Masculinizing Surgery - Phalloplasty
Specialized procedures for male gender affirmation.
There is no ideal technique for penile construction that perfectly mimics natural form and function. All available techniques have advantages and disadvantages, and each involves a high degree of complexity and risk of complications. In addition, each procedure requires multiple surgeries to achieve the desired result.
In general terms, the steps in this process include:
Construction of the non-functional neophalluswhich can be performed with or without urethra, depending on the technique used. Testicular prostheses can also be implanted during this first stage.
Creation of the urethrain case it has not been formed in the previous stage.
Implantation of a penile prosthesiswith the objective of providing erectile capacity to the neophallus.
Commonly used phalloplasty techniques include the use of pedicled flaps and vascularized free flaps.
Pedicle FlapsThese techniques are considered safer, as they use local tissues that slide into the prepubic region to form a tubular structure similar to a penis. The most common technique is the one that uses suprapubic tissue, although tissues from the gluteal or thigh area can also be used.
Vascularized Free FlapsIn this case, tissues taken from other parts of the body are used and reconnected in the genital region through the union of arteries, veins and nerves. The most frequently used flaps are those of the latissimus dorsi muscle (back) and the forearm.
Each technique has its own advantages and limitations, which should be carefully discussed with each patient, considering their individual expectations and characteristics.
The operative time and postoperative hospitalization period vary according to the technique used. Generally, the minimum interval between each of the stages of surgery is approximately 6 months.
