Phalloplasty

Phalloplasty is the surgical construction or reconstruction of a penis using a flap of your own skin and tissue, most often from the forearm or thigh. It is performed as gender-affirming surgery for transgender men and for men who have lost the penis through injury, cancer or a congenital condition.

It can give a penis of adult size, allow you to pass urine standing if the urethra is lengthened, and later allow penetrative sex once an erectile implant is placed. Its main limit is that it is staged surgery with a high rate of urethral complications, and the result does not produce natural erections.

What Phalloplasty involves

The surgeon raises a flap of skin, fat, blood vessels and nerves from the donor site, commonly the non-dominant forearm (radial forearm flap) or the outer thigh (anterolateral thigh flap). The flap is rolled into a tube within a tube so that the inner tube forms the new urethra. It is then moved to the pubic area, where its artery, veins and nerves are joined under the microscope to vessels and nerves in the groin. The donor site is covered with a skin graft. In later stages, usually months apart, the glans is shaped, the scrotum is formed with testicular implants, and an erectile device is inserted once sensation has developed.

Who is a good candidate for Phalloplasty?

Phalloplasty suits adults who have thought through a long surgical pathway and have realistic expectations of function and scarring.

• Transgender men with persistent, well-documented gender dysphoria and supporting letters from mental health professionals
• Men who have lost the penis after trauma, cancer surgery or severe infection
• Non-smokers, or people who have stopped nicotine completely for several months
• People able to return for staged operations and to manage catheters and wound care

It is usually not the right choice if:

• Anyone still using nicotine, because flap loss and wound breakdown become much more likely
• People with poorly controlled diabetes, severe vascular disease or a very high body mass index
• Those who cannot accept a large visible donor-site scar on the forearm or thigh
• People who cannot commit to several trips or to long follow-up close to home

Technique options

• Radial forearm free flap: The most widely used technique. Thin, sensate skin gives the most reliable urethra and sensation, at the cost of a conspicuous forearm scar.
• Anterolateral thigh flap: Used when you want to avoid a forearm scar. The thigh scar is easier to hide but the flap is often bulkier and may need thinning.
• Metoidioplasty: A smaller alternative for transgender men that uses the hormonally enlarged clitoris. Fewer complications, but a small phallus that usually does not allow penetration.
• Erectile implant stage: An inflatable or malleable prosthesis is placed roughly 9 to 12 months after the first stage, once protective sensation has returned.

What happens during your treatment

The first stage takes 6 to 10 hours under general anaesthesia, often with two surgical teams. You wake with a urinary catheter, usually a suprapubic tube as well, drains, and a monitor on the flap. The first 5 days are spent on strict bed rest or limited movement while nurses check the flap's blood supply hourly. Hospital stay is commonly 7 to 10 days.

Preparing for your trip

Plan for 4 to 5 weeks for the first stage in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Catheters usually stay for 3 to 4 weeks until a dye test shows the new urethra is watertight. Most people need 6 to 8 weeks off work and avoid heavy lifting for 3 months. The forearm needs hand therapy and a compression sleeve. Sensation grows slowly into the phallus over 6 to 18 months. Later stages each need 1 to 3 weeks of recovery.

• Back to everyday activity: 6 to 8 weeks
• When results show: Shape immediately; sensation over 6 to 18 months
• How long they last: Permanent; implants may need replacing

Safety, risks and revision policy

This is among the most complication-prone operations in reconstructive surgery, and you should expect at least one revision.

• Urethral fistula (a leak) or stricture (a narrowing), affecting roughly a third to a half of patients who have urethral lengthening
• Partial or, rarely, complete loss of the flap from a clot in the joined vessels
• Wound breakdown, infection and delayed healing at the groin or donor site
• Reduced grip strength, numbness or poor graft take at the forearm
• Infection, erosion or mechanical failure of the erectile implant, with a higher rate than implants in a native penis
• Limited or absent erotic sensation in some patients
• Dissatisfaction with size, shape or scarring requiring further surgery

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Phalloplasty in Türkiye

Clinic-Y does not publish a single price for Phalloplasty, because the honest figure depends on your case. What moves it:

• Choice of flap and whether urethral lengthening is included
• Number of planned stages, including glansplasty, scrotoplasty and implants
• Type of erectile prosthesis chosen
• Length of hospital and intensive monitoring stay
• Revision surgery for fistula or stricture if needed

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions