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Because hormonal treatment has little influence on breast size, the first and, arguably, most important surgery performed in the female-to-male FTM transsexual is the creation of a male chest by means of a SCM. Regardless of the technique, it is extremely important to preserve all subcutaneous fat when dissecting the glandular tissue from the flaps. Techniques The semicircular technique Fig. A new phalloplasty technique: The recommendations of the authors are summarized in their algorithm Fig. By the way, contrary to the opinion of Kenneth Lam, there are many different types of phalloplasty procedures.

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Another advantage is that its cost is substantially lower than that of phalloplasty. Hoebeke, in the largest series to date on erection prostheses after penile reconstruction, only used the hydraulic systems available for impotent men. If a solution could be found for a well-vascularized urethra, use of the ALT flap could be an attractive alternative to the radial forearm phalloplasty.

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