Phalloplasty also called penoplasty [ 1 ] is the construction or reconstruction of a penis or the artificial modification of the penis by surgery. The term is also occasionally used to refer to penis enlargement. Russian surgeon Nikolaj Bogoraz performed the first reconstruction of a total penis using rib cartilage in a reconstructed phallus made from a tubed abdominal flap in Later improvements in microsurgery made more techniques available. A complete construction or reconstruction of a penis can be performed on patients who: [ citation needed ].
There are different techniques for phalloplasty. Construction of a new penis sometimes called a neophallus or neopenis [ 6 ] typically involves taking a tissue flap from a donor site such as the forearm. Extending the urethra through the length of the neophallus is another goal of phalloplasty. Temporary lengthening can also be gained by a procedure that releases the suspensory ligament where it is attached to the pubic bone, thereby allowing the penis to be advanced toward the outside of the body.
The procedure is performed through a discreet horizontal incision located in the pubic region where the pubic hair will help conceal the incision site. However, scar formation can cause the penis to retract. Therefore, the American Urological Association "considers the division of the suspensory ligament of the penis for increasing penile length in adults to be a procedure which has not been shown to be safe or efficacious.
Phalloplasty requires an implanted penile prosthesis to achieve an erection. Penile prostheses are implanted devices intended to restore the erectile rigidity in cisgender men and to build a neophallus new penis in transgender men.
Penile implants have been used in phalloplasty surgeries both in cisgender and transgender patients since s. There are two main types of penile implants β malleable also known as non-inflatable or semi-rigid and inflatable implants. Both types have a pair of cylinders implanted into the penis, replacing the non-erectile tissue in cisgender men and serving as the core for the neophallus in the phalloplasty procedure. The cylinder of the inflatable implant is filled with sterile saline solution.
