Phalloplasty

Phalloplasty is the most comprehensive FTM genital surgery — constructing a full-size phallus using a flap of skin, subcutaneous tissue, and blood vessels taken from a donor site on the body. The radial forearm free flap (RFFF) and the anterolateral thigh flap (ALT) are the two most commonly used donor sites worldwide. The constructed phallus can achieve erection for penetrative intercourse using a penile prosthesis implanted at a later stage.

Phalloplasty is one of the most technically complex operations in reconstructive plastic surgery — requiring microsurgical anastomosis (reconnection of blood vessels under the operating microscope), urethral construction, and multiple stages over months to years. Dr. Bhavya Sree's fellowship-level microsurgical training is directly applicable to this procedure.

⚕️ Phalloplasty is typically performed in multiple stages over 12-24 months. It is irreversible. Complications are not uncommon — urethral fistula, stricture, and donor site scarring are the most frequent. Full and honest discussion of risks, stages, and realistic outcomes is the foundation of every phalloplasty consultation with Dr. Bhavya Sree.

Why Choose Dr. Bhavya Sree for Phalloplasty?

• M.Ch Plastic Surgery — NIMS Hyderabad (India's premier surgical training institution)
• FAM & FAS (Belgium) — Dual international fellowship credentials in reconstructive and aesthetic surgery
• Specialist training in genital reconstructive and gender affirming surgery
• All consultations and procedures performed personally by Dr. Bhavya Sree — never delegated
• Compassionate, non-judgemental approach — your identity, your goals, your timeline
• Visakhapatnam's most qualified plastic surgeon for complex genital reconstructive procedures

The Two Most Common Donor Sites Donor Site Advantages & Considerations Radial Forearm Free Flap (RFFF)

The gold standard. Thin, pliable skin — ideal for tube-within-a-tube urethral construction. Excellent cosmetic result for the phallus. Visible donor scar on the forearm — covered with a skin graft. Microsurgical anastomosis required.

Anterolateral Thigh Flap (ALT) Larger flap — donor scar on the thigh (more easily hidden). Thicker skin — more suitable for larger patients. Used when forearm is not suitable. Also requires microsurgical anastomosis.

Stages of Phalloplasty Stage 1 (Pre-Surgery) Vaginectomy + hysterectomy (usually done by gynaecologist first). Perineal reconstruction. Urethral plate preparation. Stage 2 — Phalloplasty Flap harvest, microsurgical transfer, urethral construction within the phallus. Scrotoplasty using labia majora. 6-8 hour operation.

Stage 3 — Urethral Join Connecting the constructed urethral extension to the native urethra to allow voiding from the tip. Usually 3-6 months after Stage 2. Stage 4 — Glansplasty Tattooing or surgical sculpting to create a natural-looking glans (head of the phallus). 6 months+ after Stage 2.

Stage 5 — Testicular Implants Silicone testicular implants placed into the constructed scrotum. Usually 12+ months after Stage 2. Stage 6 — Penile Prosthesis An erectile device (inflatable penile prosthesis) is implanted — allowing erection for penetrative intercourse. Usually 18-24 months after Stage 2, once all healing is confirmed stable.

Procedure at a Glance — Stage 2 (Main Phalloplasty)

Anaesthesia

General anaesthesia Duration 6-10 hours (microsurgical procedure)

Hospital Stay

7-10 nights Urinary Catheter 3-4 weeks Donor Site Healing 3-4 weeks (skin graft to forearm/thigh) Return to Work 8-12 weeks Phallus Sensation Tactile and erogenous sensation develops over 12-18 months as nerves regenerate Total Timeline 18-24 months from Stage 2 to penile prosthesis placement

Clinical photographs available in private consultation only — in keeping with the highest standards of patient dignity and privacy.

Frequently Asked Questions

Will my phallus have sensation?

Yes — nerve coaptation (joining) is performed at the time of phalloplasty, connecting the dorsal nerve of the clitoris to a sensory nerve within the flap. Tactile sensation (touch) and erogenous sensation both develop over 12-18 months as the nerves regenerate. Most patients achieve meaningful sensation, though the degree varies.

When can I have penetrative sex?

Penetrative intercourse becomes possible after penile prosthesis implantation — typically at Stage 5 or 6, around 18-24 months after the main phalloplasty. The prosthesis is inflatable — allowing the patient to create an erection when desired and return to a flaccid state afterward.

What are the most common complications?

Urethral fistula (a small urine leak at a suture line, occurring in 20-40% of cases) and urethral stricture (narrowing causing difficulty voiding) are the most common complications. Most are treatable with a minor surgical procedure. Flap failure (rare, under 5% in experienced microsurgical hands) and donor site complications are other risks. Dr. Bhavya Sree discusses every risk in detail at consultation.

Do I need a hysterectomy first?

Most surgeons recommend hysterectomy and oophorectomy (removal of the uterus and ovaries) before or at the time of phalloplasty. This is typically performed by a gynaecological surgeon as a separate prior procedure. It is not an absolute requirement in all cases — but it is strongly recommended and discussed at planning consultation.

What to Expect at Your Consultation

Your consultation with Dr. Bhavya Sree is a private, unhurried, and completely confidential conversation — with absolutely no obligation to proceed. You can expect: A thorough and respectful discussion of your goals, your medical history, and your timeline An honest explanation of what each procedure involves, what it achieves, and what it does not Clear information about the surgical process, recovery, and realistic outcomes A staged surgical plan if multiple procedures are being considered Discussion of any prerequisites — hormonal therapy, letters of support, or prior procedures A fully itemised, transparent cost estimate with no hidden fees No judgement. No pressure. No assumptions. Just an expert, compassionate conversation about your options.

Book your private consultation with Dr. Bhavya Sree — drbhavyaplasticsurgery.com | Visakhapatnam