Phalloplasty in a female-to-male transsexual using a double-pedicle composite groin flap

An operative procedure for phalloplasty in a 21-year-old female-to-male transsexual is reported that uses a double-pedicle composite groin flap. The surgical technique is described. Both the deep and the superficial circumflex iliac vessels were included in the pedicle to ensure well-vascularized extended skin and bone in the flap. The procedure was planned in two stages to prefabricate a neourethra before transfer of the flap. The large skin island and bone with its dual blood supply enabled the authors to reconstruct the penis in an appropriate size and stiffness without vascular compromise. The flap donor site was sutured easily. The patient is pleased with the operative results. His voiding and sexual intercourse are acceptable according to his report.