What Is Phalloplasty?

Phalloplasty is a surgical procedure that involves the construction or reconstruction of a penis. While it may be used in cases of traumatic injury or birth anomalies, it is most commonly associated with gender affirmation surgery for transgender men or nonbinary individuals seeking male genitalia.

This procedure typically uses tissue from other parts of the body, such as the arm or thigh, to construct a neophallus (new penis), which can allow for standing urination, sexual sensation, and in some cases, the ability to achieve erections with the use of an implant.

The Role of Phalloplasty in Transgender Surgery

For many transgender individuals, phalloplasty is a crucial part of the physical transition. Alongside hormone therapy and other gender-affirming procedures, it plays a significant role in supporting mental well-being, confidence, and social integration.

Some benefits of phalloplasty in the context of transgender surgery include:

• Creating external male genitalia

• Enabling the ability to urinate while standing

• Potential for sexual function and erogenous sensation

• Enhanced gender congruence and reduced dysphoria

It’s important to note that phalloplasty is a highly individualized process, and not all transgender men pursue this surgery. However, for those who do, it can be a powerful and affirming experience.

Techniques in Phalloplasty: Radial Forearm vs. Anterolateral Thigh

There are multiple surgical techniques available, with the two most common being:

1. Radial Forearm Phalloplasty

Radial forearm phalloplasty involves using skin, fat, nerves, and blood vessels from the forearm to construct the neophallus. This method is often preferred because:

• The tissue is thin, flexible, and easy to sculpt

• It allows for good aesthetic outcomes

• Nerve connection potential can support erogenous sensation

However, this technique leaves a visible scar on the arm and may require a skin graft to cover the donor site.

2. Anterolateral Thigh (ALT) Phalloplasty

Anterolateral thigh phalloplasty uses tissue from the thigh, offering the advantage of:

• Less visible scarring

• Larger tissue availability, which can be helpful for constructing the desired size

It may not be suitable for all patients, particularly those with higher body fat percentages, and may involve more complex surgical planning.

Additional Surgical Steps in Penile Reconstruction

In both techniques, phalloplasty may be performed in stages and include additional procedures such as:

• Urethral lengthening – to enable urination through the penis

• Scrotoplasty – creation of a scrotum, often using testicular implants

• Glansplasty – sculpting the head of the penis

• Implantation of a penile prosthesis – for erectile function, typically done in a later stage

The number of procedures required depends on individual goals and medical factors. Some patients may opt out of certain stages.

Risks and Considerations

As with all major surgeries, phalloplasty comes with potential risks and recovery needs. Common considerations include:

• Scarring at donor and recipient sites

• Potential for infection or tissue rejection

• Urethral complications like strictures or fistulas

• Need for multiple follow-up surgeries

Pre-operative consultation with a multidisciplinary gender-affirming team—including surgeons, mental health providers, and endocrinologists—is essential to ensure readiness and alignment with personal goals.

Recovery and Postoperative Care

Recovery from phalloplasty can be extensive and typically involves:

• Hospital stay for monitoring and wound care

• Use of catheters for urinary diversion

• Physical rest followed by gradual mobility

• Follow-up appointments to monitor healing

The total recovery timeline can range from weeks to several months, especially if multiple surgical stages are involved. Emotional support and connection to trans healthcare networks are vital during this process.

Choosing the Right Surgeon and Facility

Not all hospitals offer gender affirmation surgery or phalloplasty, so finding a qualified, experienced surgeon is crucial. When evaluating your options, consider:

• Surgeon’s experience with trans-related procedures

• Access to follow-up care and revisions

• Availability of peer support programs

• Insurance and financing options

Look for facilities that emphasize patient-centered, trauma-informed care tailored to the needs of transgender and gender-diverse individuals.

Final Thoughts

Whether you’re exploring radial forearm phalloplasty, anterolateral thigh phalloplasty, or simply gathering information about your options, phalloplasty represents an empowering choice for many seeking penile reconstruction or transgender surgery.

By understanding the procedure, its goals, risks, and variations, you can make informed decisions that best support your identity and long-term well-being.