Kamol Hospital - Thailand Cosmetic & Plastic Surgery

Home Our Service Phalloplasty

Female to Male @ Kamol Hospital - Thailand Cosmetic & Plastic Surgery


Phalloplasty



Phalloplasty / Female to Male Surgery (FTM Bottom Surgery)

in Bangkok, Thailand 

 

What is female to male sex reassignment surgery?

          Female to male sex reassignment surgery changes the apperance of female genitals to those of a males. This has a profound and confirming effect on trans men as they have the body they were supposed to be born with. They can urinate standing up. Can achieve erections with many procedures. Will no longer have a vagina and also if a hysterectomy is performed no longer menstruate.

          There are two main methods in creating a new penis. It sometimes involves changing the clitoris into a penis or it can involve taking a skin flap from the patient's forearm or thigh and creating a penis using this skin. A person will have taken male hormones for at least a year before surgery for either surgery. During the procedure, the surgeon also removes the vagina, in a vaginectomy and a hysterectomy is often performed at the same time.

 

What is Phalloplasty?

          Phalloplasty is the surgical creation of a penis. In this procedure, surgeons harvest one or more "flaps" of skin and other tissues from a donor site on your body, arms, thighs or abdomen and use it to form a penis and urethra.

 

Who is a good candidate for Phalloplasty?

          A good candidate is someone who has taken male hormones for over a year, is healthy and has realistic expectations about the surgery & ongoing care that is needed afterwards. 

 

Benefits of Phalloplasty include:

  • Patients are more likely to be able to sexually penetrate their partners.
  • The phallus is significantly larger than those created through metoidioplasty although sensation is significantly lower.
  • People feel that this surgery creates more natural-looking genitalia.

 

What is Metoidioplasty? Who is a candidate of Metoidioplasty

       Metoidioplasty is the creation of a penis from a hormonally enlarged clitoris. During a metoidioplasty, the clitoral ligaments are detached which allows the clitoris to lengthen and drop into a position similar to that of a cisgender penis. On average metoidioplasty creates a penis that is between 5 and 7 centimeters long.

 

Benefits of metoidioplasty include:

  • Metoidioplasty usually has a slightly lower risk of complications than phalloplasty.
  • Metoidioplasty is usually more affordable.
  • This procedure offers a shorter healing time.
  • The phallus created by metoidioplasty has natural erectile function, and there is no need for a penile prosthesis.
  • Erotic sensitivity of the clitoris is maintained in the phallus.
  • It has lower complication rates and requires fewer procedures, even with urethroplasty.
  • It does not result in large scars.

 

Phalloplasty in Female-to-Male Gender Confirmation Surgery

Candidate for phalloplasty should have qualities as follow:

1. The patient must be at least 20 years of age. Consent from parents or legal guardians is required to complete the surgery for minors under 20 years old.
2. The patient must have continuously taken male hormone for at least one year.
3. The patient must have lived a life as a man for at least one year.
4. The patient must have undergone a psychiatric evaluation and been declared mentally stable and fit by a psychiatrist.
5. The patient must be physically fit.
6. The patient must have undergone mastectomy and total hysterectomy-oophorectomy for at least six months prior to phalloplasty.

 

Dr.Kamol Pansritum

Since 1997 Dr Kamol has performed over 10,000 procedures on transgender patients and over 5,000 sex reassignment surgeries (SRS). Recognized and respected throughout the medical community as one of the most experienced surgeons working in gender reassignment surgery in the world Dr. Kamol currently performs more than 500 male-to-female sex reassignment surgeries each year. He is the chief plastic surgeon at Kamol Cosmetic Hospital in Bangkok, Thailand where he leads the team in male-to-female and female-to-male sex transitions and face feminization. 

See more Dr. Kamol Profile

 

Phalloplasty Techniques

Kamol Hospital offers the options for phalloplasty as the follows:

1. Anterolateral thigh pedicle flap (ALT-Phalloplasty)

This is the primary option of phalloplasty in Kamol Hospital. The surgery is a two-stage technique with the urethral prefabrication. The skin with its pedicle containing nerves and vessels from the front and outer part of the thigh is used to reconstruct the new penis. The donor area is covered with a split-thickness skin graft from the adjacent area. The vaginectomy, hysterectomy, and oophorectomy must be done at least 6 months before the penile reconstruction. The surgeons will connect the urethra at one stage. A candidate for this technique must have the skinfold thickness of tight approximately 1.5 cm, and non-overweight. This is a non-vessel anastomosis technique, thus the risks of vascular thrombosis are very low. 

Advantages and disadvantages of ALT Phalloplasty:

  • Good skin color match
  • Larger girth than RFF Phalloplasty
  • Some natural rigidity
  • Less obvious donor site, concealable with clothing
  • Decreased surgical time with Pedicled ALT
  • Good sensation
  • Good potential for urethroplasty

Disadvantages of ALT Phalloplasty:

  • More difficult in patients with thicker skin and more subcutaneous thigh fat
  • In some patients, girth can be excessive
  • Less predictable perforator layout adds complexity
  • Sensation is reportedly less than RFF Phalloplasty
 
 

2. Alternate options of phalloplasty in Kamol hospital

• Radial forearm free flap (RFFF): The skin at the front side of the forearm is used to reconstruct the new penis under the microsurgery technique.

The advantages and disadvantages of RFFF

Advantages:

The skin in this area tends to be thinner.

Disadvantages:

Donor site can be difficult to conceal.

Partial skin graft loss

Decreased sensitivity,

Possible motion issues with the hand

 

• Fibula Free Flap (FFF): The skin, nerves, and some parts of the fibula bone are used as the neophallus (penis) under the microsurgery technique.

The advantages and disadvantages of FFF

Advantages:

  • Length of the flap's blood supply
  • Less prominent scarring;
  • Natural rigidity for penetration with the use of the  fibula bone

Disadvantages:

Rigid appearance of the phallus.

Potential bone resorption

Potential curving and fracture of autologous bone transplants

 

• Musculocutaneous Latissimus Dorsi (MLD) flap: The skin island containing nerves and vessels is moved to the genital area to reconstruct the neo penis under the microsurgery technique.

The advantages and disadvantages of MLD

Advantages:

●      Less conspicuous donor site.

●      Relatively hairless donor site

●      Good aesthetic outcomes.

●      Possibilities for penetrative sex.

 

Disadvantages:

●      Poor sensitivity of the phallus

Phallus can be large requiring additional debulking procedures

ALT-Pedicle Flap

Picture 1: ALT-Pedicle Flap

 

Radial forearm free flap (RFF) technique:

We provide two techniques, as follows;

1. Two-stage technique

The two-stage radial forearm free flap technique involves urethral prefabrication prior to themain step (phalloplasty) for six months. This is suitable for those who have small size of forearm.

 

Radial Forearm Free Flap

Picture 2: Radial Forearm Free Flap

 

2. One-stage technique

The one-stage radial forearm free flap involves reconstruction of the neo penis and neo urethra in one stage under microsurgery technique.

Radial Forearm Free Flap

Picture 3: Radial Forearm Free Flap

 

Fibula free flap (FFF) technique:

The skin, a piece fibula bone, and nerves are used for the neo penis in one stage under microsurgery technique. The neo urethra is being pre-laminated in situ for six months prior to the main step of neo penis reconstruction.

Fibula Free Flap

Picture 4: Fibula Free Flap

 

Musculocutaneous Latissimus Dorsi (MLD) free flap technique:

The skin paddle contained nerves and vessels is moved from the area behind the arm to the genital area under the microsurgery technique to reconstruct the neo in the first stage. The neo urethra is constructed the second stage

MLP

Picture 5: Musculocutaneous Latissimus Gorsi (MLD)

 

Urethral reconstruction of phalloplasty

Kamol Cosmetic Hospital currently offers three options for neo urethral reconstructions as follow.
1. Skin graft from the groins
2. Peritoneum
3. SCIP flap

 

Comparison of different phalloplasty techniques

Flap technique

Size of neo penis

Donor scar

Sensation

Self-stiffness

ALT

Medium-to-Large

Thigh

Yes

No

MLD

Medium-to-Large

Side of Torso

Yes

No

Radial forearm

Small -to-medium

Forearm

Yes

No

Fibula

Small

Leg

Yes

Yes

 

Frequently asked questions for Phalloplasty

1. What preparations are involved in having phalloplasty surgery?
Hysterectomy including removal of the cervix. This should be done at least 6 months before the procedure
Permanent hair removal on the donor site must be completed before the surgery
Stop smoking. Smoking severely inhibits healing. 
 
2. Can I choose the length and size of my penis?
The length and size of your penis are determined according to the thickness and length of the skin of the donor site but the surgeon will give you a better idea and discuss your goals with you during your consultations.
 
3. Can I undergo a phalloplasty without proceeding with the closure of my vagina?
It is not possible to have a complete phalloplasty without a vaginectomy because vaginal tissues are needed in creating the urethra and the scrotum.
 
4.Do I have to stop taking my testosterone before or after surgery?
You don’t have to stop taking testosterone and can continue to use it normally. 
 
5.Will I be able to have an orgasm after phalloplasty?
Most patients can achieve orgasm. The clitoris is not removed and is instead worked into the base of the penis. Sensation varies from one patient.
 
6.Will I be able to ejaculate after my surgery?
No, because the prostate and tissues responsible for ejaculation are not present. Orgasms can be achieved though. 
 
7. What is the lifespan of testicular and penile implants?
So long as there are no complications. Testicular and penile implants can be left in indefinitely.
 
 
 
Preparation for Phalloplasty or Metoidioplasty
● Consultation with the surgeon to discuss your surgical goals, medical conditions, and treatments.
● Stop smoking and drinking alcohol for at least 2 weeks before surgery.
● Stop medicines, vitamin, or herbs that interfere with blood clotting, such as aspirin

 

Why Thailand is a plastic surgery destination?

          Thailand is a top destination for plastic and cosmetic surgery, as it is the high quality and specialist skills of the surgeons, they provide  the first class hospital treatments and the affordable cost all add up to a satisfying all-around package. There is also the added temptation to recover post-procedure in luxury hotels or recovery service apartments.

 

Why Kamol Cosmetic Hospital, Thailand, is a global GENDER CONFIRMATION SURGERY destination?

Kamol Cosmetic Hospital, one of the world’s best destinations for gender confirmation surgery.

Kamol Cosmetic Hospital is where dreams become reality. Accredited by the Joint Commission International (JCI), the gold standard in global healthcare, our surgeons have been recognized as the most skilled and experienced in the industry since our opening in 2012.

We aim to make your difficult transformation process as comfortable as possible.


World-Class Elite Plastic Surgeons

World-Class Professional

World-Class Services

 

See more

 

 

New Life, New found Family Love (FTM Story)

 

Our plastic surgeon

 

Request Consultation

 


Phalloplasty Before & After



See more before & after




ALT Phalloplasty Reviews


See more



CONTACT US
Consultations Daily : 08:30-18:00
Request a consultation