What is Phalloplasty?
At L Plastic Surgery, our board-certified plastic and reconstructive surgeon, Dr. Charles K. Lee, performs phalloplasty or reconstructive surgery for a penis. Dr. Lee is skilled in surgically creating a penis for trauma victims, cancer patients, and transitioning female-to-male patients with designer flaps and phalloplasty. Many people also know this as FTM bottom surgery. This type of designer flap surgery is made possible from a section of tissue (skin, fat, nerve, and muscle) connected to their own blood supply, and relocated to make a penis. The donor tissues can be designed and fashioned into various shapes and sizes. The techniques that Dr. Lee prefers for this surgery are the radial forearm free (RFF) flap and the anterolateral thigh (ALT) flaps for phalloplasty.
Dr. Lee trained with world renowned plastic surgeons, Drs. Robert Walton & Lawrence Gottlieb at the University of Chicago, and Harry Buncke, in San Francisco, where he was first introduced to advanced microsurgical techniques and designer flap surgeries in 2001. More recently, Dr. Lee was asked to join the world-renowned team of Drs. Curtis Crane and Michael Safir, at the Crane Center in San Francisco, CA, where he works with fellow expert microsurgeons (Drs. David Chang, Gabriel Kind, and Brian Parrett). If you would like to discuss this surgery with Dr. Lee, please make an appointment at L Plastic Surgery in San Francisco, CA for a consultation.
"When you want work done to your body or face, you want to make sure you go to the right doctor. It took me years to finally choose one and I'm so glad I chose Dr. Lee. He is an amazing surgeon and I would definitely recommend him to anyone that wants any procedures done. It's been 5 weeks since I got breast augmentation and they're healing very well. The scars are very light and will get even lighter after time. He will give you his honest opinion about your suggestions and will make you look very natural. Most doctors just want your money and do whatever you want, but Dr. Lee cares about his reputation and that's why he gets so many referrals. I have a ton of friends who are going to him after seeing my breasts. I absolutely love them :)"- S.R. / Yelp / Jan 25, 2020
"Been shopping around for quite a while to look into getting an old tattoo removed. Spoke with a few places and decided to go with L Plastic Surgery as they are honest and realistic about how they treat these tattoos along with the cost behind it. After my consultation, which was free. I made an appointment to get the process started. The pain was not as bad as most people tend to describe it for myself at least. Definitely would recommend anyone looking into getting a tattoo removed to come here. Will be going to back for my third this session week."- H.T. / Google / Jul 31, 2020
"Feeling More Refreshed and Youthful After Facelift - I have been considering a face lift surgery for a couple of years now as a retirement gift to myself. Working long hours and not having enough time for myself for the past few decades have aged my face to a point where I felt and looked older than my actual age. I was recommended to Dr. Lee by a good family friend who just had the upper blepharoplasty by him and the results were naturally amazing. I went in for a consultation to discuss the process of getting a facelift and after seeing before and after pictures I was all in! Dr. Lee was very professional, knowledgeable, and personable. The ladies that work with him are also very friendly and guided me the whole way. I had the MACS Facelift with Upper Eyelid Blepharoplasty in November 2019 and the results are remarkable. I honestly can say that because Dr. Lee and his staff were so attentive and informative, it made the recovery process so much easier. Every question I had was answered in a timely manner regardless of how trivial I thought my question was. Dr. Lee is highly skilled and I recommend for everyone to see him! Now I’m just waiting for COVID to be over so I can travel and enjoy retirement and my new found youth."- J. / RealSelf / Jul 03, 2020
"Dr. Charles Lee, Thank you so much for a successful surgery! My arm is healing so well and the appearance at only 2 mo. post op, is much better + nicer than I ever imagined. Thank you for being helpful and responsive during the recovery and healing process! Please accept this as appreciation. Until next time"- Anonymous / Office Visit / Jun 24, 2020
"Chuck & staff I'm rocking a bikini on the beach thanks to Charles. (Maybe he should send you guys on a vacation down here) Thanks for everything"- Anonymous / Office Visit / Jun 24, 2020
Who qualifies for the surgery?
Phalloplasty may be needed to reconstruct a penis after a penile trauma, cancer removal surgery, and or female-to-male (FTM) gender reaffirmation surgery. To find out if you qualify for phalloplasty, we require our patients (age 18 or older) to have a consultation with Dr. Lee to discuss eligibility. He will discuss the risks and benefits of this surgery. If you are a patient who is transitioning from female-to-male and would like to this surgery. You may also discuss laser hair removal options, and other plastic surgeries to recontour your facial or body contours. We have a compassionate team of medical professionals that will help coordinate your care.
Dr. Lee's Surgical Technique
Every phalloplasty is a customized procedure designed for the patient's needs. This surgery is performed in a hospital under anesthesia and will require an inpatient stay for a few days post-procedure. Dr. Lee prefers to take the donor tissue from the forearm or thigh to reconstruct a penis, which may create a penis that is 5 – 8 inches in length. This type of reconstructive surgery can take eight hours or longer to perform. A RFF flap from the forearm is detached from the body, which means that the blood vessels and nerves have to be reattached. The ALT flap from the thigh or abdomen can eliminate the step for reconnection as the blood vessels and nerves are repositioned to make the penis without detachment. A penile implant or inflatable device may also be inserted into the flap to make the penis capable of erections.
Using his microsurgical skills, Dr. Lee will relocate the autologous tissue, and he will make sure that the nerves and blood vessels are intact. He will create a tube-within-a-tube technique to make the urethra, outer shaft, and glans. All of the details of this surgery will be discussed with you in full detail. All incisions will be made as inconspicuously as possible at the donor site and for the newly formed penis. Once the flap has been made, you will be taken to a recovery area where our post-op nursing team will carefully monitor your vital signs and blood flow to the new flap.
Recovery From Phalloplasty
Dr. Lee and his medical team will go over post-surgical instructions and make sure you have a follow-up appointment scheduled
You’ll have to remain in the hospital for 5 days after your procedure so you’ll be fully cared for and monitored as you heal.
For the week and a half after you return home, expect close supervision from your medical team to watch for any complications. If you had your urethra extended, you may need to wear a catheter for up to three weeks while you heal.
Good post-op care is critical following phalloplasty. You’ll have to wear supportive underwear, keep the neo-penis dry and elevated, and watch for any changes in color (such as the skin turning red or purple).
If you chose to get a donor graft from your forearm, you may need physical therapy to restore full function to your hand in the weeks following surgery.
Frequently Asked Questions
Are there other surgeries I can have as well as phalloplasty?
Dr. Lee will take the time to get to know you in your consultation and can make recommendations for your care after he meets you. Many patients do have more than one type of surgery no matter if it is for reconstructive after an accident, a removal because of cancer, or as a gender reaffirming surgery. At L Plastic Surgery, we want you to be a part of your treatment decisions and we will try to make recommendations that are your best interest for your health and safety.
Will I be able to have sex after phalloplasty?
Given that you have the type of phalloplasty that involves giving you the capability to have an erection (such as a penile implant or inflatable device), then you should be able to have penetrative sex. If you have a metoidplasty (a penis created with the clitoris), you would not have erections. With phalloplasty, you would be able to sense touch and temperature.
What can be done to optimize the donor site?
Dr. Lee performs the Integra + Skin Graft as a single stage procedure at the time of the phalloplasty. He has been perfecting this technique for over 10 years and has performed hundreds of improved donor site grafts to the radial forearm and ALT donor sites. In addition, Dr. Lee performs secondary procedures such as fat grafting and lasers to the donor sites for improved appearance and function. Please ask him about these techniques which will improve the function and aesthetics of the donor site.
Will I have extensive scarring?
Scars occur from a herediary factor (genetics and predisposition with darker skin), and surgical technique (tension at the suture line) .Dr. Lee will do everything he can to prevent excessive scarring but scars come with the complexity of the operation.
Discuss Your Designer Flap
If you are considering phalloplasty, we would like to offer you a consultation with our board-certified plastic and reconstructive surgeon, Dr. Lee. He is well-versed in the microsurgical technical skills that are needed for this surgery. If you would like to meet with him to discuss your surgical goals, please call our office in San Francisco, CA to schedule an appointment. If you have other doctors that Dr, Lee will need to work with in tandem for your treatment, he would be happy to assist with wrap-around services and care. Call today.