A Brief Information about Phalloplasty

Phalloplasty is a medical term of constructing, reconstructing, or modifying a person’s penis due to medical condition or cosmetic purposes (also known as penis enlargement). A phalloplasty is usually performed to patients with genitalia deformities like micropenis or hypospadias, patients who lost their penis, or female to male transsexual patients. First phalloplasty ever recorded in history was performed with the aim of female to male sex reassignment surgery, undergone by a trans man, Michael Dillon, in 1946. Dr. Harold Gillies, the surgeon, documented the technique in Pagan Kennedy’s book “The First Man-Made Man”.

Basic Methods of Phalloplasty

Surgeons have four different methods in performing phalloplasty. Basically, these methods include a graft of tissue and skin from donor and an extention of the urethra. Phalloplasty can create a penis up to 7 inches long (approximately 14-18 cm) and 5.9 inches (approximately 11-15 cm) in circumference.

Phalloplasty is simpler for real male (or termed as cis men) than for trans men, because there is no significant requirement of urethra extension. In trans men, the urethra finishes close to the vaginal opening and, therefore, needs to be significantly extended. The urethra extension is the most difficult phase of phalloplasty. In trans men, phalloplasty is also followed by scrotoplasty. Scrotoplasty is a construction of scrotum, where testicles are located. Scrotoplasty can be done by using labia majora or vulva. Then prosthetic testicles can be inserted in the scrotum after scrotoplasty is done.

The success of a phalloplasty can not be measured just by whether the penis has been constructed/reconstructed or not, but by whether the penis could perform similar functions like natural penis. For instance, could it achieve an errection and sexual penetration? In this case, an implanted erectile prosthesis is required in every phalloplasty. Some kinds of this implanted erectile prosthesis include malleable rod-like medical devices—that allow the penis to erect or be flaccid. Still, in this case, the success rate of erectile prosthesis implantation in trans men is lower than that in cis men. But, surgeons usually use their experience in sex reassignment surgery to trick the implantation to lower down the potential risk.

Former methods of this implantation require a bone graft as part of the phalloplasty. Studies from Germany and Turkey have given proof that these reconstructions can hold the stiffness without any further complications. However, in this case, the penis will not have the ability to become flaccide without breaking the bone graft apart.

In penis enlargement, phalloplasty is sometimes performed by cutting the suspensory ligament that hold the penis near to the upper skin. It allows the penis to grow toward the outside of the body instead of upward. This is done by doing a horizontal incision around the pubic bone region, where the pubic hair will help covering the incision part. After all, the penis is free from any incisions.

There is still research in progress about synthesizing corpus cavernosa, or the erectile tissue, performed on rabbits in laboratory. This is done to dig more about eventual use in patients who require phalloplasty. The last report of this research tells that the rabbits give response to sexual stimulation, just like to the tissue of male rabbit which is not any parts of the research.

Patient Satisfaction

Approximately 90% of the patients undergoing phalloplasty is satisfied, while only 9% of them complain about the sensitivity of their new penis. Meanwhile, 51% of them are able to do sexual penetration without pains or difficulties. Moreover, 40% of these patients are able to apply for a job they can not apply for when they were still female. There is 27% of them who needs temporary use of anti-depressants, while 93% (or mostly) of them said that they were happy with their new penises.

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