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Khavanin et al. Plast Aesthet Res 2020;7:47 Plastic and
DOI: 10.20517/2347-9264.2020.63 Aesthetic Research

Review Open Access

Conventional surgical techniques and emerging
transplantation in complex penile reconstruction

Nima Khavanin, Richard J. Redett

Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Correspondence to: Dr. Richard J. Redett, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of
Medicine, 601 N Caroline St, Baltimore, MD 21287, USA. E-mail: rjr@jhmi.edu

How to cite this article: Khavanin N, Redett RJ. Conventional surgical techniques and emerging transplantation in complex penile
reconstruction. Plast Aesthet Res 2020;7:47. http://dx.doi.org/10.20517/2347-9264.2020.63

Received: 7 Apr 2020 First Decision: 19 Jun 2020 Revised: 20 Jun 2020 Accepted: 30 Jul 2020 Published: 1 Sep 2020

Academic Editor: Marlon E. Buncamper Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Complex penile reconstruction continues to pose a significant challenge to surgeons and patients alike. The ideal
phalloplasty is one that can be reproducibly performed in a single stage, creates a neourethra that allows for
voiding while standing, produces a phallus with tactile and erogenous sensation, allows for penetrative sexual
intercourse, and offers satisfactory aesthetic results. With recent advances in microsurgery and perforator
flap dissection, several techniques and modifications thereof have been described that aim to achieve these
reconstructive goals. All of these now conventional techniques, however, fall short in one way or another - often
with regards to urinary transport, the ability to achieve an erection, and the need for multiple surgical stages and
revision operations. These limitations of conventional reconstruction have led some surgeons to explore new
avenues for complex penis reconstruction, giving birth to the novel field of penile transplantation. In this article,
we discuss the complexities of male genitourinary reconstruction in the context of conventional methods for
reconstruction as well as the burgeoning field of penile transplantation.

Keywords: Phalloplasty, total penile reconstruction, free flap, vascularized composite allotransplantation, penis
transplantation, reconstructive surgery, urologic reconstruction

INTRODUCTION
Despite nearly a century’s worth of cumulative experience in complex penile reconstruction, the ideal
neophallus continues to elude us, presenting a significant challenge to reconstructive surgeons. The first

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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