GENDER AFFIRMATION SURGERY
Phalloplasty is a transgender genital surgery that allows the reconstruction of a functional, sensitive neopenis that will allow bipedal urination and erogenous sensitivity. This surgery is usually completed with penis and testicular prostheses.
GENDER AFFIRMATION SURGERY IN MADRID AND BARCELONA
At IM GENDER, we are experts in FTM bottom surgery and have the most advanced tools to ensure the best results.
We know that phalloplasty is a delicate intervention that can generate many doubts and concerns in patients who undergo it. That’s why, in our gender reassignment clinic, we adapt to your needs and accompany you throughout the process, from the first consultation to postoperative follow-up.
We understand that each patient is unique, and that’s why we offer you a personalised and humanized approach in each of our interventions. Our team of highly qualified professionals will guide and advise you at all times so that you feel safe and calm throughout the process.
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At IM GENDER, we know that knowing real cases of phalloplasty results is important before making any decision. In these images, you can see real cases of patients who have been treated at the clinic, so that you can get an idea and help you make a more consolidated decision.
before the surgery
For some trans men, FTM bottom surgery is a natural and important step, while for others it is an unnecessary procedure. Therefore, each trans person must make personal decisions that best suit their individual needs.
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.
It is important to have a blood test at least 3 months before the surgery. It is essential to control your diet and clean your intestines. It is also necessary to undergo hormonal treatment that aims to increase the size of the clitoris. The surgeon, along with the medical team at IM GENDER, will advise you on how and when to undergo this treatment.
Finally, if there is a lot of hair on the inner side of the forearm, it is recommended to undergo laser hair removal on the non-dominant forearm 3 months to 1 year before the surgery. This is done to remove as much hair as possible from the forearm, because this area will become part of the urethra of the neophallus.
When you visit your doctor, everything will be explained and any doubts that may arise will be clarified.
FTM bottom surgery allows transgender persons to transform a vagina into a penis in order to recognize their authentic gender. This surgery is a big step to alleviate symptoms like gender dysphoria. Obviously, there are some risks as in all surgical procedures:
- Infection: the incision area and the urethra can get infected sometimes. In these cases, patients can experience burning sensation in the urethra, discomfort, and/or hematuria.
- Urinary retention: a poor blood flow can block the pass of urine or makes it harder.
- Catheter complications: a catheter must be used for a few weeks after the surgery. This can become blocked or twisted in some cases.
- Urine leakage through adjacent areas to the neophallus.
- Wound dehiscence.
- Redness and swelling of the phallus.
- Increased pain.
A member of the medical team will instruct you on how to prevent possible complications and what to do in case they happen. If you have any doubts or abnormalities after the procedure, you should consult your doctor so that they can diagnose the issue and provide a solution.
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.
FAQS ABOUT PHALLOPLASTY
What is phalloplasty?
Is a surgical technique that allows the reconstruction of a phallus (penis). To achieve this, tissue from other parts of the body is used, most commonly skin and fat from the forearm, although tissue from the thigh or abdomen, among others, can also be used.
This neopenis has a very anatomical appearance, allows bipedal urination (urinating while standing up) and has tactile and erogenous sensitivity. It is important to clarify that in order to allow sexual penetration, it will require a prosthesis that will have to be implanted in a second surgical procedure.
What is FTM bottom surgery like?
The phalloplasty technique uses tissue from other parts of the body, usually skin and fat from the forearm. With this tissue, the surgeon can recreate a penis of anatomical dimensions that, once shaped, is transported to its final position. Once there, thanks to the advancement of microsurgery, the suturing of the arteries and veins, which supply blood and nerves, is performed in order to achieve tactile and erogenous sensitivity. To extend the urethra in the first few centimeters, the surgeon uses tissue from the anterior wall of the vagina (with a length of about 5 centimeters and a width of 2 to 3 centimeters) and a flap made with the skin of the labia minora. Then it is sutured with the urethra previously created in the phallus.
During the same procedure, the labia majora are mobilized dorsally and joined in the midline to form a new scrotum. Once the scrotal sac is created, silicone testicular implants are placed. The implantation of the testicular prostheses can be performed during the same surgical procedure or postponed to a second intervention depending on the surgical criteria.
Is hospital admission necessary for this procedure?
You will be admitted to IM GENDER on the same day as the surgery. During the hours before the operation, our team will carry out the necessary monitoring. This surgery is always performed under general anesthesia and usually takes 10 to 12 hours.
Is there sensitivity with phalloplasty?
To achieve erogenous sensitivity, the surgeon anastomoses a nerve from the clitoris to one of the nerves of the neopenis and also to the clitoris itself, which will remain buried under the phallus.
FAQS ABOUT PHALLOPLASTY RECOVERY
Will I have to be hospitalised after surgery?
After phalloplasty surgery, you will need to remain hospitalised for at least one week to ensure better monitoring of your progress by the medical team at the IM GENDER Gender Unit. This is also to provide both the patient and their companion with the necessary environment and comfort for a speedy recovery.
After the first 48 hours following the surgery, patient mobility will be permitted.
When will I be able to go home after the surgery?
Although you will be discharged from hospital one week after the operation, you will need to wear a bladder catheter for at least 21 days. Occasionally, at the surgeon’s discretion, a suprapubic catheter may be inserted. This allows the bladder to empty by preventing urine from flowing through the urethra, keeping it dry in the early stages of recovery.
What is recovery like?
It is important to follow the advice of the medical team at IM GENDER throughout the postoperative period, as well as attend all follow-up visits after phalloplasty and contact the medical team if there are any doubts about the recovery process. Only they can properly evaluate your recovery. Usually, once you have been discharged from the hospital, you will be given an appointment for the next postoperative check-ups and wound care. These will typically take place about one month, three months, six months, and one year after the treatment. At all times, you will have access to a support phone number during the postoperative period.
What is the result of phalloplasty?
After your recovery, you will have a penis that is functional, anatomically and aesthetically similar to that of any man. While you will have to wait a few months after surgery for a penile prosthesis to allow penetrative sex, you will have erogenous sensation.
TIPS AFTER SURGERY
After the phalloplasty surgery, a normal diet can be followed, but it should be rich in fiber to avoid constipation. If it is necessary, a laxative can be taken.
The urinary catheter should be used for 4 to 6 weeks and connected to a urine collection bag. It is important to change the leg where the catheter is attached daily.
You should have relative rest, meaning you can take short walks, but you should avoid exertion and not overload your legs, so that you could have a great recovery.
DON'T LEAVE WITH DOUBTS
If a microsurgical flap technique was used in your phalloplasty, you should keep the wrist of the donor arm elevated and wear a compression garment on the arm.
RETURNING TO SPORTS
It is important not to exercise without the surgeon’s permission and to follow medical recommendations on activity and sports to avoid during the full recovery.
Do not to miss any visits after surgery. Wound care will be personalised according to each case and technique used. External stitches in the genital area will fall out on their own.
IM GENDER Team
At IM GENDER we have been specialising in the care of transgender people for more than 20 years. Two decades of experience, professionalism, research and training endorse our medical team and staff.
Do you want to know the price of a phalloplasty? Contact us for further information!