The surgical procedure to construct penis is called phalloplasty. The aims of phalloplasty are:
The erectile and functional penis requires two stages for reconstruction:
There are two techniques for penile reconstruction depending on the donor tissue site.
Duration of Procedure: 7-8 hrs. You need to stay for about two to three weeks.
Recovery Time: Back to work in 4-5 weeks. Strenuous activities in 8- 9 weeks.
Longevity of Results: Permanent.
To make the penis erectile and stiff, a penile implant is inserted. The usual requirement is that the penis should be fully sensate. It means it can be performed 6 to 9 months after stage I of phalloplasty as the penis gains sensations till tip during this period.
Duration of Procedure: 1 -2 hrs. You may go home on the same day, though if you wish you may stay overnight.
Anesthesia: GA or local with sedation.
Recovery Time: Back to work in 2- 5 days. Strenuous activities in 4- 6 weeks. Sexual activities after 8 week.
Longevity of Results: Permanent.
Most of the urinary problems (mostly the fistula) resolves within one or two months. Nowadays a controlled fistula is recommended at the junction of neourethra and native urethra. After few weeks (3 to 5 weeks) both are joined thus leading to normal urethra. Urinary problem can always be rectified and it is should never be permanent.
After penile implants, erection is not painful. Nowadays the prostheses are hinged and erect penis is easily accommodated in the underwear. Sexual intercourse has not been experienced as uncomfortable by our clients.
Native clitoris remains erogenous and is buried at the base of neophallus. Owing to usage of maximum nerves in free flaps (like in radial artery forearm flap phalloplasty), the sensations are normal in neophallus.
In addition to sexual pleasure almost all achieve orgasm. This is because the native nerves used are erogenous pudendal nerves leading to fully sensate and erogenous penis/ phallus.
Yes, you will get certificate after phalloplasty stage 1 and that is legally valid.
There is no thumb rule for the timings of vaginectomy and it is personal preference of the client. In most of the cases vaginectomy is done before phalloplasty. During vaginectomy I use a vaginal tissues to elongate the urethra (also called as urethral extension and urethral masculinization). This elongated urethra is very useful during phalloplasty. Stage one phalloplasty is long and dedicated procedure and should not be combined with vaginectomy. Vaginectomy can be done along with stage 2 phalloplasty.
Scrotoplasty can be done with phalloplasty stage 2 or as a separate procedure depending on the budget.
Glansplasty can be done about 3 months after stage one once the tissues are soft. This can also be done about 3 months after stage 2 once the implants are settled. Please note that glans reshaping is also done during phalloplasty stage 1 (subjected to blood supply) to give more or less normal looks.
You will be able to urinate while standing if native urethra is joined to phallo neo urethra. Occasionally the urethra is joined at a later date to allow better healing for neo phallus.
You will look like male and you can perform sexual activities like normal males. Most of the FTM candidates start look like a male even after few months of testosterone therapy.