Skip to content

Metoidioplasty Procedures

Centurion Metoidioplasty

Centurion MetoidioplastyCenturion Metoidioplasty is a variation of Metoidioplasty that was developed by Dr. Peter Raphael and first performed in 2002. The technique differs in that it uses the round ligaments that run along the sides of the labia to provide extra girth by bringing them together along the shaft of the neo phallus.

Centurion results in a natural-looking though small penis that retains full sensation. Centurion penises get erect without need of an implant or device but tend to be too small for penetrative sex. Because native tissues are used, the procedure doesn't require skin grafts from other parts of the body, which leave visible scars.

Centurion typically includes vaginectomy, urethroplasty, scrotoplasty and placement of testicular implants, as well as hysterectomy if this has not already been performed. Together, operating time is about 4 hours. Without hysterectomy, operating time is about 3 hours.

The urethral extension runs to the tip of the neo phallus and is formed by joining skin flaps around a catheter along the underside of the phallus.

Rotating the round ligaments leaves a hollowed out area for the testicular implants, and the scrotum is fused to create a single sac.

Recovery from Centurion Metoidioplasty

A Foley catheter is left in place for about 2-4 weeks, until the new urethral extension has healed. Revisions at a later date may be required to improve aesthetics or functionality or to fix complications. Recovery time is usually 2-4 weeks.

Potential Complications

  • Urethral fistula
  • Urethral stricture
  • Scrotal implant extrusion

Requirements and Eligibility

  • Minimum of 1-2 years on testosterone to maximize growth of neophallus pre-operatively;
  • Good growth of neophallus from testosterone therapy;
  • WPATH Standards of Care: Two referrals from qualified mental health professionals; persistent Gender Dypshoria; capacity to decide about and consent to surgery; good mental health; 1 year of HRT; 1 year of RLE.

Surgeons Offering Centurion Metoidioplasty

  • Dr. Raphael, TX, USA

For more information: