What is Scrotoplasty?

Scrotoplasty is a surgery to repair or create a scrotum. Some transsexual men, intersex and non-binary people designated female at birth may choose to have this surgery to create a scrotum as part of their transition. It can be used to repair a damaged or defective scrotum and is also commonly performed as a way to create a scrotum as part of gender reassignment surgery. It is possible to create a scrotum and keep the vagina, and there are trans people who have done that.


1. Why have a scrotoplasty?

2. Procedure

3. Benefits of scrotoplasty

4. complications

5. Cost

Why have a scrotoplasty?

The reason a man often has this surgery is the sagging of the scrotum. This produces physical discomfort that is usually manifested when performing certain physical activities such as sports or even during sexual intercourse. It is also usually carried out for aesthetic reasons. It seeks to achieve a more homogeneous proportion of the different parts of the body.


Normally, when a man or trans transmasculine person has a scrotoplasty the labia majora (the labia of the vulva ) are dissected and joined to form hollow cavities in an approximation of a scrotum.

If there isn’t enough skin to make a scrotum, the surgeon can use some kind of tissue expansion before the operation. This can be done by placing expanders under the skin. Over the course of a few months, more salt water ( saline ) will occasionally be added to the expanders through an external port. This helps to expand the skin and grow more skin. Each expansion procedure is done on an outpatient visit to the hospital. The patient does not need to stay overnight in the hospital, but will have to stay close to the hospital and return several times. 

Subsequently, silicone prosthetic testicles can be placed. They can be inserted through small cuts to fill the new scrotum. If expanders were used, they are no longer needed at this point. The skin is then closed around the artificial testicles. Artificial testicles only give shape and do not create semen, sperm or hormones. With current technology, it’s still not possible to create testicles that do.

Before and after Scrotoplasty

Once the patient has been examined and diagnosed, the necessary tests are carried out to verify that the intervention can be carried out safely. A complete blood analysis where more than 40 different parameters are studied, including hemogram and blood coagulation. An electrocardiogram is also done, which evaluates the state of the heart. Finally, a pre-anesthetic test is carried out to guarantee the tolerance of this by the patient.

The patient and the doctor will decide how much scrotal bag is to be removed to ensure maximum functionality and aesthetics after treatment.

After the intervention, the patient may experience some inflammation in the operated area and especially in the wound. The doctor may prescribe some medicine to reduce this inflammation and the pain that the wound may be causing. It is important that the patient maintain exhaustive hygiene in the genital area for proper healing and avoid infections.

During the first days, just after the treatment, it is advisable to use briefs so that the support is greater. Normally, between 4 and 6 weeks after the intervention, the aches and pains disappear. This period is usually enough to resume sexual activity. Sensitivity is not lost in the genital area so sexual intercourse should be just as satisfactory for the patient.

Read also: Thoracotomy-Indications, procedures and contraindications

Benefits of Scrotoplasty

This type of treatment usually brings great benefits to the self-esteem of patients and improves health in some aspects. They can also increase the satisfaction of sexual intercourse. Here are some of the benefits of Scrotoplasty:

  • Increased functionality
  • Elimination of discomfort or feeling of heaviness
  • Facilitates body hygiene
  • Aesthetic improvement
  • Increased satisfaction with sexual intercourse.
  • Increased self-esteem


As with any surgery, there are risks involved in scrotoplasty. Typically, the risks for this procedure are relatively small. Major concerns include an adverse reaction to the anesthetic or excessive bleeding. In rare cases, implants can be extruded from the body. The known complications of scrotoplasty deal primarily with testicular implants. If they are too large, there is a chance that the implants could be uncomfortable or be the cause of chronic pain. Another complication is that the implant can corrode the skin of the scrotum. This can cause infection or an unwanted hole (a fistula ) where the implant can exit the body.

Other complications are those typical of any surgery, such as blood loss, infection or problems with anesthesia. There is also the possibility that the patient will be dissatisfied with the results of the procedure.


Scrotoplasty for a trans male or trans male person typically costs around $3,000 to $5,000. These costs may be covered by the health plan, although the patient must communicate extensively with their insurance to be sure this will happen.

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