Phallus-Preserving Vaginoplasty
ART Surgical and Dr. Angela Rodriguez provide gender-affirming care for non-binary and transgender individuals in San Francisco, California and across the country. For each procedure, including phallus-preserving vaginoplasty, Dr. Rodriguez meets with each patient to understand their goals and needs.
What is Phallus-Preserving Vaginoplasty?
Phallus-preserving vaginoplasty is a surgical procedure performed as part of gender-affirming care. Sometimes referred to as penile preserving vaginoplasty or Salmacian surgery, this type of vaginoplasty creates a neovagina while preserving the existing penis. It’s often an important consideration for individuals who wish to maintain the option of using their penis for sexual function or other reasons.
During this procedure, the surgeon creates a neovagina using penile and scrotal tissues while retaining the penis. The procedure involves reshaping and repurposing these tissues to form the vaginal canal. The goal is to provide individuals with a functional and aesthetically pleasing vagina while maintaining the original genital structure.
Specific techniques and procedures are determined by the individual's preferences, goals, and medical considerations. Non-binary and transgender individuals often work closely with their healthcare team to determine the most suitable approach for their gender affirmation journey.
Who is the Best Candidate For Phallus-Preserving Vaginoplasty?
Phallus-preserving vaginoplasty is a gender-affirming procedure. It is chosen based on personal preferences, goals, and medical reasons. This surgical approach caters to a range of individuals. Some individuals want to affirm their gender identity without undergoing a standard penectomy. Individuals may choose to retain their penis for sexual function or personal identity. Alternatively, they may opt for retention. This surgery offers gender affirmation while preserving the existing genital structure.
Some individuals are drawn to this unique approach. It can allow them to maintain certain aspects of their original anatomy. Those wanting sexual function post-surgery may find this option aligns with their goals. The reasons for choosing phallus-preserving vaginoplasty vary, encompassing factors like sexual function, fertility preservation, urinary function, and individual identity.
Individuals who are considering phallus-preserving vaginoplasty should engage in thorough discussions with qualified healthcare professionals. Talk to surgeons and mental health specialists about your unique circumstances. It will help you choose the most suitable path for your gender affirmation journey.
How is Phallus-Preserving Vaginoplasty Performed?
During phallus-preserving vaginoplasty, the surgeon typically uses the penile skin and tissue to construct the neovagina. The procedure involves inversion of the penile skin to form the vaginal canal. The testicular tissue is often used to create the labia minora. The glans of the penis may also be used to create a clitoral hood, simulating the appearance of the clitoral area. If there isn't enough skin available between the penis and scrotum to create the desired depth of the vaginal canal, a skin graft sourced from the hip, lower abdomen, or inner thigh may be used.
Planning for Surgery (Before Phallus-Preserving Vaginoplasty)
Preparing for phallus-preserving vaginoplasty involves a combination of medical, logistical, and emotional considerations. First, schedule consultations with experienced gender-affirming surgeons who specialize in phallus-preserving vaginoplasty. Discuss your goals, expectations, and any concerns you may have. This will help you make an informed decision about the procedure. Having a good understanding of what to expect can help alleviate anxiety. This can also contribute to a smoother recovery.
Your gender-affirming care team will recommend undergoing physical and mental health evaluations with qualified professionals prior to the procedure. A comprehensive medical evaluation will assess your overall health and identify any potential risks or contraindications for surgery. Conversations with a mental health professional can help ensure emotional readiness for the surgery and any additional recommendations related to gender dysphoria and gender affirmation.
If you are undergoing hormone therapy, discuss the prescribed regimen with your doctor and surgeon. Hormone therapy may be part of the preparation process for some individuals.
It's also recommended to maintain a healthy lifestyle. This includes regular exercise to promote overall fitness, quitting smoking and limiting alcohol consumption. Follow any preoperative instructions provided by your surgeon. Following guidelines on diet, medications, and hygiene is essential.
Lastly, make logistical arrangements for the surgery, including travel plans, accommodations, and support during the recovery period. Establish a strong support system of friends, family, or a support group who can provide emotional support and assistance during the recovery process.
What to Expect During Vaginoplasty Recovery
The recovery process after phallus-preserving vaginoplasty is a crucial period that requires careful attention to postoperative care. While individual experiences may vary, there are some general expectations during the recovery phase.
You will likely spend a day or two in the hospital after the surgery for initial monitoring and postoperative care. Pain and discomfort are common initially. Your healthcare team will provide pain management medications as needed. A urinary catheter may be in place temporarily to assist with urination during the initial recovery period. Swelling and bruising around the surgical site are normal and should gradually subside over time.
Upon release from the hospital, there will be at-home care to carefully manage. Proper wound care is crucial. You should clean and care for the surgical site as instructed by your healthcare team. Most patients are also restricted from doing certain activities during the initial weeks after surgery. This may include strenuous exercise, heavy lifting, and sexual activity. Gradually, you will be able to resume normal daily activities. The timing for the resumption of specific activities will be guided by your surgeon's recommendations.
Beyond physical care, emotional support is equally important during recovery. It is essential to have a family member or friend available 24/7 for support especially during the first couple weeks after surgery. It's common to experience a range of emotions both in the pre and post-operative period. Having a support system in place is crucial.
Regular follow-up appointments with your surgeon will be scheduled to monitor your healing progress and address any concerns. During these appointments, you might also receive hormone therapy adjustments and scar management instructions.
It's important to follow the postoperative care instructions provided by your healthcare team closely. Each individual's recovery experience is unique, so be sure to communicate openly with your healthcare providers about any concerns or questions you may have during the recovery process.
To learn more about phallus-preserving vaginoplasty and how Dr. Angela Rodriguez and her team will guide you through the process, book a one-on-one consultation.
Body Feminization Surgery FAQs
Phallus-preserving gender-affirming surgery affirms a person's gender while keeping the natural phallus intact. The procedure may include reshaping or adjusting surrounding tissues. This aims to reduce dysphoria and help match a patient's identity with their body. Recovery usually involves lots of rest. You should also have careful wound care and follow-up visits with the surgical team. All these steps support healing. This option is a meaningful choice for those who want gender-affirming changes without removing the phallus.
The length of phallus-preserving gender-affirming surgery can vary. It depends on the specific techniques used and each patient's unique goals. On average, the procedure may take several hours. During this time, the surgical team carefully reshapes tissue. They also create proper alignment for both function and appearance. Because every body and surgical plan is different, your surgeon will provide a more accurate estimate of how long your surgery is expected to take. Be sure to ask any questions during your consultation.
Choosing the right vaginoplasty depends on your goals, anatomy, and personal preferences. The most common types include penile inversion vaginoplasty. This uses penile and scrotal tissue to create a vaginal canal. Some patients may also consider a vulvoplasty. This creates external genitalia without a vaginal canal. Other options may include penile-preserving surgery or Salmacian surgery. Each option has different benefits, recovery needs, and long-term outcomes. Discussing your goals openly with your surgeon is the best way to determine which procedure is right for you.
Like any major surgery, gender-affirming procedures have some risks. Potential complications can include bleeding and infection. Poor wound healing, changes in sensation, or issues with urinary or sexual function are also possible. However, serious complications are rare. Most patients have safe outcomes when surgery is performed by experienced surgeons in accredited facilities. Complications vary depending on the specific procedure. They are generally low. The majority of patients report high satisfaction with their results. Your surgical team will review the risks in detail. They will provide guidance to help minimize them before and after surgery.
Insurance coverage for phallus-preserving gender-affirming procedures can vary. It depends on your plan and provider. Some insurance companies cover gender-affirming surgeries. However, the specific types of procedures included may differ. Policies and requirements are not the same for everyone. It's important to check directly with your insurance provider to understand what is covered. They will also tell you what documentation may be needed, and whether pre-authorization is required. Your surgical team may also be able to assist with submitting information. Your doctor can also help you navigate the approval process.
The cost of phallus-preserving gender-affirming surgery can vary. It is based on the specific procedure, the surgeon's expertise, the hospital or surgical center. It is also based on whether your insurance provides coverage. Without insurance, bottom surgery procedures can range from tens of thousands of dollars. Additional costs may include anesthesia, hospital stays, and follow-up care. If insurance covers part or all of the procedure, out-of-pocket expenses may be significantly reduced. Every situation is unique. Patients are encouraged to speak with their surgical team and insurance provider. These conversations will help you get a clear estimate of costs and financial responsibilities.