In the first stage, penis and testis excision, urethral transfer and artificial vaginoplasty should be carried out at the same time, which is also the key to the success of male-to-female transsexual surgery. The operation steps are: (1) suprapubic cystostomy, sterile urine bag and catheterization. ⑵ Skin flap formation. ⑶ Excision of testis and epididymis. (4) urethral reduction. 5] Preserve nerves and blood vessels and reconstruct clitoris. [6] Cavernectomy. Once the vagina is reconstructed. (8) Reconstruction and shaping of female vulva. Levies iodoform gauze strips are filled in the vagina, and the dressing in the operation area is shaped and bandaged.

The second operation is breast augmentation, and the general doctor will implant it with silicone prosthesis. Transgender people, with less breast tissue and big breasts, generally choose a larger breast prosthesis. The incision was designed in the anterior axillary fold to cover the postoperative scar. Prosthesis can be implanted under pectoralis major muscle, and the surgical steps are obviously different from those of female breast augmentation.

The third stage operation is the operation of feminizing facial contour. Men's faces lack femininity of women. Doctors can make overall design according to the specific situation of patients' faces, and then carry out feminine operations such as forehead plastic surgery, nose plastic surgery, chin plastic surgery and cheekbone and cheek plastic surgery step by step.

Finally, in the fourth stage of the operation, thyroid cartilage volume reduction plasty is performed, that is, an incision is designed at the lateral skin of the patient's jaw floor and neck, which is separated under the skin. After the thyroid cartilage is fully exposed, the most prominent part of the wing plate of the thyroid cartilage on both sides (that is, the Adam's apple) is exposed, which is removed and sutured in layers.