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Bottom surgerymay or may notinclude the creation of a scrotum or the use of testicular implants.
https://myhealth.alberta.ca/health/AfterCareInformation/pages/conditions.aspx
Bottom surgeries
These may include:
Hysterectomy. The uterus (and sometimes ovaries) are removed through a small cut in the belly or through the vagina.
Vaginectomy. The surgeon removes the vagina. Then the surgeon closes the vaginal opening.
Creation of a penis. Options include:
Metoidioplasty. The clitoris is used to form a small penis. Sometimes tissue from another part of the body is also used (skin graft).
Phalloplasty. A skin graft (often from the forearm, belly, or thigh) is used to form an average-sized penis. This often involves more than one surgery, especially if you want a penile implant.