Gender Surgery

Phalloplasty

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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We've won 12 top industry awards since 2010 and regularly feature in the national and international press.

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What is a Phalloplasty?

A phalloplasty is the medical term for the construction, or reconstruction, of a penis. The term also encompasses the artificial modification of the penis via surgery. This procedure is commonly performed on men who have undergone female to male (FTM) gender reassignment. This type of surgery is also carried out on men who have congenital conditions which affect the size, function or growth of the penis, or men who have lost their penis in an accident, trauma or to cancer.

Phalloplasty is a major surgery and is often carried out as several smaller procedures, often over the period of weeks or months. These surgeries vary depending on the patient and their personal needs. This may include creating the penis, lengthening the urethra, creating a scrotum, placing testicular and/or erectile implants and removing the vagina in transmen.

To create the penis, donor skin will be taken from the arm, leg or side. The donor site depends on factors such as the patient’s fat distribution, blood flow, nerve functionality, overall health and the desired outcome of surgery.

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Why do people have it?

There are a number of different reasons why a person may wish to undergo phalloplasty surgery:

Gender confirmation surgery: If a person has a diagnosis of gender dysphoria (a condition where a person has a strong sense of disassociation between their gender identity and biological sex) then they may undergo FTM gender reassignment surgery. This may include phalloplasty.

Trauma: Men who have experienced trauma to the penis can undergo reconstructive phalloplasty surgery. Penile trauma may have been caused by burns, road traffic accidents, complications arising from circumcisions or as a result of penile fracture, which occurs when the penis is suddenly bent during an erection.

Congenital conditions: There are several congenital conditions (conditions that are present from birth) which may require phalloplasty surgery. These include aphallia, when a person is born without a penis, and micropenis, where the penis is abnormally small but normally structured.

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The Cost of Phalloplasty

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Included in this treatment

Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea

Your procedure carried out at London’s leading specialist cosmetic surgery centre of excellence

24/7 on call nurse assistance 

Dedicated Patient Co-ordinator, as a personal point of contact through your journey with Cadogan 

A pre-operative medical assessment to ensure you are fit for surgery 

Comprehensive post-operative aftercare courtesy of our specialist cosmetic nurses


Who is suitable?

Cadogan Clinic considers individuals fit for phalloplasty, if all of the following are true of them:

  • Physically and psychologically fit and healthy
  • Are dissatisfied with the appearance and/or function of their penis or the lack of a penis
  • Have realistic expectations of what can be achieved by surgery

You may also be experiencing one of the following:

  • Gender dysphoria requiring FTM gender surgery
  • Trauma to the penis requiring reconstructive surgery
  • A congenital condition resulting in an absent, abnormally small or deformed penis

How does the procedure work?

During phalloplasty surgery, a large section of skin or tissue is taken from a donor area. This is then rolled up to create the shaft of the penis and is attached to the groin. The donor skin and tissue, also referred to as a flap, is usually taken from a leg, arm or from the side or back.

Donor tissue taken from the forearm is referred to as a radial forearm free flap, tissue taken from the thigh is called an anterolateral thigh free flap and the technical term for donor tissue taken from the back is a latissimus dorsi myocutaneous flap.

Depending on the individual patient and their needs, a number of other phalloplasty surgeries may also be carried out as part of this treatment. If the phalloplasty is being carried out as part of FTM gender confirmation surgery, additional procedures may include the removal of the vagina (vaginectomy) or a hysterectomy, a surgical procedure to remove the uterus (womb). The cervix, ovaries and/or fallopian tubes may also be removed at the same time.

A common procedure that may be included in phalloplasty is an operation to extend the urethra

(urethra lengthening), allowing the patient to urinate standing up.

The surgeon may also construct the patient a scrotum (sometimes using the labia majora in transmen) or head of the penis (glans) and insert artificial testicles into the scrotum which result in a natural feel.

An implant device may be used to enable the patient to have an erection, but these are not always necessary. Flaps of skin taken from the back offer the best potential for an erection without the need for a device. Radial forearm free flaps provide a better sensation overall, along with excellent cosmetic results, while anterolateral thigh free flaps give more options in terms of penis length. Scars on the thighs are also easier to hide than on other parts of the body.

It may take a year or two to have a fully-functioning penis after phalloplasty surgery.

Phalloplasty is a bespoke treatment that can be tailored to meet your specific needs. Book a consultation with one of our expert surgeons who will be happy to discuss phalloplasty surgery options with you and how the Cadogan Clinic can help you to achieve your body goals.


What to expect

Below you will find some key information to help you prepare for surgery and make necessary arrangements to ensure you have the support you need and that everything runs smoothly on the day.

Your journey with the Cadogan Clinic will start with a consultation with one of our leading specialist plastic surgeons at our award-winning premises in Chelsea. These consultations will take between 30 and 60 minutes.

During your consultation, your surgeon will ask about your expectations for surgery and talk about what will happen during the procedure. They will also explain how the procedure will affect you.

It is important that you are open and honest about what you hope to achieve through surgery to help ensure the best possible result. Your surgeon will be happy to answer any questions you may have at this point. It may be a good idea to write your questions down before attending the consultation. Having established what you want from the surgery, and what is possible given your anatomy, several key measurements will be made and standard clinical photography will be taken. Your medical history will be discussed and a physical examination will be carried out.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed with your surgery or not following a two week 'cooling off' period.

Avoid smoking and drinking for 48 hours ahead of your phalloplasty as this can delay the healing process. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements in the week ahead of surgery.

In the six hours prior to surgery you must not consume food or any drink, other than small sips of still water, black coffee or black tea, which will be allowed up to two hours before you are admitted to the clinic.

A general anaesthetic will be used to put you to sleep, so you will not be able to feel any pain. Donor tissue will be taken from the arm, leg or back and rolled into a phallus which is attached to your groin. Other procedures, such as urethra lengthening, may take place at the same time.

Following your phalloplasty, you will recover in our ambulatory recovery rooms. You may feel a little drowsy but this often wears off within a few hours.  Once you are able to eat and drink, and our specialist nursing team are happy that your initial recovery is complete, you will be allowed to leave the clinic with a friend or family member.

Once you have returned home, you should keep the phallus elevated and the incisions clean and dry, redressing them as instructed.

In the first few weeks following phalloplasty, you may experience swelling, bruising, itching,  blood in your urine, constipation and nausea. Rest assured that these are all normal.

Avoid lifting and strenuous activity for eight weeks after surgery.

Our on-call nursing service is open 24/7 during your recovery period to help with any questions or queries that you may have.

It is important that you follow all the aftercare instructions issued by your doctor. Failure to do so may impact on your recovery and the final result.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

As phalloplasty often involves a number of different operations performed over a period of time, the recovery time can vary. Some procedures may be carried out at the same time.

You should be able to return to work between four and eight weeks after your phalloplasty, depending on whether your job requires strenuous activity or not. Lifting and exercise should be avoided during those first few weeks, with nothing more strenuous than a brisk walk. A catheter will be in situ after phalloplasty surgery but you should be able to urinate through the penis within two to three weeks of surgery. You must not try and urinate through the penis before you are supposed to. Keep the catheter in place until then and make sure you empty your urine bag at least three times a day.

After your phalloplasty, you must follow the aftercare advice issued by your surgeon in order not to delay the healing process. In the days after your phalloplasty, it’s important that you avoid putting pressure on the phallus and keep it elevated in order to reduce swelling and improve blood flow.

It is important that surgical incisions are kept clean and dry and you wash the area carefully, as directed by your surgeon. You should not shower in the first two weeks following your surgery

If you are having your phalloplasty surgeries separately, you should wait at least three months between each stage. The penile implant, which enables erections, is always the final stage and you must have full feeling in your penis before having the implant. This may take a year or more.

It may take up to two years to fully recover from phalloplasty surgery.

Penile implants or an inflatable pump can be used in order for your penis to become erect, allowing you to have penetrative sex. The implants are only put in place at the very end of your phalloplasty treatment and this procedure can only be carried out if you have regained full feeling in your newly constructed or reconstructed penis. It may take a year to regain feeling in your penis after phalloplasty surgery.

This really depends on how many different procedures you are having as part of your phalloplasty treatment. You may have several different operations at the same time, or your surgeries may be spaced out. If you are spacing them out, you should leave at least three months between each procedure. This is something that you should factor in and your surgeon will be able to give you more information about the timescale involved in your treatment.

It may take up to two years to fully recover from phalloplasty surgery.

The size of your new phallus depends on the size of the donor site, but it is typically five or six inches long, which is the average penis size in the UK today.

As a rule of thumb, patients who are thinner and have less fat on their arms and legs will have a penis that has less girth than a patient who has a greater amount of fat on their donor site. Once attached, your penis will be swollen and it will take several days for this to settle down to reveal the full result of your phalloplasty.

Phalloplasty is a complex surgery and there is a chance of complications such as infection, partial phallic loss and urethral stricture, where scar tissue blocks urine flow. However the chances of complications are greatly reduced if the surgery is carried out by a highly-skilled, expert surgeon, like those operating here at the Cadogan Clinic. Many people leave satisfied with the appearance and function of their new phallus.

A less risky procedure for those undergoing gender confirmation surgery is metoidioplasty, which involves creating a penis using the body’s existing genital tissue, such as the clitoris, labia and the vaginal wall.

Yes, it is possible for you to feel pleasure after your phalloplasty surgery. In radial forearm free-flap phalloplasty, the donor tissue is removed with the nerves and blood vessels intact. These are expertly reattached, restoring sensitivity and allowing the phallus to feel pleasure. In gender confirmation surgery, the clitoris may be positioned at the base of the penis to increase sensation.

However you must remember that it can take a year for you to feel the full sensation in your new penis.


A state of the art, award winning clinic.

Founded in 2004 by world renowned plastic surgeon Mr Bryan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.

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All of our treatments take place at our beautiful boutique premises in Chelsea. We have six consulting rooms and five operating rooms, as well as a dedicated pre and post-operative suite, and a full team of specialist nursing staff.

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We were founded in 2004 by world renown plastic surgeon Mr Bryan Mayou, best known for his pioneering work in the area of liposuction, lasers and microvascular surgery. We continue to collaborate with pioneers in our field.

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We offer surgical consultations in London, Birmingham, Chelmsford and Bristol, and attract international patients from all corners of the globe such as as the USA, the Middle East and Europe.

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What are the risks?

Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. 


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We believe in the delivery of excellent outcomes and results, and exceptional levels of service. Our outcomes are natural and long-lasting, and we remain the premier choice for cosmetic surgery treatments in the UK.


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