Fibula Free Flap Phalloplasty (FFFP)
Fibula free flap phalloplasty is a genital reconstruction surgery to construct a penis for a trans man. It is a good alternative for patients who do not want an arm scar. The skin of the leg is taken with the bone, the penis form is shaped in a cylindrical appearance, and then, it is transferred to the groin area by microsurgery.
Advantages:
• Less pronounced scars than the RFF method.
• Penetration can be achieved with the natural stiffness provided by FFFP.
• Natural stiffness with the length of the vascular pedicle of the wing.
Functional Loss Risk in the Bone:
A functional imbalance may occur while standing on one leg. Problems may occur in the part of the distal tibia while running. The former function of the leg from which the bone is taken cannot be expected to recover, but there is no substantial morbidity.Urethral Lengthening
Urethral lengthening is performed with the inner labia local flap (ILLF) technique or the vaginal mucosa flap (VMF) technique. The VMF technique involves a lower risk of complications. When ILLF is performed, the risk of complications increases.Scrotoplasty
An implant is placed inside the labia majora tissue expanded with the help of a pump. Tissue expansion pumps are used before scrotoplasty. The aim is to achieve a scrotum-like appearance.Feeling
The amount of sensation in the penis to be constructed varies depending on the technique that is used. Ten percent of patients who have surgery do not feel anything, while it was observed that 90% of them had feeling from the middle of the penis to the root of the penis. While performing phalloplasty, the clitoris area is preserved, and having an orgasm is made possible as the flap is connected to the clitoris through nerves.It is a good alternative for individuals who prefer to not focus on aesthetic concerns and do not want to have visible scars. Ensuring natural hardening and eliminating psychological concerns of using a dildo are among the method’s significant advantages.
Due to the perpetually erect state of the penis, it is possible to experience difficulties in terms of hiding the penis and attempts of making it less noticeable from the outside.
The rate of loss of sensation in the penis may vary according to the technique applied by the physician. In some cases, the rate of loss of sensation in the penis can be 10%, whereas this rate may be higher in some patients.
Taking bone tissue from the leg substantially disrupts balance while walking in the first few days, while this balance will be recovered to a significant extent after a few days.
In this technique, there is no orgasm problem because the flap is attached to the clitoris via nerves, and the neural structure of the clitoris region is preserved.