Musculocutaneous Latissimus Dorsi Phalloplasty

Musculocutaneous latissimus dorsi phalloplasty is a complex surgical procedure used to create a penis for transgender men or for men who have lost their genitals due to injury or disease. This method enables the formation of a functional and aesthetically acceptable penis using tissue from the latissimus dorsi muscle, located in the upper back.

Before surgery, patients undergo thorough consultations and evaluations with their surgical team. The evaluation includes medical history, physical examination, and psychological assessment to ensure that patients are good candidates for the procedure. Discussions about expectations, possible risks, and steps of the operation are held, and postoperative recovery and support are planned. It is crucial for patients to understand all aspects of the operation, including the prolonged recovery process.

The surgery begins by harvesting a skin and muscle flap from the latissimus dorsi muscle, preserving its nerve and vascular connections. The flap is then carefully transferred to the genital area, where it is shaped into a penis. The blood vessels and nerves of the flap are microsurgically connected to those in the groin area to enable circulation and sensation. The procedure also includes the formation of a urethra, allowing urination while standing, which is often an important aspect for men undergoing transition. Additional surgeries may be necessary to create the glans (tip of the penis) and to implant penile prostheses that enable erection.

Recovery from total phalloplasty is intensive and requires careful monitoring. Patients typically spend several days to weeks in the hospital. Initial recovery involves the healing of both the back area and the new genital region. Patients are under constant supervision to prevent complications such as infections or problems with circulation in the new penis. Postoperative care includes regular medical checks, monitoring the functionality and aesthetics of the penis, and psychological support. Complete recovery and adaptation to new bodily functions can take several months. Due to the complexity of this operation, it is extremely important that patients consult in detail with their surgical team about all aspects of the procedure, including expectations, possible complications, the length and phase of recovery, as well as the psychological and social implications of gender change. Adequate psychological support is crucial both before and after the surgery.