Phalloplasty: photos of the results before and after, help for women with gender reassignment, price, video of the operation for review

The history of successful phalloplasty operations began in 1936.
To the surprise of the medical and other public, Dr. Bogoraz reconstructed one poor fellow's phallus using a piece of his skin and rib cartilage. After the torment he had endured, the patient was cheerful and fresh. The operation was put on a conveyor belt, and we will tell you how it happens in the 21st century. However, it should be warned that the need for this kind of intervention is decided primarily by doctors, and not by the whims of aesthetes. After all, this is a full-fledged and delicate surgery, and not temporary makeup.

In contact with

What it is

Plastic surgeons have come up with such a move, after which a person’s penis is restored. Along with it, a high quality of life, normal urination and sex returns. In addition, doctors calmly conjure over its size and shape, giving it an aesthetic appearance.

As our expert said, the new technologies are very clever and are based on the use of the patient’s own tissues . As a result, the lucky one receives a real neophallus, which in its skills and abilities is not inferior to an ordinary living member. Of course, there are different options in microsurgery - more on that below.

Consequences of phalloplasty

Plastic surgery helps patients improve the quality of their sex life and cope with psychological and social problems. But complex surgical interventions can also have negative effects:

deterioration of erectile function or complete impotence;
decreased or complete absence of sensitivity;
difficulty and pain when urinating;
complications after surgery, infection, inflammation;
rejection of implants and the patient’s own tissues.

Therefore, before agreeing to phalloplasty, you should weigh everything, give yourself a few months to think, and study the information. If possible, try non-surgical penis enlargement methods that will give results without risks. In resolving such a delicate issue, it is better not to save money and choose specialists who, in case of complications, will be able to provide any assistance.

Article reviewer

Petrovich Ruslan Yurievich

Urologist-andrologist, microsurgeon, plastic surgeon. Specialization: surgical andrology, plastic surgery. Federal State Institution LRC of the Ministry of Health and Social Development, Moscow. 20 years of experience. Doctor's contacts

Have a question? in chat

on WhatsApp

Or call toll-free number 8 (800) 555-04-86

Kinds

Progress does not stand still and doctors have come up with many ways to restore the penis.
Reconstruction can be complete or partial and varies in complexity and scope. However, the essence is the same - the penis is formed from a skin-muscle flap. Next, the lucky one will undergo urethroplasty, head formation, and penile prosthesis.

Total (thoracodorsal, radial plastic surgery)

The goal is to model a full-fledged, functional neophallus. Full sexual intercourse , typical male urination (standing), is performed with the finished unit. All over the world, the penis is modeled from scratch on the basis of a thoracodorsal flap taken from the back in the area of the latissimus muscle. The fact is that this is where the motor nerve is located. It sets sensitivity after surgery.

Who needs it:

artificial sex change (transsexualism);
loss of an organ after severe injury, cancer;
congenital pathology of the genitals.

More options:

phalloplasty with prosthetics
- an implant is implanted into the new penis in order to restore an erection;
urethroplasty
– formation of the urethra;
aesthetic correction
- glans plastic surgery;
circumcision
- circumcision of the foreskin for religious, medical or aesthetic reasons.

Carrying out

Phalloplasty has different reviews. Most patients are satisfied with the treatment and the silicone implant. The method is used for the aesthetic formation of an organ, increasing its thickness. The healing period is relatively short.

An option used to change the length of the penis is displacement of the ligament responsible for supporting it. After this type of intervention, a man needs relatively easy rehabilitation. The length may increase by several centimeters.

In what cases is the operation performed?

The goal of all manipulations is the same - to achieve normal urination and an active sex life.

Doctors vote for surgery in the following cases:

transsexualism - total intervention is carried out during gender correction - from female to male. Sometimes the poor souls have to correct the mistakes of past operations;
elimination of gross deformations , mechanical obstacles to urination;
loss (amputation) of a member after serious injury, burns, fractures, tears, surgery, diseases (cancer, gangrene);
congenital pathologies , underdevelopment of the phallus. These diagnoses sound like hypospadias, micropenis, epispadias, hidden penis, congenital absence of the penis.

Indications

Phalloplasty is recommended for congenital developmental anomalies:

curvature of the penis, underdevelopment of part of the urethra (hypospadias);
small size or hidden penis syndrome;
splitting of the walls of the urethra (epispadias).

The operation eliminates complexes and improves the quality of life.

Another indication is acquired pathologies:

injuries resulting in deformation or severe damage to the tissues of the penis;
artisanal attempts to enlarge the genital organ, causing tissue proliferation (oleogranuloma);
forced amputation due to cancer or other reasons.

Phalloplasty is indicated in the absence of an erection, if it is impossible to do without implantation. The operation restores the physiological functions of the male genital organ - after it, urination is normalized, and normal sex life becomes possible.

Procedure for women during gender reassignment

We know that transsexuals are forced to undergo painstaking preparation with an emphasis on the psychological aspect.
Doctors need to make sure that the patient’s body really has a different sex immured in it. Mere mortals are prescribed a consultation with a urologist - andrologist, therapist, sex therapist, plastic surgeon. Typical list of examinations:

screening, blood biochemistry, analysis for hepatitis C, B, HIV, syphilis, coagulogram, RW;
urine test, check of the genitourinary system (ultrasound, ultrasound examination of the penis, urethroscopy, cavernosography, smear to detect infections);
fluorography;
ECG.

5 days before day X you should not take anticoagulants. The process itself is carried out as planned, in a well-equipped andrology department. You must come to the clinic clean, with a shaved pubic area and on an empty stomach, otherwise there may be problems with the anesthesia.

What is more important: length or thickness?

LengthThickness

Stages

Phalloplasty is performed in several stages:

patient examination;
taking a skin flap, covering the donor area with skin;
preparing the groin area for surgery;
fixation of the neophallus with the attachment of musculocutaneous and nervous blood tissues;
rehabilitation.

After complete engraftment, additional surgical procedures are performed:

the head of the penis and the urethral canal are formed;
corpus spongiosum prostheses are implanted.

After phalloplasty is completed, the penis becomes a functionally and aesthetically valuable organ.

Progress of the procedure

The course of the process depends on the goals set: aesthetics (removal of curvature, thickening, enlargement) or modeling of the penis from scratch (reconstruction, restoration). All manipulations are performed under general anesthesia . Ideally, phalloplasty involves two doctors: a plastic surgeon and a urologist.

Phalloplasty with thoracodorsal flap

Operation stages:

cutting off the flap according to the markings;
neo-phallus modeling – the skin is twisted into the shape of the future penis;
the surgeon works his magic on the restoration of muscle and skin tissue;
An additional skin flap is placed on the wound (from some side);
the finished phallus is sewn onto the periosteum in the pubic area according to the markings;
muscle strengthening occurs. If there is a transsexual on the table, the clitoris is sutured into the base of the penis. This preserves sensitivity;
restoration of the vascular system, connection of arteries, nerves that provide sensitivity and blood flow.
suturing wounds

Working with a radial flap (fallourethroplasty)

Option of stem urethroplasty.

The technology is as follows:

the skin along with the vascular bundle is cut off from the forearm area. Two flaps are taken, since the area between them will form the future urethra;
the skin is formed into a tube - this is the basis of the penis;
when finished, it moves to the groin;
microsurgically, the “blank” is connected to veins, arteries, and nerve endings by hand;
The neo-urethra is connected to the patient’s urethra, and the wounds are sutured.

The method provides normal blood circulation and sensitivity.

Pubic phalloplasty

The doctor removes a flap from the lower abdomen. It also curls into a tube, creating the body of the phallus. This approach is used much less frequently - it makes it impossible to urinate while standing. But there are also benefits: with pubic plastic surgery, the penis is used more flexibly for penetration.

Aesthetics (enlargement plastic surgery)

To thicken and enlarge the reproductive organ, do this:

the surgeon gets to the ligament that supports the penis;
it is dissected and shifted forward, which gives a few extra centimeters;
Thickening is achieved by pumping the patient's fat taken from other places. Silicone is often used instead of fat.

Are you happy with your size?

Yes I want more

Penile prosthetics

Phallus prosthetics is performed after the main stage of phalloplasty.

It happens like this:

vascular endoprostheses are introduced into the neophallus, replacing the cavernous bodies;
when a thoracodorsal flap was used, the prosthesis is placed directly into the muscle tissue;
If a radiation flap was taken, implantation is carried out under the skin.

Vascular prostheses grow in 100% within 2 months. Then semi-rigid dentures are inserted into them.

Prosthetics of cavernous bodies

Prostheses of the corpora cavernosa of the penis are used to enable the neophallus to become erect, or in severe cases of erectile dysfunction.

They are often in the form of inflatable rods that allow you to simulate an erection and perform sexual intercourse. Or these are semi-solid silicone implants implanted into the body of the penis for the same purpose.

In modern phalloplasty, a two-stage approach is usually used: first, vascular prostheses are introduced into the body of the neophallus. They are fixed to the pubic periosteum and grow into the organ within 2 months. The vascular prostheses are opened and semi-rigid or inflatable penile prostheses are implanted.

That is, the silicone prosthesis is attached not to living tissue, but to a vascular structure that has already grown into the body of the penis. This 2-stage operation can significantly reduce the likelihood of prosthesis rejection, its displacement and erosion of surrounding tissue, inflammation and implant rejection.

Vascular implants of inflatable prostheses prevent them from inflating too much and squeezing the tissues of the neophallus, and also rigidly fix the silicone implants in the right place. That is, vascular implants play the role of the protein membrane of the penis.

Postoperative period

If everything went well without complications, you will have to undergo 10 days of therapy in the hospital. The body is supported with antibiotics and painkillers . The urethra is washed daily and bandaged. The sutures are removed within 8-10 days.

After six months, we need to improve the result:

restore the head for the most natural look;
if the operation was performed on a thoracodorsal flap, the surgeon will only have to make the urethra (urethroplasty);
acquire rigidity - the ability to coitus will be returned by the endoprosthesis.

At this time, heavy physical activity is unacceptable. Sexual intercourse is possible after 2 months.

Preparation

Before phalloplasty, the patient undergoes diagnostics. At this stage, possible contraindications are identified. He visits a therapist, cardiologist, urologist, sex therapist, surgeon, and other doctors as indicated. A set of studies is being carried out:

fluorography;
ECG;
Ultrasound of the genital organs;
lab tests.

The list of laboratory tests includes blood tests for:

HIV status;
biochemical composition;
clotting;
blood group, Rh factor.

You also need to submit:

general blood and urine tests;
smear from the urethra.

It is necessary to talk with the anesthesiologist, inform about the medications taken, and receive recommendations on preparing for anesthesia.

Price

The cost of reconstruction is calculated individually. If the doctor performs the operation in one stage, the costs will be lower. A technically complex, multi-stage intervention can last a year and requires significant financial investments. In the capital, average prices for phalloplasty start at 210 thousand rubles. It will be cheaper in the regions.

Here are some useful addresses:

Medlux - metro station Pervomaiskaya, Sirenevy Boulevard - 32 A;
Andrology Clinic - metro Chkalovskaya, Second Syromyatnichevsky Lane - 10;
Research Institute of Urology named after N.A. Lopatkina - metro station Shchelkovskaya, Third Parkovaya street - 51, building 1.

results

Depending on the goals of phalloplasty, the following results are achieved:

the length and width of the penis changes within the required limits;
Congenital defects are corrected, the process of urination is normalized, and normal sex life becomes possible;
the quality of sexual life improves with erectile dysfunction.

There are no visible scars or scars after surgery. Advanced techniques minimize the risk of developing any complications.

Contraindications

In order for a serious intervention not to backfire, excellent health is required.

Hopes of getting a new member fade if there is:

decompensated diabetes mellitus;
pathological changes in the kidneys, liver, bladder, heart, lungs;
severe somatic conditions;
cystitis and other inflammations of the genitourinary system;
autoimmune diseases;
mental problems;
blood incoagulability;
damage to the genitals by infections - trichomoniasis, gonorrhea, herpes, chlamydia;
fistulas, dermatitis, boils.

How much do you want to increase?

1-3cm3-5cm

Rehabilitation

Depending on the complexity of the phalloplasty, the patient spends one to four days in the MHC hospital. While there, competent postoperative care is provided, and high-quality and timely medical care is provided. Patients take antibacterial drugs prescribed by the doctor. Emptying the bladder during this period is carried out through a catheter. Swelling persists for some time. At the end of their stay in hospital, patients are discharged from the clinic and receive recommendations. The regime is scheduled for one to two months.

Rules for carrying out hygiene procedures. For several days, hygiene procedures should be carried out so that water does not get on the bandage. Subsequently, you can wash as usual, but you cannot rub the surgical site.
Sexual rest. Intimacy is possible no earlier than one and a half months after phalloplasty.
Physical activity. For at least two weeks, you should not exert yourself too much - play sports, lift weights. Otherwise, the seams may come apart.
Psychological peace. After phalloplasty, it is recommended to avoid stress and avoid strong emotional shocks. If you have increased anxiety, it is useful to take time for quiet walks in the fresh air.
Cloth. During the rehabilitation period after phalloplasty, tight clothing and tight underwear are contraindicated.
Taking medications. After discharge, you may need to take some medications - the doctor makes the necessary prescriptions.
Scheduled visits. You must come for examination and dressings at the frequency specified by your doctor.

In the future, the man can lead a full life.

Advantages of MHC

In Novorossiysk, penile plastic surgery is performed by MHC surgeons.
At the clinic, you can quickly take the necessary laboratory tests, do an ultrasound, and consult with doctors. Completing a comprehensive examination in one place shortens the preparatory stage. The operation is performed by experienced surgeons. The use of modern techniques minimizes the duration of recovery after phalloplasty in the hospital and at home. After its completion, patients spend time in the hospital in comfortable conditions under the supervision of doctors. The cost of staying there depends on the category of the ward and the period of rehabilitation. Patients can choose a single, double or VIP ward - they are equipped with everything necessary. If you have any questions, you can ask them in the chat on the website, by phone – +7(8617) 309-001, +7(8617) 309-002) or by ordering a call back. Author of the article: urologist surgeon, oncologist-urologist, plastic urologist. Highest category, K.M.N. Sherudilo Nikolay Vasilievich

Phalloplasty: photos before and after surgery, reviews and videos