There are four main donor site options for phalloplasty:
- Radial forearm free flap (RFFF): This is the most common donor site for phalloplasty. The skin and underlying tissue from the forearm are used to create the phallus. The RFFF has a good blood supply and sensation, and the donor site can be closed primarily.
- Anterior lateral thigh (ALT) flap: The skin and underlying tissue from the thigh are used to create the phallus. The ALT flap is also a good donor site, but it has a thicker skin than the RFFF.
- Groin flap: The skin and underlying tissue from the groin are used to create the phallus. The groin flap is a less common donor site, but it can be used in patients who are not suitable for the RFFF or ALT flap.
- Latissimus dorsi flap: The latissimus dorsi muscle is located in the back. The skin and underlying muscle from the latissimus dorsi can be used to create the phallus. The latissimus dorsi flap is a less common donor site, but it can be used in patients who are not suitable for the other donor sites.
The best donor site for a particular patient will depend on a number of factors, including the patient’s anatomy, goals for the surgery, and surgeon’s preference.
Here are some of the factors to consider when choosing a donor site:
- The patient’s anatomy: The patient’s height, weight, and body fat distribution will affect the size and shape of the phallus that can be created from a particular donor site.
- The patient’s goals for the surgery: Some patients may want a phallus that is as large and natural-looking as possible, while others may be more concerned with function. The surgeon will need to discuss the patient’s goals and expectations in order to choose the best donor site.
- The surgeon’s preference: Each surgeon has their own experience and preference for different donor sites. The surgeon will discuss the pros and cons of each donor site with the patient in order to make a recommendation.
Phalloplasty involves the use of tissue from a donor site on the body to create a neophallus (new penis). The choice of donor site can significantly impact the size, shape, and appearance of the neophallus. Several donor site options are available, and the selection is based on individual patient factors, including anatomy, body type, and patient preferences. Here are some common donor site options for phalloplasty:
- Radial Forearm Flap (RFF): The radial forearm flap is one of the most commonly used donor sites for phalloplasty. In this procedure, a section of skin, subcutaneous tissue, and the radial artery is taken from the forearm. The radial forearm flap provides a thinner and typically hairless neophallus. It is well-suited for individuals who desire a smaller, aesthetically detailed phallus.
- Anterolateral Thigh Flap (ALT): The anterolateral thigh flap involves using tissue from the thigh to create the neophallus. The ALT flap offers a larger amount of tissue and can result in a thicker phallus. It is often chosen by individuals who want a more substantial appearance.
- Abdominal Flap (Abdominal Phalloplasty): In abdominal phalloplasty, tissue is harvested from the lower abdomen, which may include skin, fat, and sometimes muscle. This technique can provide a larger neophallus and is often chosen by individuals who want a longer phallus.
- Musculocutaneous Latissimus Dorsi Flap (MLD): The MLD flap utilizes tissue from the back (latissimus dorsi muscle) and is typically combined with abdominal tissue to create the neophallus. This combination can offer a balance between size and aesthetic detail.
- Groin Flap: A groin flap involves taking tissue from the groin area. This technique can provide a relatively small amount of tissue and is less commonly used compared to the other options.
- Combined Flaps: In some cases, surgeons may combine tissue from multiple donor sites to create the neophallus. This approach allows for customization to achieve the desired size and appearance.
The choice of donor site is influenced by factors such as the patient’s body type, skin quality, and the surgeon’s expertise. The goal is to create a neophallus that aligns with the patient’s gender identity and meets their individual goals for size and aesthetics.
During the surgical consultation, the surgical team will assess the patient’s anatomy and discuss the advantages and disadvantages of each donor site option. Ultimately, the decision is made collaboratively between the patient and the surgical team to achieve the best possible outcome.