"The gender affirmation process is one of life's deepest and most respectable turning points, building complete harmony between a person's inner identity and their physical existence. This surgery is not merely a technical operation; it is a reconstructive art that requires microsurgical precision, neurovascular preservation and deep ethical responsibility. Our aim is to help the person step into a safe and healthy future, at peace with their true self."
— Assoc. Prof. Dr. Ozan Balık, Specialist in Plastic, Reconstructive and Aesthetic Surgery
The gender affirmation process is a different journey for everyone. For some people, surgery is an important step that supports harmony between how they express themselves to the outside world and their body. This decision is not made in haste; it requires assessing the person's expectations, health and long-term care needs together.
Within male-to-female genital gender-affirming surgery, one of the most frequently discussed procedures is vulvoplasty and vaginoplasty. In vaginoplasty, in addition to creating the external genital appearance, a vaginal canal can also be created depending on the person's preference and the surgical plan. There are also options in which no canal is created or which involve a more limited genital reconstruction. Which approach is suitable depends on the person's goals, anatomy and medical assessment.
For patients considering this surgery in Istanbul, the process is not just the day of the operation. The pre-operative assessment, accommodation in Turkey, dressing and care support, discharge from hospital, dilation training and follow-up after returning home should be planned together. In our clinic the stay in Turkey is planned as three weeks. It is particularly important that a relative who can help with the patient's care is with them. If the patient has no such companion, a helper must be arranged to accompany them throughout their stay in Turkey.
Gender-affirming surgery options
Although "sex change surgery" is a common expression, today the terms gender-affirming surgery or genital gender-affirming surgery are used more often in communication between patients and physicians. The surgical options described here include creating a vulva and, optionally, reconstructing a vaginal canal, depending on the person's goals.
Vaginoplasty describes the surgical approach in which a vaginal canal is created in addition to the external genital structures. Vulvoplasty, on the other hand, aims to create the external genital appearance and does not include creating a vaginal canal. This distinction should be discussed in detail in the pre-operative consultation with regard to the person's expectations.
There are different surgical methods and possible tissue sources for creating the vaginal canal. Which technique is used is determined by the surgeon's assessment and the patient's anatomical characteristics. This article does not present any particular technique as if it were suitable for every patient. The scope of the operation and the individual surgical approaches used in our clinic should be explained at the examination and consultation.
What is discussed before deciding on surgery?
This operation is an important decision that affects the person's life and long-term care. The consultations cover not only how the operation will be done, but also what result the patient wants and how post-operative care will be maintained.
At the initial assessment, the following topics may be discussed:
- General health and regular medications
- Previous operations and anaesthesia history
- Allergies, smoking or nicotine use
- The patient's expectations and priorities from surgery
- The wish for a vaginal canal and the long-term need for dilation
- Preparations that may be needed before surgery
- Stay in Turkey, companion and dressing support
- Follow-up after returning home and access to local health services
- And most importantly, you need medical documentation from your country showing that you are a suitable candidate for gender-affirming surgery.
In the assessment for gender-affirming surgery, communication with the healthcare team should be open and respectful. The WPATH Standards of Care emphasise the importance of considering the person's health needs, expectations, benefits and risks, and post-operative support together in the surgical assessment.
This information is a general framework. The required documents, assessment criteria and pre-operative preparations are determined by the person's situation and the applicable health procedures. The patient should be told in advance which documents are required and at which stage they should be submitted.
Cinsiyet Değiştirme Ameliyatlarında Geri Dönüş | Cinsiyet Değiştirmede Pişmanlık | Yanlış Cinsiyet
The first step: a free online consultation
For patients considering travelling to Istanbul from abroad, the process can start with a free online consultation. The person's goals, medical history and questions about the surgery are discussed. Photos or videos may be requested for the initial assessment; they do not replace an in-person examination but help with the preliminary consultation.
It is important that the patient feels comfortable in the consultation and can ask every question that might affect their decision. The scope of the operation, whether a vaginal canal will be created, post-operative dilation, companion support and the three-week stay in Turkey can all be discussed in these consultations.
The online consultation is not a definitive approval for surgery or a guarantee of results. The plan is finalised after the in-person examination, tests and the necessary assessments.
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Arriving in Istanbul and pre-operative planning
As the surgical plan progresses, the patient's travel dates, length of stay in Turkey and companion arrangements are discussed. Hotel arrangements to the requested standards and VIP transfers between the airport, clinic and hotel can be planned.
After arrival in Istanbul, an in-person consultation takes place. The medical history, examination findings and the expectations discussed earlier are assessed together. The necessary blood tests and anaesthesia assessment are completed. Suitability for surgery and the surgical plan become clear as a result of these assessments.
Before the operation, the patient is informed about the hospital stay and the care expected after discharge. The dressing routine, personal hygiene, movement, medications and when dilation training will begin are explained according to the surgical plan.
What is the Butterfly Flap technique?
In male-to-female gender-affirming surgery, the "Butterfly Flap" technique is a surgical method described in our clinic. This method has been published in a respected international plastic surgery journal and has attracted attention worldwide. The operation you will have uses this method. With this method, not only a sensate clitoris but also a sensate labia minora can be created. Of course, a moist canal and the ability to reach orgasm are also among the main goals of the surgery we will perform for you. The article is available on PubMed, or you can request it from us.
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The operation and hospital stay
Vaginoplasty and vulvoplasty are procedures performed under general anaesthesia, depending on the scope of surgery. The duration of the operation varies with the chosen surgical approach and individual anatomical characteristics. The hospital stay is about one week, and the time of discharge also depends on the patient's post-operative condition.
After the operation it is important to protect the area, to do the dressings correctly and to understand the care instructions. In these first days, not being left alone and being able to get support with daily care makes recovery easier.
Companion and care support
After genital gender-affirming surgery, support with dressings and personal care may be needed. It is recommended that someone who can accompany the patient and help with the dressings is with them. This person helps the patient learn the care instructions and contact the healthcare team when necessary.
If there is no one with the patient who can provide this support, a helper who can accompany them throughout their stay in Turkey should be arranged. This need should be discussed before travelling; it should not be assumed that the patient will be alone after the operation. The scope of the helper's duties should be agreed in advance, respecting the patient's privacy and care needs. This helper is not needed during the first week, which is spent in hospital, but will be needed once the patient moves to their accommodation, whether a home or a hotel.
Length of stay in Turkey: three weeks
The length of stay in Turkey for this operation is three weeks. This period is set aside for early recovery after hospital, the planned check-ups, dressing and care support, and the assessment before returning home.
Three weeks does not mean that every patient will heal at the same speed. The surgical plan, the patient's clinical condition and the course of recovery can affect the length of stay. If considered necessary, a longer stay or additional check-ups may be planned. Fitness for the journey home is determined not only by the number of days on the calendar but by the patient's post-operative assessment.
When planning flights and accommodation, it is useful to allow for possible changes. Having a changeable return date before the operation can give the patient flexibility if an extra stay is needed.
Dilation and long-term care
After a vaginoplasty in which a vaginal canal is created, dilation can be an important part of surgical care to help maintain the canal's opening and depth. When dilation starts, which dilators are used and how often will be explained to our patient in detail in line with our protocol.
The frequency and duration of dilation can vary with the surgical technique and the patient's healing; so do not use another patient's programme as your own care plan. UCSF patient information also states that dilation schedules can differ between surgeons and that patient-specific instructions should be given. In addition to these dilation exercises, our patient will be given a soft silicone mould to use.
If there is marked pain or unexpected resistance during dilation, the surgical team's instructions should be sought instead of continuing. The patient should be given dilation training, and the necessary materials and follow-up plan should be explained in advance. This is because the most unwanted complication of this operation, rectovaginal fistula, is thought to be associated with incorrect dilation and use of the silicone mould.
In vulvoplasty plans in which no vaginal canal is created, the need for dilation may not apply in the same way. It is therefore important to understand before the operation which method is planned and the long-term care requirements of that method.
When can the first sexual experience take place after gender-affirming vaginoplasty?
After male-to-female gender-affirming surgery, for the skin lining of the vaginal canal to heal completely and the labia to heal fully, a period of two to three months needs to pass before the first sexual experience. However, clitoral sensitivity becomes apparent in the first week after surgery. For this reason, patients may experience masturbation at around the first month, before penetrative intercourse. Of course, since this period runs parallel to your wound healing, any problem with wound healing may delay sexual intercourse. Especially during the periods when dilation and the silicone mould are used, a higher likelihood of damage to the suture line is observed among patients. Of course, separations of the suture lines need to be re-sutured at a suitable time. Irreversible permanent damage is generally not seen.
Follow-up after returning home
Post-operative follow-up does not end with the three-week stay in Turkey. After returning home, it is important to remain in online contact with the surgical team, have the patient's questions answered and monitor recovery. In our clinic we aim to maintain online contact with our patients for at least one year. Although many platforms say short-term dilation is enough, this is generally not correct. Our patients will be advised to use dilation and the soft silicone moulds for a minimum of one year, and even, if they will not have a regular sex life, to do dilation exercises from time to time in the following years.
Follow-up after vaginoplasty can cover wound healing, canal care, dilation, hygiene and returning to daily activities. Situations in which the patient may need support from a health professional in their country of residence should also be discussed before returning. The WPATH Standards of Care emphasise the importance of planning travel, safe accommodation, post-operative resources and follow-up care in advance for gender-affirming surgery.
Information about possible risks
As with any major operation, genital gender-affirming surgery has risks. These can differ according to the person, the surgical technique, health and the course of recovery. The risks and the follow-up plan need to be discussed openly with the surgeon before the operation.
In general, the possibilities of bleeding, infection, wound-healing problems, pain, changes in sensation or the need for further surgery are discussed. Technique-specific issues such as narrowing of the canal after vaginoplasty or difficulty maintaining depth should also be discussed with the patient. It should be emphasised that these possibilities do not mean they will occur in every patient, but that they are part of an informed decision.
If after surgery you develop fever, increasing pain, marked redness, foul-smelling discharge, heavy bleeding, difficulty passing urine or any other unexpected symptom, contact the healthcare team without delay. In an emergency, go to the health service where you are.
Is our surgery covered by health insurance?
Within the health protection programme for international patients, our clinic will arrange your health insurance and complication insurance before you even arrive in Turkey. This way, from before you board your plane until six months after you return to your country, you will be under the protective umbrella of our national health system.
What affects the price of gender-affirming surgery?
The price of gender-affirming surgery varies with the patient and the surgical plan. The scope of the procedure, hospital and anaesthesia conditions, and additional services such as accommodation or transfers can affect the overall plan. When getting a quote, it is useful to ask what is included in the price and how post-operative check-ups are arranged.
When comparing different clinics' prices, do not look only at the figure. Find out in which hospital the operation will be performed, how the surgical plan is made, how follow-up is organised and whom you will contact after returning from abroad. Offering affordable, high-quality care without compromising patient safety is our core principle.
Frequently asked questions
What is the difference between vaginoplasty and vulvoplasty?
Vaginoplasty includes creating a vaginal canal in addition to creating the external genital structures. Vulvoplasty aims to create the external genital appearance; no vaginal canal is created. Which option is suitable depends on the person's goals and the surgical assessment.
Are photos and videos enough before surgery?
No. Photos and videos can help with the online pre-consultation; they do not replace an in-person examination, tests and the necessary assessments.
How long do I need to stay in Turkey?
The length of stay in Turkey for this operation is three weeks. An additional stay may be needed depending on recovery and the clinical assessment.
Do I need someone to come with me?
Because support with dressings and daily care may be needed after surgery, it is important that a companion who can help is with the patient. If there is no such person, a helper should be arranged to accompany you throughout your stay in Turkey.
How long is dilation done for?
Dilation can be an important part of care after operations in which a vaginal canal is created. When it starts and how often it continues depend on the surgeon's protocol. You will be given individual training and a follow-up plan.
Does follow-up continue after I return home?
Yes. Follow-up can continue through online contact. If an unexpected or urgent symptom develops, you need to get medical care where you are.
A personal plan for gender-affirming surgery in Istanbul
Gender-affirming surgery is planned by assessing the person's goals, anatomy, health and long-term care needs together. A free online consultation can help answer your first questions and plan your visit to Istanbul. The surgical plan is then finalised with an in-person examination and the necessary assessments.
A three-week stay in Turkey is planned for post-operative care and check-ups. During this time it is important that a relative who can help with dressings is with the patient; if there is no such person, a helper should be arranged to accompany the patient continuously in Turkey. Online contact and follow-up continue after you return home.
This article is for general information only and is not an individual diagnosis or treatment recommendation. The surgical method, suitability for surgery, recovery and travel plan are determined by examination and the physician's assessment.
"The art of surgery requires deep respect for the limits of human anatomy and careful listening to each patient's unique story. We will be happy to welcome you to Istanbul so that you can safely regain your body's core balance and the shape you desire."
Assoc. Prof. Dr. Ozan Balık Clinic — Levent, Beşiktaş, Istanbul | www.ozanbalik.com
Kadından Erkeğe Cinsiyet Değiştirme Ameliyatı: Abdomino Phalloplasty ( English Subtitle)
Medically reviewed by Assoc. Prof. Dr. Ozan Balık. Last updated: 30 October 2026
The information on this page is for general information only; always consult your doctor for diagnosis and treatment.