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FTM Surgery – Female to Male Surgery

Having been trained in urology, reconstructive urology and plastic surgery allows Dr. Crane to understand the complex transformation from female to male from both the urologist and plastic surgeon’s perspective.

Dr. Crane strongly believes in a personalized approach in assisting his patients in achieving their surgical goals.  He has complex one on one discussions with his patients regarding placement of incisions and resultant scarring in the pre-operative consultation.  He gives all his patients his own, personal cell phone number should his patients have any urgent questions during their stay in San Francisco.  By not having to go through an answering service or another doctor on call, patients have reported extremely high satisfaction rates with his care and compassion.

For details about the FTM surgery procedures offered by Dr. Crane in San Francisco, please click the links below.

FTM Top Surgery

Top Surgery is one of the most common female to male gender confirmation surgeries. Dr. Crane performs both the double incision and keyhole surgical procedures.  For double incision patients, Dr. Crane does not use drains.  He safely accomplishes this by leaving an abundance of lymphatic tissue which allows your own body to reabsorb the fluid that the drains would remove.  With the combination of not using drains and performing intercostal nerve blocks with Lidocaine before starting the procedure, Dr. Crane’s patients have a dramatic decrease in their post-operative pain.

FTM Bottom Surgery

Patients may pursue a metoidioplasty (meta) or phalloplasty with or without urethral lengthening. Dr. Crane does perform his own vaginectomy, completely, and there is no drainage hole so the perineum is that of a male.

Dr. Crane works with several gynecologists in the Bay area that are proficient at laparoscopic hysterectomy for trans men.


Metoidioplasty is a “FTM bottom surgery” procedure that creates a phallus from the hormonally-enlarged clitoris. Urethroplasty, vaginectomy, and scrotoplasty are optional.

FTM Phalloplasty

Free flap phalloplasty techniques offer optimal sensation, and include radial forearm, anterior lateral thigh (ALT) and musculocutaneous latissimus dorsi (MLD) phalloplasty. Urethral lengthening, vaginectomy, scrotoplasty and penile implant placement are optional.

For genital reconstruction, Dr. Crane does follow the World Professional Association of Transgendered Health (WPATH) guidelines and requires two letters of recommendation from mental health professionals, hormonal treatment and a year real-life test.  Some exceptions are made for patients that transitioned years beforehand and have had legal documents changed reflecting their true gender.

Payment: Dr. Crane does accept major credit cards, however there is a 3% fee for their use. Care Credit is a financing company that the office also accepts. Information about Care Credit can be found at www.carecredit.com.

Insurance: If your insurance does not have any trans exclusions, the office is happy to submit a letter on your behalf to your insurance company after receiving all pertinent information regarding your transition and your letters of recommendation. Dr. Crane is one of the few trans surgeons that is accepting insurance and due to the high volume of requests, we find it necessary to have patients first schedule a surgery date.  Once insurance reimburses Dr. Crane, half of your scheduling fee will be reimbursed if your insurance has covered the entire balance.  The remainder is used to cover the costs of working with your insurance.

The scheduling fee for meta is $1000.  The phalloplasty scheduling fee is $2000.


For more information about having female to male (FTM) surgery in San Francisco with Dr. Crane, please contact us.