Kamol Hospital - Cosmetic & Plastic Surgery Joint Commission International
Kamol Hospital - Cosmetic & Plastic Surgery

Female to Male @ Kamol Hospital - Cosmetic & Plastic Surgery


Phalloplasty



Phalloplasty in Female-to-Male Gender Confirmation Surgery

Our criteria of those who quality for phalloplasty are as follows:
1. The patient must have be at least 20 years of age. If the age is lower than 20, it is required that the legal parents or guardian authorize their permission to the surgery.
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 1 year.
4. The patient must have undergone a mental test and been certified by a psychiatrist as in normal mental state.
5. The patient must be in physically fit condition.
6. The patient must have undergone mastectomy and total hysterectomy-oophorectomy for at least 6 months.

 

Kamol hospital offers 4 options for phalloplasty

1. Anterolateral thigh pedicle flap (ALT)
Skin with its pedicle containing nerves and vessels from the upper and outer part of non-dominant thigh is used to reconstruct the new penis.
 
2. Radial forearm free flap (RFF)
The skin at the front side of forearm is used to reconstruct the new penis under microsurgery technique.
 
3. Fibula Free Flap (FFF)
The skin, nerves and some parts of the fibula bone are used as the neo phallus (penis) under microsurgery technique.
 
4. Musculocutaneous Latissimus Dorsi (MLD) flap
The skin island containing nerves and vessels is moved to the genital area to reconstruct the neo penis under microsurgery technique.

Anterolateral thigh pedicle flap technique:

 We provide two techniques, as follows;

1. One flap technique
     The surgical technique involves a two-step operation; the first step includes oophorectomy-hysterectomy (O&H), vaginectomy, urethral lengthening and urethral tube preparation (urethral prefabrication). The neophallus (penis) is reconstructed with the pedicle flap with sensory nerves and urethral anastomosis (connection) is in the second step. The duration between first and second step is approximately 6 - 12 months.

 

2. Double flaps technique or Two flap technique
     Patients also need O&H, vaginectomy and urethral lengthening 3-6 months prior to the step of neo penis reconstruction. The redial forearm free flap is used for the neo urethra under microsurgery technique while nerves and urethral re-connection are performed. The ALT flap is wrapped around the radial forearm urethra at one-stage operation.

 

(Picture 1: ALT-Pedicle Flap)

 

Radial forearm free flap technique

We provide two techniques, as follows;

1. Two-stage technique
The two-stage radial forearm free flap technique involves urethral prefabrication prior to the main step (phalloplasty) for 6 months. This is suitable for those who have small size of forearm.

 

(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.

(Picture 3: Radial Forearm Free Flap)

 

Fibula free flap 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 6 months prior to the main step of neo penis reconstruction.

(Picture 4: Fibula Free Flap)

 

Musculocutaneous Latissimus Dorsi (MLD) free flap

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

 

(Picture 5- MLP)

 

Urethral reconstruction of phalloplasty

Kamol hospital currently offers 3 options for neo urethral reconstructions, as follows;
1. Skin graft from the groins
2. Buccal mucosa
3. Intestinal musculo-mucosa

 

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

Yes

Radial forearm

Small -to-medium

Forearm

Yes

No

Fibula

Small

Leg

Yes

Yes



Phalloplasty Before & After



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Reviews Phalloplasty


ALT Phalloplasty Reviews

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**INDIVIDUAL RESULTS WILL VARY. IMAGES DO NOT CONSTITUTE A PROMISE **

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