Frequently asked questions

Female to Male FAQ | Phalloplasty

  1. Can I procreate (father a child) after having phalloplasty?
  2. Which methods are used to have biological children?
  3. What preparations are involved in having phalloplasty surgery?
  4. Why do I have to remove the hair on my forearm?
  5. I currently have tattoos on one or both arms. Am I still eligible for phalloplasty?
  6. How can I know which forearm (donor arm) will be used for the construction of my penis?
  7. Before surgery, should I work out to strengthen the muscles in my forearm ?
  8. Will I have less feeling in my arm after surgery?
  9. Why do I have to wear a compression sleeve on my arm after surgery?
  10. Can I tattoo the donor arm after surgery?
  11. Can I choose the length and size of my penis?
  12. Can I undergo a phalloplasty without proceeding with the closure of my vagina?
  13. Do I have to stop taking my testosterone before or after surgery?
  14. Do I have to remove the sutures after surgery?
  15. Will I be able to have an orgasm after phalloplasty?
  16. Will I be able to ejaculate after my surgery?
  17. Will I be able to ejaculate after my surgery?
  18. Can I choose the length of my penile implant before having surgery to insert it?
  19. After the insertion of my penile implant, will I be able to have sexual relations with penetration?
  20. What is the lifespan of the testicular and penile implants?

  • 1. Can I procreate (father a child) after having phalloplasty?

    No, this surgery will not allow you to father a child. The main objective of this surgery is to obtain the most natural as possible male external genitals. To have children, your body needs internal male structures like testes, where sperm is created, and a prostate, which makes secretions of male seminal fluid possible.

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  • 2. Which methods are used to have biological children?

    Depending on your goals and expectations, your doctor will be able to provide you with information and resources. Discuss your options with your doctor before surgery.

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  • 3. What preparations are involved in having phalloplasty surgery?

    • Hysterectomy including removal of the cervix (at least 6 months before the procedure);
    • Permanent hair removal on the donor arm by laser and/or electrolysis (must be completed before the procedure);
    • Smokers are not candidates for phalloplasty. If you smoke, you must stop using tobacco and products derived from tobacco at least 6 months before and after surgery.

    These conditions are essential; without them, surgery will be postponed.

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  • 4. Why do I have to remove the hair on my forearm?

    The skin of the forearm will be used to construct the phallus. Removing the hair from the forearm is therefore necessary, otherwise:

    • hairs may grow inside the urethra and cause complications;
    • hairs may grow on the penis. In this case, it is possible to continue hair removal treatments once your wounds have completely healed.

    During your preoperative appointment, your surgeon will confirm which arm’s skin will be used for surgery and will provide you with more information about the area to remove hair from. Following this appointment, begin your permanent hair removal treatments as soon as possible.

    *If you wish, you can begin now to consult with an aesthetician to find out which permanent hair removal treatments works best for you, as well the estimated time to complete the treatment. You will then have this information with you during your preoperative consultation with your surgeon.

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  • 5. I currently have tattoos on one or both arms. Am I still eligible for phalloplasty?

    Yes, the surgery can still be performed despite the presence of tattoos. However, these tattoos risk being found on the penis after surgery. The preoperative consultation is the appropriate time to discuss with your surgeon what options are available to you.

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  • 6. How can I know which forearm (donor arm) will be used for the construction of my penis?

    The skin is usually taken from the non-dominant arm unless you present a medical reason not to, or if you have tattoos that you do not want on your penis. During your preoperative appointment, your surgeon will perform a painless test to determine which arm will be the best donor and go over the alternatives with you.

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  • 7. Before surgery, should I work out to strengthen the muscles in my forearm ?

    No, exercising the forearm before surgery will have no beneficial effect on the surgery, or on you postoperative recovery. It is, of course, important to maintain good overall fitness.

    After surgery, you will have to perform specific exercises on the operated forearm to promote rapid and maximum recovery. The care team will inform you about these exercises and their frequency of execution.

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  • 8. Will I have less feeling in my arm after surgery?

    Because the nerves will be affected, the donor arm will no longer have the same sensitivity after surgery at the site of the graft. It is therefore important after surgery to pay particular attention to that region as the sensation of pain after an injury and the perception of temperature variations will be altered.

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  • 9. Why do I have to wear a compression sleeve on my arm after surgery?

    The compression sleeve helps reduce the appearance of scars on the donor arm. Once the wounds on the arm are completely healed, you will have to wear the compression sleeve 24 hours a day except in the shower, for a period of about 1 year. A medical prescription for this will be given to you during your recovery at Asclépiade.

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  • 10. Can I tattoo the donor arm after surgery?

    Yes, it is possible to get a tattoo on the operated arm about 1 year after surgery.

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  • 11. Can I choose the length and size of my penis?

    The length and size of your penis are determined according to the thickness and length of the skin of the forearm. Your surgeon will give you more information about this subject during your preoperative consultation.

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  • 12. Can I undergo a phalloplasty without proceeding with the closure of my vagina?

    No, it is not possible to have a complete phalloplasty without a vaginectomy because the tissues of the vagina are necessary for the construction of the urethra.

    *If a vaginectomy is not performed, only the phallus can be constructed. It will then be impossible to construct the urethra that would allow you to urinate standing up or to construct a scrotum with a masculine appearance.

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  • 13. Do I have to stop taking my testosterone before or after surgery?

    No, you can continue taking your testosterone according to your regular schedule.

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  • 14. Do I have to remove the sutures after surgery?

    Two types of sutures are used. The first will be removed by a nurse or doctor 3 weeks after your surgery. The other sutures are “dissolvable stiches” and take 30 to 90 days to dissolve completely.

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  • 15. Will I be able to have an orgasm after phalloplasty?

    Yes, because the nerves of the clitoris will be released and freed during surgery, creating the possibility that they grow into the phallus. The clitoris is preserved and buried at the base of the phallus. Therefore, you will retain your sensibility allowing for sexual pleasure in this area, and possibly also on the phallus.

    Nerve regeneration is significantly influenced by your age and lifestyle habits, such as smoking. The younger and healthier you are, the better the chances for nerve regeneration are. In the case where the nerves do not develop, the clitoris can still be stimulated in its new location at the base of the phallus. Your ability to achieve orgasm after phalloplasty remains essentially the same as before surgery.
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  • 16. Will I be able to ejaculate after my surgery?

    No, because internal male structures, such as the prostate, seminal vesicles, and glands are absent. However, a clear fluid from the Skene’s glands (preserved during surgery) may flow from the urethra in an amount that varies from one person to another.

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  • 17. Will I be able to ejaculate after my surgery?

    No, because internal male structures, such as the prostate, seminal vesicles, and glands are absent. However, a clear fluid from the Skene’s glands (preserved during surgery) may flow from the urethra in an amount that varies from one person to another.

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  • 18. Can I choose the length of my penile implant before having surgery to insert it?

    The penile implant is available in different lengths, but will be chosen by your surgeon in the operating room according to the length of your phallus.

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  • 19. After the insertion of my penile implant, will I be able to have sexual relations with penetration?

    Yes, you can have sexual relations with penetration about 6 weeks after surgery as you will have satisfactory rigidity of the phallus. It is important to note that the penis will not grow in length and will not rise as much during an erection as in biological men.

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  • 20. What is the lifespan of the testicular and penile implants?

    The implants can be left in place as long as no complications arise. If you do have a problem, it will be important to contact your surgeon.

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