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Fibula free flap phalloplasty: modifications and recommendations
J J Hage1, H A Winters, J Van Lieshout
1Department of Plastic and Reconstructive Surgery, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands.
Microsurgery
|January 1, 1996
Summary
The sensate fibula free flap offers an alternative to forearm phalloplasty, minimizing donor site scarring. Modifications improve outcomes for phalloplasty when forearm scars are a concern.
Area of Science:
- Reconstructive surgery
- Microsurgery
- Urology
Background:
- Radial forearm flap phalloplasty is the gold standard but results in significant donor site scarring.
- Alternative donor sites are sought to improve patient aesthetics and satisfaction.
Observation:
- This study presents modifications and recommendations for utilizing the fibula free flap in phalloplasty.
- Key recommendations include preconstruction and secondary anastomosis of the neo-urethra, preoperative nerve infiltration for flap sensation, and optimizing the osseous component length.
- A longitudinal flap design with two triangular tongues is suggested for aesthetic improvement.
Findings:
- The fibula free flap, when modified, can achieve the goals of phalloplasty, particularly for patients avoiding forearm donor site scars.
- Despite improvements, secondary surgeries are often necessary.
- Potential functional loss in the fibula donor region may occur.
Implications:
- The sensate fibula free flap is a viable option for phalloplasty, offering a solution for patients concerned about forearm scarring.
- Further research and refinement of techniques can optimize functional and aesthetic outcomes.
- This approach expands reconstructive options in gender-affirming surgery.