The next operative procedure consists of the genital transformation and includes a vaginectomy, a reconstruction of the horizontal part of the urethra, a scrotoplasty and a penile reconstruction usually with a radial forearm flap or an alternative. The resulting scar traverses the areola horizontally and passes around the upper aspect of the nipple. Tattooing of the glans should be performed after a 2- to 3-month period, before sensation returns to the penis. Many authors seem to agree that the fibular osteocutaneous flap is an optimal solution for penile reconstruction in a natal male. A new phalloplasty technique:
Liposuction is only occasionally indicated laterally, or to attain complete symmetry at the end of the procedure.
Sex Reassignment Surgery in the Female-to-Male Transsexual
This usually does not occur for at least a year. The creation of a phallus with a tube-in-a-tube technique is performed with the flap still attached to the forearm by its vascular pedicle Fig. The likelihood of an additional aesthetic correction should be discussed with the patient in advance. Free nipple graft technique. Obtaining rigidity in total phalloplasty: