Penis creation surgery, often referred to in medical contexts as “phalloplasty,” is a procedure commonly pursued by transgender men and non-binary individuals assigned female at birth who wish to have male genital contouring. Phalloplasty aims to construct a neophallus (new penis) using tissue from other parts of the body.

Here’s an overview of the phalloplasty procedure:

1. Donor Site Selection:
   • The tissue used to construct the neophallus can come from various donor sites, with the most common being the forearm (radial forearm phalloplasty), thigh (anterolateral thigh flap or ALT), and back (musculocutaneous latissimus dorsi flap or MLD).
   • The choice of donor site depends on various factors, including the desired size and appearance of the phallus, the amount of available tissue, potential scarring, and individual preferences.
2. Procedure:
   • The selected tissue, which includes skin, blood vessels, and sometimes nerves, is harvested from the donor site and shaped into a phallus.
   • Microsurgery is used to connect blood vessels and nerves to the recipient site to ensure the viability of the tissue and potential for sensation.
   • Urethral lengthening can be performed simultaneously or in stages, using tissue from the donor site, labia, or buccal mucosa (mouth lining), to allow for urination through the phallus.
   • The clitoris is often left intact at the base of the neophallus to preserve sexual sensation.
3. Additional Procedures:
   • Glansplasty: This procedure creates a glans or head of the penis for a more realistic appearance. It can be done during the initial surgery or as a separate procedure.
   • Scrotoplasty: The labia majora can be fused to create a scrotum, which can later be filled with saline or silicone testicular implants.
   • Erectile Implants: To facilitate penetrative intercourse, some individuals opt for the placement of erectile prosthetics, typically done in a separate surgery after the phallus has healed.
4. Recovery:
   • Initial hospitalization typically lasts about a week, with the patient being advised to avoid strenuous activity for several weeks to months.
   • Complications, such as tissue loss, fistulas (abnormal connections between the urethra and skin), or strictures (narrowing of the urethra), can occur and may require additional surgeries.
5. Results:
   • The neophallus will have the appearance of a penis, and with urethral lengthening, the individual can often urinate while standing.
   • Sensation can vary. While the clitoris retains its sensation, the neophallus itself might have protective sensation or erogenous sensation, especially if nerve hook-ups were successful.
   • Scarring will be present both at the site of the neophallus and the donor site.

It’s worth noting that phalloplasty is one of several options for genital surgery. Some individuals may choose metoidioplasty, a different procedure that takes advantage of testosterone-induced clitoral growth to create a smaller phallus. As always, the decision to undergo any surgical procedure should be made after thorough research, consultation with experienced medical professionals, and consideration of individual goals and circumstances.