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

For details about the FTM surgery procedures offered by Dr. Crane and Dr. Satterwhite 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 and Dr. Satterwhite perform both the double incision and keyhole surgical procedures.  For double incision patients, Dr. Crane and Dr. Satterwhite do not use drains.  This is safely accomplished 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 and Dr. Satterwhite’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: Brownstein & Crane Surgical Services 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: Dr. Crane and Dr. Satterwhite are two of the few trans surgeons that are currently accepting insurance. Due to the high volume of requests, we find it necessary that you provide our office with a copy of the front and back of your insurance card along with the letters of recommendation required by your specific insurance company prior to scheduling surgery. Our office will verify if your insurance plan includes trans benefits and we will submit your letters of recommendation along with a letter from your surgeon to your health plan.

Our office does not currently accept Medicare and if the surgeons are out of network with your insurance plan you may be responsible for the surgeon’s fee prior to surgery. Our office will always submit for prior authorization in order to try and obtain reimbursement for patients postoperatively.

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 and Dr. Satterwhite, please contact us.