Lower Surgery Q & A – Part 1

1 day post op first stage!

Please note these answers relate to the London UK surgical team, other countries do things slightly differently. It also mostly refers to forearm phalloplasty and relates to my personal experiences.

Jumping straight into the sex stuff because these are always the first questions I get, and there’s an awful lot of incorrect information being spread around putting people off phallo saying that you can’t feel it, so here we go..

Q. Can you still orgasm? 
A: Yes. it is a really rare complication to lose the ability to orgasm. They hook up the clitoral nerve to the phallus so usually you get erotic sensation all the way up the shaft, while also retaining sensation in your original anatomy. If losing erotic sensation is something you are more concerned with the team offer the option of leaving your original junk visible (but it sits inbetween your balls under your dick so could only see it if you lift your dick up) so it is still easily accessible instead of covering it over. If you choose to “bury” it then it’s just underneath the skin at the base of your penis so you still feel it.

Q: Can you ejaculate or where does the fluid go when aroused?
A: The UK team perform a vaginectomy as standard procedure unless you tell them you don’t want it. This removes most of the vaginal lining and sews up the hole. When turned on you either then don’t produce any liquid or it’s a smaller amount and get reabsorbed by the body. There is no hole left down there. Some guys have been lucky to find that the small amount of fluid does actually come out (dribble rather than shoot) out of their penis but this is very rare.

Q: Can you get erections?
A: With phalloplasty you unfortunately cannot get natural erections, instead you get an erectile device. Either the inflatable pump (most common and also used with cis men) or the malleable rod. The pump involves a reservoir of liquid placed in your abdomen at stage 2, connected to a pump which doubles as your second testicle. When you squeeze this it inflates cylinders in the your penis which makes it erect. You then deflate it with a button at the top of your ball afterwards.
With metoidioplasty you will get natural erections as it is your original anatomy.

Q: Do you have hair on the penis?
A: Depending on how hairy you are and where you have the skin graft taken from you will likely

about 4 days post stage 2

have hair on your phallus. However you can have laser hair removal prior to or after surgery to remove it if you want to. Though a lot of us just use hair removal cream every other week which does the job fine. Depending on how hairy your arms are you may need hair removal on the inner arm where they create the urethra from because hair in the urethra can cause issues at a later date.

Q: Can you pee through it?
A: Yes. If you have forearm or pubic(abdominal) phallo they use skin from your inner forearm which creates the urethra and is hooked up to your current urethra. If you have thigh they use skin from there.
It is also possible to have urethral hook up with metoidioplasty. For this they use a small graft of skin from the inside of your mouth.

Q: Does the skin have to come from your arm?
A: No. The UK team offer 3 phalloplasty options. Forearm (most popular due to more sensation and easier criteria to fulfil), Pubic, also known as abdominal where they take skin from your pubic area. But to stp you’ll still need a graft about the size of a £10 note from your inner forearm). Or thigh. However due to needing to be pretty hairless with little fat on your thighs not as many people meet the criteria.
Also metoidioplasty may be an option to consider if you don’t want any skin grafts.

Q: Does it look natural?
A: Yes. A lot of people don’t think the outcome is great because they’ve probably only seen early photos before any sort of aesthetic is done. In the second stage of surgery they do the glans sculpting to give you the glans/bellend/head appearance at the tip. There is also the option of self funding medical tattooing (or regular tattooist) to tattoo some veins or shading to make it look even more

graft 2 years 3 months post op
then 3 weeks after tattoo

realistic.

Q: How big is it?
A: The UK team aim for around 5.5 inches (length and girth) as this is roughly the cis average size. You can ask for it to be smaller. And sometimes It can be slightly bigger or smaller depending on where the graft is taken.
If you have metoidioplasty then it is the length of your current junk but sometimes slightly longer after surgery as they release the clitoris from the surround skin.

Q: How was it to tattoo over?
A: It was fine, no more painful than any other tattoo. Areas of my graft were slightly numb so it was actually less painful. I also used numbing cream on one occasion. You need to wait a minimum of 2 years before tattooing over scars/scar tissue. I tattooed over my chest scars as well.

Q: Is it a split or full thickness graft from your arm?
A: The London Team take a full thickness skin graft from your arm to create the phallus. The arm is then recovered with skin from under your bum which essentially gives you a bum tuck, and you’re left with 2 scar lines under each bum cheek.

Signing off with my face today
04/02/17