Phalloplasty is a complex surgery to construct a penis, repair a penis after an injury or fix a congenital condition. Benefits include relieving physical and emotional difficulties, including gender dysphoria. Working with a surgeon who has lots of experience in phalloplasty reduces surgery risks. Recovery time may take a month or longer.
In most cases, phalloplasty (FAL-oh-plas-tee) is a type of gender affirmation surgery that uses large sections (flaps) of skin to create a neophallus (neopenis). “Neo” means “new,” and “phallus” means “penis.” But phalloplasty can also be a type of genital reconstructive surgery to create a neophallus to treat a congenital (present at birth) anomaly, severe penile injury (trauma) or disease.
Phalloplasty surgery goals may include creating a natural-looking penis that allows you to:
People assigned female at birth (AFAB) sometimes request a phalloplasty to align their physical bodies with their gender identities. It helps treat gender dysphoria.
Phalloplasty is also for people who have congenital conditions or experienced trauma to their penises.
Congenital conditions include:
Penile trauma may include:
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If you’re having gender-affirming phalloplasty, you’ll work with healthcare providers for at least a year to help prepare you for the procedure. This may include:
A healthcare provider may take tissue flaps from your:
The donor tissue area will also require a skin graft. You may have the donor area skin graft at the same time as the phalloplasty or a few weeks later.
In general, before phalloplasty, you’ll need to:
If you must take some medications before surgery, you may take them with a small sip of water.
The following healthcare providers may make up your phalloplasty team:
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An anesthesiologist first gives you general anesthesia before surgery. General anesthesia puts you to sleep. You won’t feel pain or experience any other sensations during surgery.
Then, surgeons take a large flap of skin from your forearm or thigh. The flap contains all the parts that make up biological penile tissue, except for erectile tissue. This includes:
They’ll roll the flap to form a shaft and attach it to your groin. You’ll just have a shaft — you won’t have a head (glans).
You may also get additional changes or gender-affirming surgeries at the same time as your phalloplasty, or your surgeons may break them up into different stages so you have time to heal between procedures. These extra procedures may include:
It depends on many factors, including whether your phalloplasty care team performs other procedures. But in general, phalloplasty may take eight to 10 hours or longer to complete. If you choose to have other procedures in different stages, it may take between 12 and 18 months to complete.
After phalloplasty, you’ll stop receiving anesthesia. You’ll wake up after a few minutes but likely feel groggy. Healthcare providers will monitor your overall health and manage your pain once you fully wake up.
Phalloplasty is an inpatient procedure. You’ll be in the hospital for at least a week after phalloplasty to monitor the blood supply to your neophallus.
You need time to heal after the procedure. If your phalloplasty team performs the surgery in several stages, you need to schedule the other procedures several months after your first procedure.
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One of the main benefits of phalloplasty is relief from physical or emotional challenges. Results include a natural-looking penis that’s capable of functioning sexually. As part of gender-affirming surgery, it helps you achieve your gender identity.
Other benefits depend on which options you choose:
You may get a penile implant to get an erection whenever you choose. A healthcare provider will talk to you about and review penile implant options with you.
Yes, you can feel sensation after phalloplasty. But you may have less feeling in your neophallus than the donor area of your skin before the procedure. The sensation may increase on its own over time. A healthcare provider may also recommend a special rehabilitation training to improve feeling over time.
In the hands of a qualified surgeon with a lot of experience, you’ll have a typical-looking penis after phalloplasty.
The skin that healthcare providers use to make your neophallus is different than typical penis skin, so there may be differences in color and thickness — you may not be able to see veins. You may have scarring on the bottom of your shaft and around the tip. Your penis will also be about the same size when it’s erect as it is flaccid (not erect).
Your penis length may vary according to the donor site. But on average, you should expect your penis to be 5 to 6 inches (12.7 to 15.2 centimeters).
Yes, it’s possible to orgasm. Regardless of your flap type, the nerves for orgasm connect to the flap. For most people, this preserves their ability to orgasm.
Studies show that phalloplasty has a very high satisfaction rate. Most people are happy with how their neophallus looks and its sexual function.
Phalloplasty is a complex penis surgery. Many people experience complications. It’s very important to go to an experienced surgeon to lower your risk. Complications are less likely to affect your long-term results if a healthcare provider catches them early.
Potential complications of phalloplasty may include:
After phalloplasty, you must rest. Many people don’t resume their usual activities until at least six weeks after surgery. Recovery includes:
Most people can return to work or school about two to three months after a phalloplasty. But if you have a more physically demanding job, it’s a good idea to take more time off — you may need to take up to three to four months off work to recover.
Achieving the full function of your penis takes time — in most cases, a year or longer. It will require multiple surgeries. The time it takes depends on whether your treatment involves:
Schedule regular follow-up appointments with your healthcare team after a phalloplasty to see how your body is healing. It’s also a good idea to continue seeing a mental health professional with experience in transgender care if you get a phalloplasty to help transition to your gender. They can offer support as you work through your recovery and adjust to life after surgery.
Call a healthcare provider or seek emergency care if you have:
It depends on if you get urethral lengthening.
If you don’t get urethral lengthening, you’ll pee out of your original urethra, which will be in the layer of skin between your genitals and anus (perineum).
If you get urethral lengthening, you’ll pee out of your new urethra in your neophallus. This may feel strange at first — it may feel like you’re going to pee out of your old urethra in your perineum. But as you adjust to your new penis, you’ll acclimate to this new way of peeing.
If your phalloplasty includes urethral lengthening, surgeons will use donor skin from areas of your body that may have a lot of hair to extend your urethra. Without electrolysis or laser hair removal, the hair will continue to grow when the surgeons use the donor skin to make your urethra. If hair grows inside your urethra, it can increase your chances of developing urinary tract infections (UTIs) or urethral stones (kidney stones in your urethra). Before phalloplasty, your surgeon will help you identify where you must undergo permanent hair removal on your donor area.
Other names for phalloplasty include:
A note from Cleveland Clinic
You may wish to pursue phalloplasty for many reasons. It may be a step in your gender affirmation process, or it may be treatment for trauma or a congenital condition. Whatever the reason, it’s a big decision, and it’s natural to be nervous and have questions. How will my penis look? How big will it be? What will it be like to pee? Will I be able to get an erection? Will I be able to feel sensations and orgasm?
When it comes to choosing what’s right for you and your body, the input of healthcare providers with extensive experience in phalloplasty is invaluable. Make sure they answer all of your questions and consider all of your concerns. It’s your body. Your comfort and satisfaction matter most.
Last reviewed on 06/06/2024.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy