Centurion Metoidioplasty (Dr. Peter Raphael)

[dylantexas90]

I am just looking for anyone who might be able to share their experience, or share any patient built resources as there isn't too much information or active forums about this particular surgeon and procedure. Or if there are, can you point me in that direction? Thanks.

[aleon515]

I could comment but I don't have a ton of info. This is essentially a meta with the use of some other structures to add girth. I saw some pictures but no actual people who had had meta (I saw a bunch of results at Philly trans health). What I saw looked like other metas, no difference whatsoever in length, but it is a girthier phallus. I don't know that the results appealed to me personally but, you know, different strokes. You might get a little extra in length, but I don't know that it would be very much, depending on your anatomy, since it obviously works with what you have. I think Dr Raphael is the ONLY surgeon (perhaps his associates?) who performs this and he should really have the photo comparisons, actually probably where the guy got the photos from (though maybe not).

--Jay

[Bimmer Guy]

Quoted from Hudson's Guide:  http://www.ftmguide.org/grs.html#centurion




Centurion
The Centurion procedure is a unique variation of metoidioplasty that was first performed in 2002 by Dr. Peter Raphael. In the Centurion, the round ligaments (which run along the sides of the labia) are freed from the labia majora and brought together along the shaft of the clitoris to provide girth for the new penis. The extraction of the round ligaments from the labia majora leaves a hollowed-out area which serves as a "pocket" for solid silicone scrotal implants. The labia major are later joined to form a scrotal sac. A urethral extension to the tip of the new penis is formed by joining skin flaps around a catheter that runs along the underside of the clitoris. The catheter remains in place for about two weeks until the new urethral extension has healed.

The typical operating time for the Centurion procedure is about 2.5 hours; if it is also being performed with vaginectomy and hysterectomy/oophorectomy, the time increases to about 4-5 hours. The patient may require additional follow-up procedures and revisions at a later date. Recovery time is usually between 2 to 4 weeks of very limited activity.

Pros, Cons, and Risks
The advantages of the Centurion are that it results in a natural looking (albeit small), erotically sensate penis. Since the clitoris is made of erectile tissue, the patient can achieve an unassisted erection when aroused. The procedure takes advantage of existing genital tissue, and doesn't leave visible scars on other parts of the body.

The disadvantages are that the resulting penis is usually quite small, and as such often cannot be used for penetration. It also may not be a good choice for a trans man whose clitoris has not grown substantially as a result of testosterone therapy (most surgeons recommend being on testosterone therapy for at least 6 months to 2 years in order to maximize growth of the clitoris). And, as with any surgery, there are potential risks of complication, such as the extrusion of testicular implants, the formation of a stricture (an abnormal narrowing; blockage) or fistula (an abnormal connection; leakage) in the newly constructed urethral passage, and potential problems of infection and tissue death (though tissue death is less common in metoidioplasty/Centurion as compared to phalloplasty). One must also consider the usual risks of any surgery, including bleeding, infection, problems from anesthesia, blood clots, or death (rare).

When considering the Centurion or other metoidioplasty procedure, it is important to research the surgical options carefully and discuss them with the surgeons you are considering. Each surgeon has a different approach and technique. Also, if you are unsure if you wish to have additional genital surgery (such as phalloplasty) in the future, discuss with your surgeon which procedures will leave you with the most options for later surgery.

[FriendsCallMeChris]

Dr. Crane, in San Francisco, also does Centurion Metoidioplasty

[aleon515]

The only difference from Hudson's is the girth. Other disadvantages and advantages are identical. Penetration is identical to metas, and some people do penetrate with a meta (of course some people can penetrate pre-surgery). It's not identical to a cis male, normally people who penetrate do it by position and so on.

I didn't know Dr Crane did a Centurion. I don't know if its what he normally does then?

--Jay

[dylantexas90]

Yeah, I heard Dr. Crane and his associates have some similar procedure. I actually had a phone consultation with Dr. Raphael a few weeks ago and he explained the procedure in full. It's definitely something I am considering but might still be a ways off.

[Bimmer Guy]

The only difference from Hudson's is the girth. Other disadvantages and advantages are identical. Penetration is identical to metas, and some people do penetrate with a meta (of course some people can penetrate pre-surgery). It's not identical to a cis male, normally people who penetrate do it by position and so on.

I didn't know Dr Crane did a Centurion. I don't know if its what he normally does then?

--Jay

From Crane's site:

" Dr. Crane is proficient in more than five different types of metoidioplasty reconstructions to best suit the patient's anatomy.  He takes into consideration the size of the clitoral hood, urethral plate, labia minora and labia majora to maximize the aesthetic result"

[aleon515]

Well I've seen 2-3 results of Centurion at Philly which is what I am going on. They may *look* better, but I didn't think that. Of course, Dr Crane does a terrific job, so perhaps I would change my mind on that one. But the Centurion, I believe wraps the extra tissues around the shaft making it girthier.

--Jay

From Crane's site:

" Dr. Crane is proficient in more than five different types of metoidioplasty reconstructions to best suit the patient's anatomy.  He takes into consideration the size of the clitoral hood, urethral plate, labia minora and labia majora to maximize the aesthetic result"

[Mackan]

Wow I just realised that's the procedure I had done, I just didn't know that's what it's called in english. The Surgeon used the inner labia to support the new urethra and make the penis bigger. And the scrotum is a joined scrotum and hangs down from directly under the penis.

You can read my post about my surgery here:

https://www.susans.org/forums/index.php/topic,179808.0.html

[Bimmer Guy]

I liked the look and the concept of the centurion and asked him at consult.  He said he find the surgery to be sub par and does not do them.  I can see him having done them in the pastwhile he was training with other doctors in this type of surgery. 

Crane works from his own creative mind now.  Everybody's junk is different.  he looks to see what approach would create the best product that for particular patient.

I can't wait to have my meta with him!