Pedicled deep inferior epigastric perforator flap for total phallic reconstruction

Total phallic reconstruction remains a great challenge in reconstructive surgery. The search for a suitable donor site is never ending. Based on the experiences in using free deep inferior epigastric perforator flap for breast reconstruction, the authors describe a new usage of the deep inferior epigastric perforator flap for phallic reconstruction. In this procedure, the neourethra is centrally located. The rigidity is provided with the 12th rib. The donor site can directly be closed. Over the past 4 years, this surgical procedure has been used successfully for total phallic reconstruction in 2 patients. Four years of follow-up has revealed that an aesthetically acceptable functional neopenis was achieved. The scar of the donor site is inconspicuous and is easily concealed by underwear. Moreover, this new procedure is a nonmicrosurgical technique. Although more clinical experience is needed, this flap can be chosen as an alternative option in phallic reconstruction.