Considerations for Single-Scar Phalloplasty

What is single-scar phalloplasty?

 

Phalloplasty is a complex gender-affirming procedure that creates or reconstructs a penis for transgender men. This type of surgery has a lot of parts to it, and it may come with complications, which makes it a challenging procedure to do well in medicine.

 

Phalloplasties have traditionally required patients to accept a fair amount of scarring on their arms, legs, or other body parts – most often the forearm or thigh. This is because the procedure requires taking skin from a donor site to create the phallus. We have heard many patients say that they wish to avoid as much scarring as possible, and it is always important to really try to understand the difficulties patients face and look for ways to improve the procedures to achieve the best outcome possible.

 

With single-scar phalloplasty, I am aiming to develop new ways to perform phalloplasty surgery that allows patients to reduce the amount of scarring left behind by the procedure. Using a new combination of techniques, this procedure will make it possible for patients to have a single scar line along the thigh.

 

Does this procedure differ from other phalloplasty procedures in any way?

 

The goals for single-scar phalloplasties are ultimately the same as any phalloplasty procedure, but with this technique, the difference lies in how the end goal is achieved. Patients who receive this procedure will be able to urinate, sustain erectile function and be more confident in their gender.

 

What makes someone a good candidate for this procedure?

 

We are trying to make single-scar phalloplasty applicable to as many people as possible. However, a good candidate for this procedure is well-informed about the options available to them and potential complications.

 

There are so many great surgeons that offer more traditional phalloplasty procedures, but if a patient is looking for someone who is trying new techniques that can offer less scarring, then I am happy to be their surgeon. At the end of the day, I want my patients to be happy and have a good result.

 

What are the risks/complications?

 

Two of the most common complications patients experience after phalloplasties are related to the urethra, which is the tube we urinate through. The first complication is called a urethral stricture, which is when the urethra is narrowed or has a tight area that makes it difficult to urinate. The second is a urethral fistula, which is when there is a leak in the urethra, causing

flow disruption. We offer procedures to help correct these complications that can occur post-surgery.

 

What can someone do to prepare for this surgery?

 

The biggest thing a patient can do is be informed – understanding the different plans and techniques available to them and then discussing with a surgeon what might be best for them.

 

Secondly, I would say every patient should have good social support. For all phalloplasty procedures, it is not just one operation but many over 1-2 years. It is important to have good mental health, family, and social support to help navigate your surgical journey.

 

Lastly, patients should physically be in good health, including maintaining a healthy weight and low body fat percentage, because surgery can be stressful for the body. The better shape you are in, the smoother your recovery will be.

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