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Lane et al. Plast Aesthet Res 2020;7:51 Plastic and
DOI: 10.20517/2347-9264.2020.106 Aesthetic Research

Review Open Access

Phalloplasty: understanding the chaos

Megan Lane , Emily C. Sluiter , Shane D. Morrison , Devin Coon , Katherine M. Gast , Jens U. Berli ,
1
5
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William M. Kuzon 1
1 Section of Plastic Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
2 Division of Plastic Surgery, University of Washington School of Medicine, Seattle, WA 98195, USA.
3 Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
4 Division of Plastic Surgery, University of Wisconsin, Madison, WI 53792, USA.
5 Division of Plastic and Reconstructive Surgery, Oregon Health and Science University, Portland, OR 97239, USA.
Correspondence to: Dr. William M. Kuzon, Section of Plastic Surgery, Michigan Medicine, 1500 E. Medical Center Drive, 2130
Taubman Center, SPC 5340, Ann Arbor, MI 48109, USA. E-mail: wkuzon@med.umich.edu
How to cite this article: Lane M, Sluiter EC, Morrison SD, Coon D, Gast KM, Berli JU, Kuzon WM. Phalloplasty: understanding the
chaos. Plast Aesthet Res 2020;7:51. http://dx.doi.org/10.20517/2347-9264.2020.106

Received: 11 May 2020 First Decision: 2 Jun 2020 Revised: 20 Jun 2020 Accepted: 4 Aug 2020 Published: 27 Sep 2020
Academic Editor: Marlon E. Buncamper Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Wide variation in overall strategies and surgical specifics for masculinizing genital surgery has created a
“phalloplasty chaos” that is confusing to both surgeons and patients seeking gender confirming surgery. The
purpose of this article is to review masculinizing genital confirming surgery, or “phalloplasty”, focusing on
specific goals and categorizing each component of the surgical process. Experienced surgeons from several high-
volume centers review and categorize the commonly employed strategies and techniques for gender confirming
phalloplasty, including the permutations of approaches to cutaneous flap for phallic construction, the sequence
and staging of procedures, and strategies for urethral construction. There is no clear advantage or reduction in
complications associated with particular sequences of urethral and phallic reconstruction. Because no single
technique or staging strategy has proven superior for gender confirming genital surgery, it is paramount that
surgeons are knowledgeable of all available options and the associated advantages, disadvantages, and risks.

Keywords: Transgender, phalloplasty, FtM, gender dysphoria, gender reassignment, transmasculine, gender
confirmation surgery, gender confirming surgery, gender affirming surgery, transgender genital surgery

INTRODUCTION
The purpose of this article is to review masculinizing genital gender confirming surgery (GCS) or
“phalloplasty”. Experienced surgeons from several high-volume centers review and categorize the

© 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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