Phalloplasty is a major surgical procedure that aims at constructing or reconstructing a phallus. It is sometimes indicated to correct a malformation or in the case of a micro-penis, but mainly, it is indicated for trans men.
Clandestinely performed for the first time in 1946 on Michael Dillon (a man with an impressive career), science has come a long way since, but what is it all about exactly?
What is a Phalloplasty?
Phalloplasty is the construction of a phallus, a scrotum, and a glans. The procedure is complex: it usually takes three surgeries spread over one or two years. In the end, the patient should be able to urinate from a standing position and have penetrative sex as well as orgasms. Phalloplasty consists of creating functional and aesthetic male genitals.
Phalloplasty: The Surgery
At the GrS Montreal Clinic, which specializes in trans care, the method chosen consists in first taking a skin flap from the forearm. This skin flap is then replaced by a thinner graft of skin that is harvested from the thigh. This technique is call “Radial Forearm Free-flap” (RFF). This technique allows for the penis to look more realistic and more sensitive to touch due to the thin skin and the nerve endings of the forearm. Other techniques could be considered in the case where RFF could not be performed.
Thus, the removed skin will be used to construct the phallus. The glans is then built, and the urethra is lengthened so that the patient can urinate from a standing position after the second surgery. The scrotum is created from the labia majora, and the vaginal cavity is closed. A cavity is created for the clitoris at the base of the phallus and the nerve endings are connected to create a sensitive organ with erogenous zones.
During the second surgery, the end of the new urethra is connected to the end of existing urethra and the patient will be able to urinate from a standing position.
A third surgical procedure will be performed to insert testicular implants, which will give shape to the testicles, and a penile implant, which will allow erection. This intervention will conclude the masculinization of the genitals.
Phalloplasty: How to Prepare?
The patient must fulfill several conditions before accessing a phalloplasty. GrS Montreal follows the recommendations of the WPATH.
At least six months beforehand, the patient must undergo a hysterectomy. If smoking cigarettes, the patient must stop completely at least six months before the operation because nicotine impairs healing. They must also make sure to depilate completely and permanently (i.e. by laser) the area where the skin will be retrieved from the arm.
In general, patients who take good care of their health recover better from these major surgeries.
The most recent studies show that 95% of patients are satisfied with their phalloplasty. It is recommended that you inquire thoroughly before starting the process, given the complexity of the process. In North America, the GrS Montreal Clinic is at the cutting edge of surgical advances in phalloplasty.