Phalloplasty is a surgical procedure that constructs a penis (or phallus) for transgender men and others with gender dysphoria, as well as for cisgender men with congenital or acquired absence or underdevelopment of the penis. It’s one of the options for surgical transition from female to male (or for male genital reconstruction for other reasons).
Types of Phalloplasty:
- Pedicle Flap: Uses skin from the inner forearm, the most common site, but can also use tissue from the abdomen or thigh.
- Free Flap: This involves transferring tissue from a donor site to the pubic area and requires microsurgery to connect blood vessels and nerves.
- Alt Flap: Uses tissue from the thighs.
- Mld Flap: Uses tissue from the side of the torso.
Results of Phalloplasty:
- Aesthetic Outcomes: Modern phalloplasty techniques can achieve a natural-looking penis. The appearance can be further enhanced with additional procedures like glansplasty (to construct a glans or head of the penis) and tattooing for more natural coloring.
- Sensory Outcomes: With nerve hookup, some degree of erotic and tactile sensation can return over time. The level of sensation varies from person to person.
- Urinary Outcomes: Most individuals can stand to urinate after successful urethral lengthening. However, there’s a risk of complications like fistulas (holes) or strictures (narrowing) in the newly constructed urethra.
- Sexual Outcomes: A penile implant can be placed to allow for penetrative sex. This is typically done in a separate surgery, months to a year after the initial phalloplasty.
- Scarring: As with any surgery, scarring will occur. The donor site, especially the forearm, will have a noticeable scar. There are treatments and therapies available to reduce the appearance and texture of scars.
- Complications: Like all surgeries, there are risks. Complications can include infections, issues with wound healing, tissue necrosis (death), and urinary complications. Some complications might require additional surgeries to correct.
Post-operative Experience:
- Recovery: Initial recovery in the hospital usually lasts around a week, with several more weeks of healing at home. Full recovery can take months.
- Follow-ups: Regular follow-up appointments are essential to monitor healing, assess function, and address any complications.
- Physical Therapy: Some individuals find it beneficial to see a physical therapist who can guide them through scar care, mobility exercises, and general post-operative care.
It’s essential to note that the decision to undergo phalloplasty is deeply personal. Satisfaction rates vary, with many individuals reporting increased body congruence and improved mental well-being after surgery. However, others might feel that the surgical risks or potential complications outweigh the benefits for them. As with all medical decisions, it’s crucial to thoroughly research, consult with experienced medical professionals, and consider one’s individual goals, needs, and circumstances.