To have penetrative sex with a phalloplasty, a patient can use the assistance of a silicone erectile sleeve and/or a penis pump after they have fully healed and have received clearance from their surgeon. 12 months after the phalloplasty is constructed, a patient can have an erectile device inserted: a malleable rod or a saline pump system. You can read more about these options here.

3-4 months after an RFF or ALT phalloplasty is constructed (or when incisions have fully healed), a patient can begin engaging in sexual activity with their new penis, alone or with partners. For a groin flap phalloplasty, this is about 6+ months after the first surgery.

If your phalloplasty involves preserving erogenous sensation, orgasms are possible through stimulating the penis. Patients are recommended to wait 3-4 months (or until incisions are fully healed with approval from your surgeon) before masturbating or engaging in other kinds of sexual activity with the new penis. With a completed urethral lengthening, some patients report being able to ejaculate clear fluid when they orgasm.

Nerve regeneration can start as early as three weeks after surgery, but is different for every patient. As nerves regenerate, patients may experience tingling sensations in the site until they heal after a few months. Some patients experience no nerve regeneration at all. Whether sensation is tactile or erogenous (heightened), it will generally be felt equally along the entire penis. The radial forearm flap (RFF) and anterolateral thigh flap (ALT) phalloplasty can give patients a heightened, erogenous sensation in their penis since the nerves used in the donor site (the forearm or the outer thigh) allow for more sensation. The groin flap phalloplasty allows for tactile sensation as opposed to …

The size and girth of a patient’s phalloplasty results from the unique plan you make with your surgeon during a free in-person consultation. An in-person consultation is required to determine candidacy for a phalloplasty operation. Generally speaking, the size of the patient’s body (specifically the skin flap donor site) can limit the size of the phallus.

During the initial construction of the phalloplasty, a urethra can be built inside of the penis to allow for a patient to eventually urinate while standing up. However, to let the phalloplasty heal, the natal urethra and the urethra in the penis are not connected until 6-9 months after the initial procedure. This means a patient will not be able to urinate out of the tip of their penis until 6-9 months later. Catheters will be used during the recovery process of each of these procedures.

The visibility of phalloplasty scars depends on the procedure type. Patients who get a groin flap phalloplasty will have the most concealable scars. Patients who get a forearm (RFF) or thigh (ALT) phalloplasty will have a large rectangular swath of scar tissue visible on either their forearm or thigh. This swath of scar tissue will be depressed and discolored compared to the surrounding skin, making it look similar to a burn. It can be concealed with shorts or a long-sleeved shirt. The area can be repigmented by an experienced medical tattoo artist a year after it has healed (at least 12 months post-op).