Phalloplasty is an operation to rebuild the penis, or create one from scratch. It is used, for example, for sex changes, or for serious pathologies and malformations of the penis. The reconstructed penis is artificially reconstructed using skin grafts on the patient.

Phalloplasty is an operation to create a penis (phallus), or rebuild it.

It is a major surgical operation, which requires hospitalization and preparation beforehand with urologists.

It is mainly used for transgender people, such as a male born female who wishes to have a penis, or sometimes for cases of penis enlargements or deformity / accident repair.

There are different types of phalloplasty:

• Penis enlargement operation

  It is an operation that aims to enlarge the length and width of the penis, in cases of micropenis.

• Penis construction operation

  For people who have lost their penis, with a deformity, or to change their sex, phalloplasty is used to build a new penis artificially.

Prepare for the exam

The phalloplasty operation is very heavy, but does not present a life threatening danger to the patient, apart from the complications inherent in any surgery and anesthesia.

For people wishing to change their gender (or from the point of view of a man born woman “finally having a sex”), phalloplasty is usually the culmination of a long journey of self-reflection. In this case it is rather seen as a deliverance rather than a constraint.

The operation in detail

In the case of a sex change (female-> male):

• A skin flap is removed which will serve as the basis for the new “penis”, for example on the patient’s arm. This flap will be reconstructed using a second skin graft; most often on the thigh.
• The vagina and uterus are removed to make room for the future penis (hysterectomy).
• A tube is placed to form an artificial urethral canal, which is where urine will pass once the penis has been shaped.
• The long, cylindrical shape of the penis is created from scratch by folding the flap of flesh and blood vessels taken from the arm around the tube of the urethral canal.
• The nerve of the clitoris is attached to the new sex.
• The bags are designed using what used to be the “labia minora” of the vagina.
• The penis often has the appearance of a circumcised penis, without foreskin.
• It is then necessary to connect the blood vessels, nerve and connect the urethral canal.
• An erection simulation is possible using the addition of a manually operated pump (erectile prosthesis).

The operation lasts about ten hours, it mobilizes several members of medical teams (plastic surgeon, urologist and experts).

In the case of penis enlargement

• The method this time consists of lengthening the penis, using an injection of fat and cutting the suspensory ligament which hinders its extension. The ligament serves to increase the “length” of the penis (artificially), while the fat increases the thickness.

Change gender

Phalloplasty allows transsexual people, born a girl and wishing to become a man, to have a penis. They are about 400 to undergo this operation each year in France.

Micropenis

For adults with a small penis, phalloplasty can artificially enlarge the penis. Be careful, however, this only serves to lengthen the position at rest, by severing a ligament that maintains the penis in height. This therefore has little impact on the erect penis.

Accidents and malformations

In the case of a loss of penis, following an infection or an incident, or a birth defect, phalloplasty is used to reconstruct a penis artificially.

Post-operative complications

An operation of this magnitude, especially for a sex change, causes many complications.

• Infections
• Blood clots
• Rejection of the skin graft (and loss of the prosthesis)

After penis enlargement

• The injected fat disappears after three or four years, so you have to repeat the operation regularly.
• The penis remains swollen and swollen for another two or three weeks.

After penis reconstruction

• It will take several years for the constructed penis to look “normal”. The scars will stay for life.
• In some cases it is not possible to urinate while standing.

Important note

The purpose of a phalloplasty is to cure a disorder, and not improve sexual performance or “replace a penis that is too small”. It’s a heavy operation, which is well thought out.