Female To Male

Pedicled Antero Lateral Thigh flap phalloplasty


Gender affirming surgery (GAS), commonly refers to all surgical procedures, involving facial, top and bottom surgery, that are performed to comprise the desired gender outlook of a person, in terms of cosmetic and functional purposes. Tactile sensation, penetration ability, smooth micturition, minimal donor site morbidity and an aesthetic appearance are the most important goals described for a successful phalloplasty.


Preoperative assessment and surgical technique

- Hospitalization is initiated the day before surgery.

- To prevent postoperative wound contamination, bowel preparation with antibiotic prophylaxis is initiated 1-2 hours, prior to surgery.

- Hormonal treatment is discontinued at least three weeks preoperatively.

Female to Male (FtM) GAS is usually performed in a multi-staged fashion of which our surgical steps could be summarized as;

- Stage 1: Creation of the neo-phallus by harvesting the Antero Lateral Thigh flap (ALTf,) and midline repositioning at the level of the symphysis pubis;

- Stage 2: (approx. 3-6 months later) Vaginal closure, urethral reconstruction (elongation of the urethra to the level of the clitoral hood or trans-positioning to the tip of the neo-phallus), glansplasty and/or scrotoplasty;

- Stage 3: (approx. 6 months later) Implementation of penile and/or scrotal prostheses.

Each stage, of all cases, is carried out in collaboration of a plastic surgeon and urologist, who are experienced in FtM GAS.

Advantages of pedicled ALTf phalloplasty

- Short ischemia time, short operation time and minimal flap rejection rates.

- Tactile and erogenous sensation

- Donor site that can be easily concealed by dressing