Phalloplasty
What is Phalloplasty?
Phalloplasty is a gender-affirming surgical procedure that constructs a neophallus (new penis) for transgender men and non-binary individuals. It involves using skin grafts from areas such as the forearm, thigh, or abdomen to create a functional and aesthetically natural-looking penis. This procedure can include additional steps such as urethral lengthening, erectile implants, and scrotoplasty (creation of a scrotum) depending on individual goals.
Why Choose Phalloplasty?
- Provides a penis with natural appearance and sensation
- Enables the ability to urinate while standing (if urethral lengthening is performed)
- Offers the option for penetrative intercourse with erectile implants
- Helps alleviate gender dysphoria and improve mental well-being
- Can be customised based on personal goals and preferences
Am I Ready for Phalloplasty?
- You are generally healthy with no major medical conditions affecting healing
- You have a stable BMI, as excessive weight may impact graft healing
- You are a non-smoker or willing to quit before surgery (smoking affects circulation and healing)
- You have undergone at least one year of hormone therapy (if required by your surgeon)
- You have completed any necessary psychological assessments for gender-affirming surgery
- You have realistic expectations about surgical outcomes, including scarring and sensation
- You are emotionally prepared for a multi-stage surgical process (if opting for staged phalloplasty)
- You have a strong support system for recovery
- You have consulted with a surgeon and fully understand the risks and benefits
What Happens During Phalloplasty?
Your surgeon will discuss your medical history, surgical options, donor site preferences, and whether additional procedures like urethral lengthening or erectile implants are right for you.
Phalloplasty is performed under general anaesthesia to ensure a pain-free experience during surgery.
- Tissue Harvesting – A skin graft is taken from a donor site (e.g., forearm, thigh, or abdomen).
- Penile Construction – The graft is shaped into a neophallus and attached to the genital area.
- Urethral Lengthening (Optional) – If chosen, the urethra is extended to allow standing urination.
- Scrotoplasty (Optional) – The labia are reshaped to form a scrotum.
- Erectile Implants (Later Stage) – If desired, an implant may be inserted to allow penetration.
- The initial surgery takes 6-12 hours, depending on complexity and additional procedures.
- Phalloplasty is often performed in multiple stages, requiring separate procedures over several months.
Recovery Timeline
- You will stay in the hospital for 5-10 days for monitoring.
- Swelling, bruising, and discomfort are normal.
- A catheter will be in place if urethral lengthening was performed.
- Most swelling reduces, and you can gradually return to light activities.
- If a graft site was used (e.g., forearm), it will require ongoing wound care.
- Exercises that are strenuous and require heavy lifting should be avoided.
- The neophallus will continue to heal, and sensation may gradually improve.
- Additional procedures, such as erectile implants or touch-up surgeries, may be planned.
- Scars from both the donor site and genital area will fade over time.
Benefits of Phalloplasty
- Creates a penis with natural aesthetics and the potential for sensation
- Offers the ability to stand while urinating (if urethral lengthening is performed)
- Enhances confidence and reduces gender dysphoria
- Provides the option for penetrative intercourse (with erectile implants)
- Customisable to meet individual needs and goals
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Frequently Asked Questions
Will I have sensation in my new penis?
Some sensation may develop over time, especially if nerve connections are successfully established. However, full sensation varies between individuals.
Can I urinate while standing after phalloplasty?
Yes, but only if urethral lengthening is performed. There is a small risk of complications such as fistulas (leaks) or strictures (narrowing).
How many surgeries will I need?
Phalloplasty is often performed in multiple stages, usually 2-4 surgeries over several months.
Will my new penis be able to get erect?
Yes, but only with the implantation of a prosthetic device, which is usually done in a later stage.
What will happen to my current genitalia?
Depending on your preference, you may opt for metoidioplasty first, retain the vaginal canal, or undergo vaginectomy (removal of the vaginal lining). This is discussed with your surgeon beforehand.