Phaloplasty: ALT (anterior lateral thigh) flap
Advances in modern surgical techniques allow us to fully reconstruct the male genitalia, using tissue from other parts of the body. Most generally accepted techniques today are the radial flap and the ALT flap. In the first case, the skin and tissue are harvested from the forearm and microsurgically transferred to the genital area.
Phaloplasty: expanders and penile pump
Choosing the right type of genital reassignment is a personal matter, which is based on the patient’s personal preference and sexual orientation. A flap based phalloplasty such as the ALT or radial flap, although pleasing in terms of size and appearance, may not be the first choice, due to complexity and higher complication rate.
Hysterectomy
The removal of the inner female genitals including the uterus and ovaries is performed from our partner obstetrician and is usually carried out simultaneously with the mastectomy, or any other given time. Although this procedure is not obligatory and has no effect on gender affirmation, it is required to prevent unpredictable hormonal changes on the uterus and to reduce estrogen production, helping the hormonal substitution in general.
Penile and scrotal implants
The last procedure which fulfills female to male reassignment is the implantation of penile and scrotal devices. This performed at least 12 months after the phalloplasty, when all surgical sites have healed completely. Penile implants are chosen individually and either malleable or hydraulic erectile devices can be inserted.