Sex reassignment surgery SRS is often completed to give males a female appearance. This is known as male to female, MTF, or M2F sex reassignment surgery. The central focus of the entire process is the reassignment of the male genitalia. The testicles are removed and the skin of the penis is used to form a vagina. In addition to the reassignment surgery the patient may choose to have other procedures to further enhance the transformation process. Facial feminization surgery is a cosmetic procedure where the jaw, the brow, and other facial features are modified to look more feminine. Breast implants are completed as a part of most sex reassignment surgeries. Hormone therapy enlarges the breasts to a certain extent but the majority of patients prefer a larger chest area. Voice feminization can also be accomplished through surgery. This surgery alters the patient's vocal cords and results in a more feminine pitch and range.