Primary Phalloplasty & Metoidioplasty

Phalloplasty is a multi-stage process that constructs a new penis using donor tissue from a chosen site, such as the forearm (Radial Forearm Flap or RFFF), thigh (Anterolateral Thigh or ALT Flap), or abdomen (Abdominal Flap). Metoidioplasty is an alternative that utilizes a hormonally enlarged clitoris to create a smaller phallus. Both options can include urethral lengthening (to allow for standing to pee) and scrotoplasty. 

A Multi-Stage Surgical Journey

These surgeries are the core of transmasculine bottom affirmation. They are complex, multi-stage procedures designed to create external genitalia that fully aligns with a masculine identity, enhancing self-image and supporting sexual and urinary function.

The Center for Gender Affirmation combines reconstructive urology and microsurgical excellence to perform all major phalloplasty techniques, including ALT, RFFF, abdominal flap, and metoidioplasty. Our approach balances appearance, function, and sensation while maintaining patient safety and choice. From surgical planning to follow-up care, our team is committed to helping each patient achieve results that reflect their goals and identity.

During the Procedure
Phalloplasty is performed by skilled microsurgeons in multiple stages, typically beginning with the creation of the phallus, followed by urethral lengthening, scrotoplasty, and later, the placement of testicular and erectile implants. Metoidioplasty is often a single, less complex procedure. Both require general anesthesia and a hospital stay, with our team monitoring your comfort, healing, and early mobility from the moment you wake up. Catheters, drains, and wound dressings are typically in place for the first few days, and our team will walk you through every step. 

Risks and Recovery
Risks are inherent in major surgery and include fistula, stricture, scarring at the donor or recipient site, and sensory changes. Initial healing for Phalloplasty or Metoidioplasty requires 6–12 weeks off, with a longer-term recovery for final results. We partner with pelvic floor therapists, urologists, and behavioral health practitioners to manage healing and track sensory return. Our care team stays closely involved throughout every stage of healing to ensure comfort, safety, and alignment with your goals.

Travel and Accommodations 

We proudly welcome patients from across the country. Our care team can help coordinate travel logistics and post-op lodging recommendations for out-of-town patients.

Insurance and Financial Planning

Many insurance plans now cover gender-affirming surgeries, including primary phalloplasty. Our dedicated team will help secure approvals and walk you through every step of the process.

Additional Resources

Looking for more information? Visit our Patient Resource Center for checklists, videos, and peer stories to help you prepare for your treatment.