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Innervated island pedicled anterolateral thigh flap for neo-phallic reconstruction in female-to-male transsexuals

Rubino, Corrado and Figus, Andrea and Dessy, Luca A. and Alei, Giovanni and Mazzocchi, Marco and Trignano, Emilio and Scuderi, Nicolò (2009) Innervated island pedicled anterolateral thigh flap for neo-phallic reconstruction in female-to-male transsexuals. Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 62 (3), e45-e49. ISSN 1748-6815. Article.

Full text not available from this repository.

DOI: 10.1016/j.bjps.2007.11.056

Abstract

Many techniques have been described to create an aesthetic and functional neo-phallus after penile amputation or in female-to-male transsexuals. Microsurgical free-flap phalloplasty seems to be the preferred method of penile reconstruction. For many years the radial forearm free flap has been considered the best procedure, but other flaps have been attempted to minimize donor site morbidity and optimize outcome. Pedicled flaps are considered to be reliable and to decrease the risk of total failure. Recently, a one-stage non-microsurgical technique was described for phallic reconstruction in a young male patient. We report successful total phallic reconstruction in a female-to-male transsexual patient using an island pedicled anterolateral thigh (ALT) flap. Urethral reconstruction was left as a possible further procedure due to patient's preference. A malleable soft silicone penile prosthesis was inserted within the flap and the lateral cutaneous femoral nerve stump was sutured to the dorsal clitoris branch from the pudendal nerve for flap sensation. After 6 months, the patient demonstrated successful aesthetic and functional reconstruction referring to satisfactory sexual activity. To our knowledge, this is the first report of an innervated island pedicled ALT flap used for female-to-male penile reconstruction in a transsexual patient. The pedicled ALT flap may be a reliable option to avoid visible scarring at the donor site on exposed parts of the body, and reduce the risk of total flap failure from microsurgical procedures for reconstruction of a neo-phallus in this increasing population of patients.

Item Type:Article
ID Code:1957
Status:Published
Refereed:Yes
Uncontrolled Keywords:Phalloplasty, anterolateral thigh flap, ALT flap, penile reconstruction, female-to-male reconstruction, transsexual surgery
Subjects:Area 06 - Scienze mediche > MED/19 Chirurgia plastica
Divisions:001 Università di Sassari > 03 Istituti > Dermatologia
Publisher:Elsevier
ISSN:1748-6815
Copyright Holders:© British Association of Plastic, Reconstructive and Aesthetic Surgeons
Deposited On:18 Aug 2009 10:06

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