Phalloplasty is a complex surgical procedure aimed at constructing or reconstructing a phallus, typically for transgender men, non-binary individuals, or individuals needing penile reconstruction due to congenital conditions or trauma. The procedure involves several stages and can vary significantly depending on the individual’s needs and the surgical techniques employed. Initially, a thorough consultation and preparation phase is crucial, including psychological evaluation and discussions to ensure realistic expectations. In the preoperative phase, patients may undergo hormone therapy and hair removal treatments at the donor site, often the forearm, thigh, or abdomen, to prepare for the surgery and enhance the aesthetic outcome.

The surgical process itself is intricate and typically performed over multiple stages. In the first stage, a flap of skin from the donor site is used to construct the neophallus, incorporating techniques such as radial forearm flap or anterolateral thigh flap for optimal results. Surgeons may also perform procedures like urethroplasty to extend the urethra through the constructed phallus, allowing for urination while standing. Subsequent stages might include the insertion of erectile prosthetics and the refinement of aesthetic details. Postoperative care is extensive and requires vigilant monitoring for complications such as infection, flap failure, or urinary issues. Long-term, patients may need further revisions or procedures to achieve their desired functional and esthetic outcomes. Recovery involves a combination of physical healing and, importantly, psychosocial support to assist patients in adapting to their new anatomy.