Metoidioplasty and Phalloplasty are the first and largest steps of penis or phallus reconstruction. It is often performed with or without:

• Urethral lengthening (UL)

• Vaginectomy

• Scrotoplasty/perineal reconstruction

The most common surgery is phalloplasty or metoidioplasty with everything: urethral lengthening, vaginectomy, scrotoplasty, perineal reconstruction, and associated procedures. 

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The unique combination of UL with no vaginectomy is no longer an option due to observed higher risks of complications. 

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Further reconstruction of the phallus is sometimes required due to variations in anatomy and healing. Examples include:

• Majora fold reduction (for metoidioplasty patients with prominent upper majora folds)

• Monsplasty (for prominent prepubic skin leading to perineal or inferior positioning of the penis/scrotum)

• Glansplasty (for glans atrophy/flattening or phalluses that do not have a glans)

• Phallus liposuction/plication (for phalluses with too much girth)

• Phallus reposition (for asymmetric scarring) 

• Phallus length reduction (for phallus that are too long or stretch over time)

• Penile Implants

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