Phalloplasty: The dream and the reality

Phalloplasty has come a long way as Plastic Surgery has evolved over the years. The complication ridden multistage tube pedicles popularized by Gillis were, with the advent of microsurgery, replaced by radial forearm flaps. The composite osteo-cutaneous version of this flap promised ′All for one and...

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Main Authors: Mamoon Rashid, Muhammad Sarmad Tamimy
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2013-01-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=2;spage=283;epage=293;aulast=Rashid
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author Mamoon Rashid
Muhammad Sarmad Tamimy
author_facet Mamoon Rashid
Muhammad Sarmad Tamimy
author_sort Mamoon Rashid
collection DOAJ
description Phalloplasty has come a long way as Plastic Surgery has evolved over the years. The complication ridden multistage tube pedicles popularized by Gillis were, with the advent of microsurgery, replaced by radial forearm flaps. The composite osteo-cutaneous version of this flap promised ′All for one and one for all′ assuring both a reliable urinary conduit and a phallus stiffener. Prelamination and prefabrication to make the neo-urethra came with the promise of reducing both fistula and strictures but that did not happen and flap failure rates increased. Penile stiffeners of various types have been introduced; the artificial ones were associated with high infection and failure rates and are best inserted after the neo-penis regains some sensitivity. With the introduction of perforator flaps the Anterolateral thigh flap in its sensate pedicled form has started replacing the Radial forearm free flap as the first choice flap because of a hidden donor area and lack of microsurgical expertise requirement. Being sensate it tolerates a stiffener better. It is now possible to reconstruct an aesthetically pleasing glans as well, thus meeting both the aesthetic and functional desires of the patient. Complications encountered in this reconstructive effort include flap failure, urethral fistula, urethral stricture and stiffener related problems.
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series Indian Journal of Plastic Surgery
spelling doaj-art-4666b19faa2f46e2b4f691aff50409822025-08-20T03:36:11ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2013-01-0146228329310.4103/0970-0358.118606Phalloplasty: The dream and the realityMamoon RashidMuhammad Sarmad TamimyPhalloplasty has come a long way as Plastic Surgery has evolved over the years. The complication ridden multistage tube pedicles popularized by Gillis were, with the advent of microsurgery, replaced by radial forearm flaps. The composite osteo-cutaneous version of this flap promised ′All for one and one for all′ assuring both a reliable urinary conduit and a phallus stiffener. Prelamination and prefabrication to make the neo-urethra came with the promise of reducing both fistula and strictures but that did not happen and flap failure rates increased. Penile stiffeners of various types have been introduced; the artificial ones were associated with high infection and failure rates and are best inserted after the neo-penis regains some sensitivity. With the introduction of perforator flaps the Anterolateral thigh flap in its sensate pedicled form has started replacing the Radial forearm free flap as the first choice flap because of a hidden donor area and lack of microsurgical expertise requirement. Being sensate it tolerates a stiffener better. It is now possible to reconstruct an aesthetically pleasing glans as well, thus meeting both the aesthetic and functional desires of the patient. Complications encountered in this reconstructive effort include flap failure, urethral fistula, urethral stricture and stiffener related problems.http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=2;spage=283;epage=293;aulast=RashidGender reassignmentpenile reconstructionphalloplasty
spellingShingle Mamoon Rashid
Muhammad Sarmad Tamimy
Phalloplasty: The dream and the reality
Indian Journal of Plastic Surgery
Gender reassignment
penile reconstruction
phalloplasty
title Phalloplasty: The dream and the reality
title_full Phalloplasty: The dream and the reality
title_fullStr Phalloplasty: The dream and the reality
title_full_unstemmed Phalloplasty: The dream and the reality
title_short Phalloplasty: The dream and the reality
title_sort phalloplasty the dream and the reality
topic Gender reassignment
penile reconstruction
phalloplasty
url http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=2;spage=283;epage=293;aulast=Rashid
work_keys_str_mv AT mamoonrashid phalloplastythedreamandthereality
AT muhammadsarmadtamimy phalloplastythedreamandthereality