San Francisco
2299 Post St. Suite 207
San Francisco, CA 94115
(415) 530-5335
Los Angeles
1317 5th St #300
Santa Monica, CA 90401
(310) 751-5886
Phalloplasty is a masculinizing gender-affirming surgery that creates a neophallus (penis) using tissue from another area of your body, such as the forearm or thigh. This procedure may be a good fit for patients who want reconstructive options that go beyond what metoidioplasty typically offers, including goals related to appearance, standing urination, sensation, or other functions.
At Align Surgical Associates in San Francisco and Los Angeles, California, we approach phalloplasty with clear information, thoughtful planning, and recommendations grounded in your anatomy, priorities, and overall surgical plan.
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VIEW PHOTOSPhalloplasty involves creating a neophallus using tissue transferred from another area of your body. Depending on your surgical plan, phalloplasty may also include urethral reconstruction, scrotoplasty, glansplasty, or later penile implant placement.
Phalloplasty is usually performed in stages. Rather than doing every part of the reconstruction at once, surgery is often divided into separate procedures over time so tissue can heal, circulation can stabilize, and later steps can be approached more safely. The number of stages varies from person to person, but staging is often an important part of balancing function, healing, and long-term outcomes.
Your plan starts with what matters most to you, such as function, sensation, privacy, recovery realities, and your day-to-day life.
We'll be transparent about what a technique can and can't reliably do for your anatomy and priorities, and we'll explain why we're recommending a particular approach.
We don't reduce care to a single concern or body area. We look at your goals, your comfort, and what's safest and most supportive for you overall.
We understand that many patients come in with complex past healthcare experiences and strive to create an environment where you always feel respected, welcomed, and seen at every step.
Gender-affirming surgery isn't a side offering at Align—it's our life's work.
Care and language change over time. We are dedicated to staying current, listening, and adapting.
Phalloplasty may be a meaningful option for transmasculine, nonbinary, and other gender-diverse patients whose embodiment goals include a penis. Depending on the plan, this procedure may involve staged reconstruction, urethral lengthening, and later implant placement.
Because phalloplasty is highly individualized, consultation is less about following one standard path and more about understanding which options make sense for your anatomy, priorities, and overall goals. Some patients also compare phalloplasty with metoidioplasty, depending on their goals for size, function, and surgical staging.
Phalloplasty requires a donor site to construct the neophallus. The main options differ in scar location and visibility, tissue characteristics, and how they support goals related to sensation, standing urination, and overall staging.
Some phalloplasty approaches involve more specialized planning or microsurgical techniques.
| Consideration | RFFF (Forearm) | ALT (Thigh) | Abdominal-Based Flap | Latissimus Dorsi (Back) | Single-Scar Phalloplasty (SSP) |
| Donor area | Forearm | Thigh | Lower abdomen | Back | Thigh |
| Scarring | Visible forearm scar | Thigh scar, often easier to conceal | Lower abdominal scar, often more concealable | Back scar, often less visible day to day | Single linear thigh scar designed for easier concealment |
| Sensation potential | Often strong | Variable | More limited | More limited | Depends on anatomy and plan |
| Standing urination | Commonly supported with urethral lengthening | Possible in select staged plans | Less commonly pursued | Less commonly pursued | Possible in select cases |
| Staging | Usually multi-stage | Usually multi-stage | Multi-stage | Multi-stage | Depends on anatomy and goals |
| Best suited for | Patients prioritizing sensation and standing urination | Patients wanting a more concealable donor site | Patients for whom other donor sites are not ideal | Patients needing greater tissue volume | Patients prioritizing scar concealment who meet anatomy and safety criteria |
Many phalloplasty plans include optional procedures that support specific functional or aesthetic goals.
Some surgeons "offer" gender-affirming surgery among many other services. For Align, it's the center of our life's work. Our 6 board-certified surgeons have committed themselves wholly to gender-affirming care and research. This means we aren't just helping patients reach their embodiment goals; we are helping to make their care better—better understood, better supported, and performed in the best way possible. Meet the specialists behind the transformations.
Recovery after phalloplasty usually involves a hospital stay, activity restrictions, and close follow-up during early healing. Patients should expect wound care, limited mobility, and careful monitoring while both the donor site and reconstructed tissue recover.
Depending on your surgical plan and phase of treatment, recovery may involve catheters, drains, or other temporary supports. Your board-certified Align surgeon will explain what to expect at each stage, including when it may be safe to return to work, exercise, and other daily activities.
Some patients come to Align for primary phalloplasty, while others need help after prior surgery performed elsewhere. In some cases, additional surgery may be needed to improve healing, address urinary issues, refine contours, or treat other complications.
Common revision concerns include fistula, an abnormal connection that can cause urine leakage, and stricture, a narrowing that restricts urinary flow. Repair planning depends on your anatomy, tissue health, prior surgeries, and the specific issue being addressed.
Gender-affirming care, including phalloplasty surgery, is often covered by insurance. If you are using insurance, we will guide you through the authorization process and what to expect.
If you prefer to pay out of pocket, we will give you a personalized quote based on the details of your surgical plan, including the donor site, staging, and any additional procedures.
Travel planning can involve a lot of moving parts, especially when you're coordinating around surgery. If you're coming to Align from outside the Bay Area or Los Angeles, we have resources specifically for you.
As with any major surgery, phalloplasty carries risks, such as bleeding, infection, scarring, healing concerns, and changes in sensation. Because the procedure involves donor tissue, staged reconstruction, and sometimes urethral work, the planning and healing process can be more complex than with less complex procedures.
It is also important to understand that different donor sites and add-ons come with different trade-offs. We will help you understand which approach is most realistic for your anatomy and goals during your consultation.
The number of stages depends on the donor site, whether urethral lengthening is included, your healing progress, and which additional procedures are part of the plan.
There is no one best donor site for everyone. The right fit depends on your anatomy, sensation goals, scarring preferences, and how the donor site supports the rest of your surgical plan.
It may be possible if urethral lengthening is part of the plan. Your surgeon will explain whether that option is realistic for your anatomy and priorities.
Single Scar Phalloplasty (SSP) is designed to reduce visible donor-site scarring by using a single linear scar along the thigh. It is a specialized option that may not be the right fit for every patient.
Often, yes. Revision planning starts with understanding your surgical history, current anatomy, and the specific issue you want to address, whether that involves function, healing, or appearance.
We recommend booking a consultation if you’re looking for clear guidance on whether phalloplasty aligns with your embodiment goals, which donor-site options may fit you best, and how a staged plan may be structured around your priorities. This is also the right time to seek expert input if you are considering revision or repair after prior surgery.
When you’re ready, we’re here to help. Request an in-person or virtual consultation using the online form or call Align Surgical Associates to get started. We are proud to offer gender-affirming phalloplasty for Los Angeles and San Francisco patients, as well as individuals traveling from outside of California.
San Francisco Office: (415) 530-5335
Los Angeles Office: (310) 751-5886
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