Phalloplasty is a complex surgical procedure primarily used for gender affirmation and also as a reconstructive option for congenital anomalies, severe penile trauma, or disease. The goal of phalloplasty is to create a functional and aesthetically pleasing neophallus that meets the individual’s needs and enhances their quality of life.
The procedure aims to construct a natural-looking penis that allows for standing urination, provides sensation and pleasure, enables erection with a penile implant, and supports sexual intercourse. It typically involves using skin flaps to form the new penis, which can help address both physical and emotional challenges, such as gender dysphoria.
The success and safety of phalloplasty are highly dependent on the surgeon’s expertise, with more experienced practitioners generally achieving better outcomes and reduced surgical risks. Recovery from phalloplasty can be lengthy, often requiring a month or more for full healing and optimal functional results.
Phalloplasty may be recommended to address congenital conditions, such as:
Phalloplasty can also be performed on those who have experienced penile trauma from events like car accidents, complications from circumcision, or penile cancer.
Some women also go through this surgery to align their physical bodies with their gender identity and help alleviate gender dysphoria.
Complications are common with phalloplasty. Early detection of issues can help reduce their impact on long-term outcomes.
Complications of this major and complex surgery include:
Before the procedure, patients should provide a list of all allergies and medications, including herbal supplements, and stop taking blood-thinning medications if applicable. It is also important to avoid eating or drinking for 8 to 12 hours before the surgery, although essential medications may be taken with a small sip of water.
Individuals may also receive health recommendations, such as quitting smoking or achieving a BMI under 32, to minimize surgical risks.
For individuals undergoing gender-affirming phalloplasty, preparation typically spans at least a year. It usually involves:
For phalloplasty, tissue flaps are usually taken from the forearm or thigh, and the donor site will need a skin graft, which can be done during or after the surgery.
The duration of the surgery typically ranges from eight to ten hours, though it may be longer if additional procedures are performed.
The procedure is often done as follows:
If the phalloplasty involves multiple stages, the complete process could extend over 12 to 18 months.
Additional gender-affirming surgeries can be performed alongside phalloplasty or staged separately to allow for healing between procedures:
Phalloplasty is performed as an inpatient procedure. One will stay in the hospital for at least a week to ensure proper blood supply to the new penis.
After phalloplasty, the patient will awaken from anesthesia, likely feeling groggy. Healthcare providers will monitor their health and manage pain as they fully regain consciousness. Additional procedures are often scheduled several months after the initial operation, in cases of staged surgery.
After phalloplasty, rest is essential, and most individuals return to their normal activities only after at least six weeks. Regular follow-up appointments with the healthcare team are crucial for monitoring the healing process. Additionally, ongoing visits with a mental health professional experienced in transgender care are recommended to support recovery and adjustment during this period.
It is also important to monitor for potential complications during recovery. Seek immediate medical attention if any of the following is experienced:
These may also be recommended during recovery period:
Generally, phalloplasty benefits include:
Specific advantages include:
A penile implant offers the ability to achieve an erection at will. Various implant options will be discussed and evaluated as needed.