Phalloplasty

In ancient times, the masculinity factor of a man was considered to depend upon the size of his penis. Larger the size of the penis, greater will be the masculinity. The culture of each part of the world, including India, Europe, Greece, and Egypt, worships phallus as a symbol of creative energy. The size, shape and functioning of the men often affects their personality and self-confidence. They either feel embarrassed or proud in public. The penis size is considered to be directly linked with a female partner satisfaction, love, intimacy, and sexual performance. The recent achievements in cosmetic field showed the development of safe and effective procedures for penis plastic surgery. Nowadays, in India, the percentage of people choosing to have Phalloplasty has increased greatly. The surgical procedures aim to improve and restore the love lives of the people. People are driven to India to have an overall improvement in the psychological aspect of self-image. They are not much interested to undergo a simple cosmetic change. One of the most selective cosmetic surgery for men is the Phalloplasty plastic surgery. Better healthcare facilities and low cost has enhanced the scope of Phalloplasty in India. It costs only about 1/10th in India when compared with cost in other countries.

A wide range of invasive procedures is included in the Penile reconstruction surgeries. Several congenital abnormalities of the penis or urethra as well corrected using radical treatments. Unsatisfactory sexual performance, intimacy or relationship problems and other such issues can be improved by Penis modification. In the cosmetic field, Phalloplastry can be referred to as the construction or artificial modification of a penis. The procedure is often known as penis enlargement. The girth, length, and/or glands of the penis are tremendously enhanced with the Penis plastic surgery. The penis surgery comprises of two major holy grails. First is the ability to have a penetrative sex while the second deals with the proper passing of urine from the tip. Congenital or acquired reasons may cause the missing penis condition in men. This medical condition requires plastic surgery for correction. The surgery is also indicated for women with gender dysphoria. The artificial construction or reconstruction plastic surgery of a penis involves many other disorder aspects such as failed epispadlas or hypospadias repair, penile agenesis, sexual development disorder (intersex conditions), micropenis and penile cancer.

In genital reconstructive surgery, one of the most crucial surgical procedure is the Neophalloplasty. Construction of cosmetically and functionally acceptable penis is the main goal of the neophalloplasty. Surgeons involved in the genital reconstruction in neophalloplasty face the major challenge in Urethral reconstruction. Phalloplasty comprises of four different techniques. However, all techniques make use of a tissue graft from a donor site and urethra extension. In urethral lengthening, it is suggested to use different flaps such as scrotal skin, labial skin, penile skin, etc. or grafts like bladder, skin, and buccal mucosa. Sometimes, the surgery may also involve graft from the leg, arm, side of the chest, or around the pelvic bone. The easiest operation is the one which uses the forearm as the donor site. However, a cosmetically undesirable scar is formed on the exposed arm area.

Stages of Phalloplasty:

The Phalloplasty procedure involves following fours stages:

Stage 1: Phallus formation

Stage 2:Urethra formation

Stage 3: Testicular prostheses, Glans-sculpting, etc

Stage 4: Penile prosthesis

For achieving an erection in Phalloplasty, an implanted erectile prosthesis is needed. A separate surgery is usually done for prosthesis to allow time for healing. In some cases, clitoris are hidden by a cleverly placed testicular prosthesis. Regardless of the type of Phalloplasty, the prosthesis implantation is done after the completion of the urinary tract. Before implanting a penile prosthesis, implantation of a reservoir of testicular prosthesis along with penile prosthesis is done.

Prior or post Phalloplasty does not necessarily require total vaginectomy. The reason is stated to be the excessive bleeding during the surgery. For sexual sensation, clitoris is properly preserved at this site.

Most of the complications are seen to occur during urethra lengthening. Less lengthening of urethra is required in cisgender men than in trans men. This makes the procedure more simple in cisgender men. The urethra of a trans men considerably needs more lengthening because urethra ends in the vaginal opening. In trans men, all major types of Phalloplasty are usually performed through Scrotoplasty, which uses labia majora. The procedure, here, involves the insertion of prosthetic testicles.

Anti-depressants are often prescribed for post-operative depression. The surgery complications, sometimes, include infection, blood supply shortage, blood clot, death of penis parts or hematoma. Scarring is usually observed on the exposed area. However, use of lasers minimizes the scarring. Another complication arises when the phallus is lost either from a disease or any blood supply issues. Scrotalization is one of the major complication seen in penile lengthening. It involves covering of the penis with scrotal corrugated skin rather than using its natural smooth skin. Uneven fat resorption resulting in nodule formation or loss of girth has a prime role in complicating Girth augmentation.

Medical reports reveal a success rate of 80% to 90% in terms of patient and partner acceptance after surgery. In terms of patient satisfaction, the rate almost increased to 95%.

Advantages of Phalloplasty Surgery:

  • Phalloplasty surgery primarily aims to enhance the self esteem of the person by making required penis modifications. They also help in sexual enjoyment.

  • Extreme penile curvature which causes painful sexual penetration can also be well-treated with Phalloplasty.

  • Advanced methods make use of less scar producing tissue and smaller incisions.

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