that gender diverse friends and I found helpful:

    https://www.uhhospitals.org/services/gender-care-services 


    https://app.wellprept.com/UHGenderCare/condition/vaginoplasty


    https://transcare.ucsf.edu/guidelines/phalloplasty 


    Trans Bodies, Trans Selves by Jennifer Finney Boylan and Laura Erickson-Schroth: https://transreads.org/wp-content/uploads/2021/08/2021

    Masc - specific resources

    Very comprehensive and extensive resource hub (has some graphic photos and illu in some articles): https://www.phallo.net 

    Great specific overview of phalloplasties: https://tau.amegroups.org/article/view/26419/24265

    Postop photos of metoidioplasty (pictures of genitals): https://www.gurecon.com/metoidioplasty-photos



    Fem - specific resources

    Vaginoplasty illustration: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/vaginoplasty-for-gender-affirmation

    Photos of healed vaginoplasties (photos of genitals): https://my.clevelandclinic.org/about/community/lgbt-health/transgender-surgical-services/before-after-photos#vaginoplasty-tab

    Intersex - specific resources

    Coming soon

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