Phalloplasty is a series of operations to construct or reconstruct a penis. It's a complicated process that may take up to two years to complete. The success rate is high, and people who have phalloplasty are usually pleased with the results.
Because phalloplasty is such an intricate process, the financial costs are very high. Most people pay tens of thousands of dollars for the procedure. Some insurance policies cover all or part of the cost of phalloplasty procedures. It is important to talk to your doctor about the costs and what your insurance will pay for before you schedule a phalloplasty.
Learn more about phalloplasty and what it costs.
What Is Phalloplasty?
Phalloplasty is the surgical construction or reconstruction of a penis. Men who have lost their penis due to illness or injury may be able to have phalloplasty to restore their penis. It is also a procedure that transgender men may have to make their genitalia match their gender identity. It is sometimes called "bottom surgery," though that term can include other genital surgeries in addition to phalloplasty.
Types of Phalloplasty
In order to construct a penis, doctors need to take skin from one part of the body and transfer it to the groin. There are three options for where the skin can be taken from:
- Radial forearm free flap (arm),
- Anterolateral thigh flap (leg)
- Musculocutaneous latissimus dorsi flap (side)
Choosing which type is best is a decision a doctor can make with you. It will depend on your goals for the phalloplasty, your blood flow and nerve sensation in the different areas, and how your skin and fat are distributed.
How Many Operations Are Needed for Full Phalloplasty?
There are three stages to the phalloplasty process:
Creation of the penis. Doctors will take the skin from another part of your body and use it to construct a penis. Before attaching it to your body, they will insert a catheter that will later be attached to your bladder so that you can urinate from your new penis. The penis is then attached to your body.
Urethral lengthening and scrotoplasty. The second stage of phalloplasty is usually done 5-6 months after the first operation to give the new penis time to heal. At this time, doctors can connect your urethra to the catheter in the penis. For a trans man, this would also be a time for a vaginectomy, where doctors close the vaginal opening. They can move the clitoris under the skin of the new penis to increase sexual sensations. Then they will use the skin from the vulva to create a scrotum. However, not all trans men choose to have a vaginectomy. You can discuss that with your doctor.
Penile implant. The final phase of phalloplasty takes place about a year after the second stage. At this time, doctors will insert an implant that allows the new penis to become erect. They will also put in testicular implants to fill out the scrotum.
It is possible to have complications after a phalloplasty, such as problems with the catheter or the penile implant. Those complications may require more surgeries to repair.
Costs of Phalloplasty
The costs of phalloplasty vary. Different doctors charge different fees for their services. In general, the price for the surgeries is approximately $25,000-$35,000.
The price of surgery isn't the only cost to consider. You may have to pay for the costs of anesthesia, hospitalization, and medications for your recovery. You may also need to pay for hair removal on the skin that your doctor will use for your penis. You will need to account for the costs of any hormone treatments your doctor requires in advance of the surgery.
If you are having phalloplasty as part of gender confirmation, you may want surgery to remove your uterus and ovaries before beginning the phalloplasty process. You should also factor in travel costs if your doctor isn't in your city. Those costs can add thousands of dollars more to the price tag. Your doctor will be able to tell you what those costs will be.
Does Insurance Cover Phalloplasty?
Phalloplasty may be considered reconstructive surgery for both people who want gender confirmation and men who lost their penis through illness or injury. Your insurance company may cover some or all of the costs of your surgeries. Your doctor and your insurance company will be able to tell you what portion of the costs are covered.
Phalloplasty is a complicated and expensive process. Many people who have had this procedure done say that they are happy with the outcome, despite the costs. If you are considering phalloplasty, discuss it with your doctor.