Figure 1.

Belgrade metoidioplasty technique. (A) Preoperative appearance. Clitoris is hormonally enlarged. (B) Clitoral ligaments are completely divided up to the bone attachment enabling maximal lengthening of the clitoris. (C) The short urethral plate is divided, and the gap between the two parts is filled with buccal mucosa graft. A fasciocutaneous flap is harvested from the left labia minora, to be joined with the buccal mucosa graft. (D) A neourethra is formed by combining the vascularized genital flaps with the buccal mucosa graft. All suture lines are covered with well-vascularized tissue.