Phalloplasty
Phalloplasty techniques are still evolving, and there is no universal procedure that applies to all patients. Reconstructing the phallus has proven to be challenging, particularly due to the lack of an adequate substitute for urethral and erectile tissue. The most commonly reported free flaps used by surgeons include the radial forearm flap (Figure 1), the anterolateral thigh flap (Figure 2), and the latissimus dorsi flap (Figure 3), which are the main options seen in clinical practice.
Figure 1. Radial Free Flap Phalloplasty
Figure 2. Anterolateral Thigh Flap
The earliest techniques proposed for phalloplasty involved the use of loco-regional pedicled flaps. Some of these techniques are still in use today, particularly the abdominal rotational flap phalloplasty described by Pryor (Figure 4).
The most common microsurgical flap used in clinical practice is the radial forearm free flap (RFFF). Although this flap is known for leaving a socially stigmatizing scar, it has numerous advantages: excellent innervation from the medial cutaneous nerve of the forearm, reliable vascularity, and thin tissue, which allows for the reconstruction of both the phallus and the urethra. The RFFF has been the most frequently reported flap in the scientific literature.
Figura 4. Latissimus dorsi flap
See also: