Phalloplasty surgery

For some trans men, phalloplasty is a natural and essential step, while for others, it may be an unnecessary procedure. As a result, each trans person must make personal decisions that best suit their individual needs.

In the phalloplasty procedure, tissue is typically sourced from other areas of the body, such as the forearm’s skin and fat. The surgeon uses this tissue to construct a penis with anatomical proportions, which is then positioned in its final location. Advanced microsurgery techniques enable the suturing of arteries, veins, and nerves to provide erogenous sensitivity. To lengthen the urethra, tissue from the anterior vaginal wall (approximately 5 centimetres in length and 2 to 3 centimetres wide) and a flap created using the labia minora’s skin are utilised. This is then connected to the urethra previously constructed in the neopenis.

Simultaneously, the labia majora are repositioned dorsally and joined in the middle to create a new scrotum. Following the formation of the scrotal sac, silicone testicular implants are inserted. Depending on the surgeon’s criterion, the implantation of the testicular prostheses may be carried out during the initial operation or deferred to a subsequent procedure.

Before undergoing phalloplasty, the medical team will assess the suitability of this surgery in each case, taking into account your state of health, your medical history and evaluating all possible options.

Preparation before transgender phalloplasty
Before phalloplasty surgery, it is equally important to focus on preoperative preparations as well as postoperative care.

A blood test should be scheduled at least three months prior to the phalloplasty operation. Proper diet management and intestinal hygiene are also of utmost importance.

Hormone therapy designed to increase the clitoris’s size is another prerequisite. The surgeon and the medical team at IM GENDER will offer guidance on the suitable approach and timing for this treatment.

Furthermore, if considerable hair growth is present on the inner forearm, it is recommended to undergo laser hair removal on the non-dominant forearm between 3 months and 1 year before surgery. This is necessary because the forearm area will later become part of the urethra in the neophallus.

Throughout your doctor’s appointment, they will clarify the entire procedure and address any uncertainties or queries that may come up.

Metoidioplasty and phalloplasty are both gender-affirming surgeries for trans men and non-binary individuals assigned female at birth, aiming to create male genitalia. However, they differ in approach, outcomes, and complexity.

Metoidioplasty is a less invasive procedure that uses the clitoral tissue, enlarged due to hormone therapy, to create a neophallus. It results in a smaller neophallus, often unsuitable for penetrative intercourse, and usually has a shorter recovery period with a lower risk of complications. Sensation and erectile function are generally well-preserved.

On the other hand, phalloplasty is a more complex and invasive surgical procedure, constructing a neopenis using tissue grafts from a donor site on the body. It results in a larger neophallus suitable for penetrative intercourse but requires a longer recovery period. Sensation and erectile function may vary, depending on surgical techniques and nerve reconnection success.

The choice between metoidioplasty and phalloplasty depends on individual preferences and priorities. Consulting with a qualified surgeon is important to determine the most suitable procedure for each patient.

What is phalloplasty surgery?

Phalloplasty is a gender-affirming surgery for trans men and non-binary individuals assigned female at birth that involves constructing a neopenis using tissue grafts from a donor site on the body, such as the forearm.

What is phalloplasty surgery recovery like?

Phalloplasty recovery varies between individuals and involves a gradual process. You can typically expect a hospital stay of 5-7 days after surgery. Swelling, bruising, and discomfort are common in the first few weeks, and you will be prescribed pain medication. It is important to avoid strenuous activities for 6-8 weeks and follow the surgeon’s guidance on catheter management. Complete recovery, including sensation and erectile function, may take up to a year or more.

What are the risks and complications associated with phalloplasty?

As with any surgery, phalloplasty carries some risks, including urinary infection, fever, urinary retention, wound dehiscence, redness and swelling of the phallus…. If you have any doubts or discomfort, you should consult your referring surgeon or the patient care team. A 24 hour phone line will be available for you to make your inquiries.

Will I have sensation in my neopenis after phalloplasty surgery?

Sensation in the neopenis after phalloplasty can vary from person to person, depending on the surgical technique employed and the success of reconnecting nerves during the procedure. Some patients may experience a good erogenous sensation, while others might have reduced sensitivity. It is important to note that nerve regeneration is a gradual process, and it may take months for sensation to develop fully in the neopenis.

Can I have penetrative intercourse after phalloplasty?

Yes, this transgender genital surgery can result in a neopenis suitable for penetrative intercourse. However, an erectile device, such as a penile implant, may be necessary to achieve and maintain an erection.

What is the result of phalloplasty surgery?

After phalloplasty recovery, you will have a penis that is functional, anatomically and aesthetically similar to that of any cisgender male penis. Erogenous sensation will be present, though it may take a few months after surgery for a penile prosthesis to facilitate penetrative sex.