Surgical changes to your body are permanent, expensive and sometimes painful. This is why surgical reassignment is not usually started until 12 months of hormonal treatment has been completed. This gives you time to be SURE that the decision to change is right for you.
Sex reassignment surgery in male to female transsexuals usually involves removing the testicles and using the scrotum to line a new vagina-like opening and labia. The penis is inverted and some of the tissue is used to create a clitoris. The nerve endings in the penis are still intact so orgasm is often still possible. Other surgery is also possible, including breast implants.
In female to male surgery the first step is the removal of the breasts and repositioning of the nipples. This is followed by the removal of the female reproductive organs. Unfortunately there is still no effective way to create a fully functioning penis.
Surgical breast implants, liquid- or gel-filled bags which are inserted in a pocket created under the breast skin, are used by some transgender women to help improve the breast development they have achieved with hormones. Some transsexual women feel that breast implants help make their bodies look more in proportion, make them look or feel more sexually desirable and make their clothes fit better. Multiple surgeries may be required though and the implants never look and feel exactly like ‘real’ breasts. The long term risks from breast implants are not yet fully known and they can deteriorate and break.
Some transgender women use injectable silicone to give them “breasts. The silicone, which is often not medical quality, is usually administered by non-medical persons using shared needles (with the associated risk of contracting Hepatitis or HIV), may cause disfigurement years later. Do not be tempted to take this ‘short-cut’ to a new body as you may regret it later and suffer serious health issues.