Options and Indications in Gender-Affirming Phalloplasty

Area of Science:

• Gender-affirming surgery
• Plastic and reconstructive surgery
• Transmasculine medicine

Background:

• Phalloplasty has evolved from binary ideals to individualized care for transmasculine patients.
• Modern approaches acknowledge diverse patient goals beyond comprehensive reconstruction.
• Patient-centered care is crucial in gender-affirming surgery.

Purpose of the Study:

• To describe the evolution and current patient-centered approaches in phalloplasty for transmasculine individuals.
• To highlight the importance of individualized surgical planning and shared decision-making.
• To outline modern phalloplasty techniques and donor site options.

Main Methods:

• Review of current phalloplasty techniques and patient assessment strategies.
• Emphasis on thorough anatomical evaluation and expectation management.
• Discussion of staged approaches, shaft-only alternatives, and donor site selection.

Main Results:

• Phalloplasty is increasingly individualized, accommodating varied patient goals and risk profiles.
• Diverse surgical options exist, including staged urethral lengthening and shaft-only phalloplasty.
• Composite phalloplasty is reserved for specific anatomical situations.

Conclusions:

• Contemporary phalloplasty emphasizes patient-centered, individualized care for transmasculine individuals.
• Shared decision-making is vital for achieving diverse outcome goals and minimizing complications.
• Surgical planning must consider anatomy, patient expectations, and donor site suitability.