#bottom surgery

(last option was supposed to say “community” but got cut off) Please reblog for larger sample size

So instead here is the process for Radial Forearm Free Flap Phalloplasty as stated by John's Hopkins page on Phalloplasty.

"Stage 1: The first stage of an RFFF approach is creating the penis using tissue from the forearm. The area where the forearm tissue is taken will require a skin graft. This may occur at the time of the initial phalloplasty surgery, or it may occur three to five weeks afterward. If it occurs later, patients will have a temporary skin covering over the forearm to help it heal.

Stage 2: The second stage, scheduled about five to six months later, may include lengthening the urethra to allow for urination out of the tip of the penis, creating the scrotum and removing the vagina, and other procedures depending on the patient’s individualized plan.

Stage 3: The third stage of surgery involves putting in place testicle implants and an erectile device to help the patient achieve an erection. The third stage typically takes place 12 months after the second."

Source: John's Hopkins

If you want to know more about phalloplasty in general you should visit the John's Hopkins page on Phalloplasty linked in this post. They discuss anterolateral thigh flap phalloplasty (ALT) as well as musculocutaneous latissimus dorsi skin flap (MLD) phalloplasty. They will also tell you about things like suprapubic tubes which are part of the process.

One thing it does not discuss are the different erectile devices and prosthetics that are available so I will discuss them here. Keep in mind these devices are only FDA approved for erectile dysfunction and not for phalloplasty and there is a chance of rejection by your body. With that said you have a two main category options for penile prosthetics. As stated by Gender Aid on their page about phalloplasty and implants:

"There are two types of devices: ‘Flexible’ erectile devices. This prosthetic device is also called 'semi-rigid' or 'inflatable'. It consists of a rod that can be bent into the desired position. It can be straightened and bent, manually. If you would also like to have prosthetic testicles, these must be placed, separately. This type of erectile device is easy to use and lasts a long time. A disadvantage is that the penis is always slightly hard, which can be more difficult to hide, for example in tight trousers or swimming trunks. This type of prosthetic also involves continuous tension on the skin, which increases the risk of the device protruding through the skin. Hydraulic erectile devices. These devices require a small balloon to be placed in the lower abdomen, which contains a fluid, and a pump that is placed in the scrotum. Squeezing the scrotum makes the penis hard. By pressing on the tip of the pump the prosthetics deflate again, bringing the penis back a flaccid state. The pump is also a filling for the scrotum. If you also want prosthetic testicles, you will only require one testicle to be placed. This type of erectile device can simulate both a flaccid and hard state. In addition, it reduces the tension on the skin and therefore also decreases the likelihood of the device protruding through the skin."

Source: Gender Aid

I highly recommend checking out Gender Aid's page on this because it also goes over the possible complications which are important to know about. They also discuss the operation and the aftercare. They cover surgeries primarily for those starting with a vagina so unfortunately this is not a resource for other kinds of bottom surgery.

The vaginal canal, labia, and other reproductive structures are left as they are. This means patients can still experience penetrative intercourse through the vagina. Also because the clitoral structure is maintained the patient still has full feeling in their clitoris. Usually the clitoris is still too small for penetration to be achieved with it.

This surgery may be done on its own or be used as a sort of stepping stone for other procedures. These can include: scrotoplasty, full metoidioplasty, ureathral lengthening, or even Phalloplasty. It may also be paired with a vaginectomy in which is a surgery to remove part or all of the vagina.

"Recovery from Simple Release is typically short and straightforward. Most patients are able to return home the same day of surgery, with swelling and soreness resolving within a few days. There is no catheter required, and most people can resume light daily activities within 1 to 2 weeks. Sexual activity is usually safe after 4 to 6 weeks, depending on the pace of individual healing. Because no grafts, implants, or urethral work are involved, the overall healing time is much shorter and easier than with more complex genital surgeries."

Source: Metoidioplasty.net

I highly recommend checking out that source for more information on metoidioplasty in general, not just simple release metoidioplasty. I hope this post encourages you to look into what options are available to you because there may be more than you thought. Obviously this post isn't proper medical advice and you should always discuss your health and personal transition goals with a healthcare professional.