Kamol Hospital - Thailand Cosmetic & Plastic Surgery

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


Phalloplasty



Phalloplasty / Female to Male Surgery (FTM Bottom Surgery)

in Bangkok, Thailand 

 

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.

 

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. 
 
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.

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

• 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.

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


Phalloplasty Before & After



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ALT Phalloplasty Reviews


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