Abdominal Phalloplasty

Abdominal Phalloplasty, or Supra-Pubic Phalloplasty, is an older procedure that has had a resurgence in popularity in recent years. Abdominal Phalloplasty is a good choice for those would like to avoid the forearm scar of RFF Phalloplasty and have a phallus that's suitable for penetrative sex, but who are less concerned about erogenous sensation and don't necessarily require Urethroplasty.

Benefits of Abdominal Phalloplasty include:

• Concealed donor site;
• Direct wound closure—No secondary skin graft required;
• Shorter operative time and recovery;
• No risk of urethral complications (unless Urethroplasty is performed.)

The donor site is left with a horizontal scar that runs from one side of the pelvis to the other. Depending on how the surgeon performs the procedure, there may be a linear scar along the top of the penis.

While electrolysis isn't required for Abdominal Phalloplasty (because the abdominal flap isn't used to create a urethra) many will find hair removal to be a desirable aesthetic upgrade.

In terms of penis size, Morrison et al. (2016) gathered data from 121 Phalloplasty journal articles and the data showed that the dimension of the phallus after Abdominal Phalloplasty ranged from 3.7 to 16cm in length (1.5-6") .

Typically, Abdominal Phalloplasty does not include nerve connection. One exception to this is Abdominal Phalloplasty with Radial Artery Urethroplasty, in which a small section of the forearm is used to create the urethra and a nerve is harvested with the flap. The nerve supply to the neo-urethra can result in erogenous sensation to the tip of the phallus. Without this nerve connection, some tactile sensation can be expected but not all the way to the tip of the phallus. Erogenous sensation from the clitoris (buried or unburied) is preserved and can be directly stimulated.

Some surgical teams offer Urethroplasty as as secondary procedure for Abdominal Phalloplasty, using tissue from the forearm, mouth, clitoris, labia or vagina. Some surgeons also offer Vaginectomy with this procedure.

"I don't have any absolutes: each patient and each patient's circumstances are different and because of this treatment will be different. I do perform urethroplasty for Abdominal and Groin Phalloplasty, but I typically will do this as a secondary operation at a later date." — Dr. Daniel Freet

The abdominal flap is pedicled—versus a free flap—so microsurgery isn't required. This makes the procedure shorter, as well as more affordable for those paying out of pocket. The cost of Abdominal Phalloplasty ranges from $30,000 - $50,000 USD.

Surgeons who offer Abdominal Phalloplasty:

• Dr. Kenan Celtik & Dr. Charles Lee - Crane Center, San Francisco, California
• Dr. Gabriel Del Corral - Baltimore, Maryland & Washington D.C.
• Dr. Daniel Freet - Houston, Texas (with Radial Artery Urethroplasty)
• Dr. Jonathan Keith - Livingston, New Jersey
• Dr. Jens Berli - Portland, OR
• Dr. Kathy Rumer - Pennsylvania, PA
• Dr. Miroslav Djordjevic - New York City & Belgrade, Serbia
• Dr. Rajveer Purohit - New York City
• Dr. Shubham Gupta - Cleveland, OH
• Dr. Kirtishri Mishra - Cleveland, OHDr. Shane Morrison - Seattle, WA
• Dr. Anh Nguyen - Houston, Texas (with Urethroplasty)
• Dr. David Ralph & Dr. Nim Christopher- London, UK
• Dr. Prapul Chandra - Hyderabad

Illustrations of Abdominal Phalloplasty

Source: Kim et al. (2017)

Journal Articles

The anatomy of abdominal flap phalloplasty for transgender surgery.
Kim, S., Dennis, M., Holland, J., Terrell, M., Loukas, M., & Schober, J. (2017). Clinical Anatomy, 31(2), 181–186.
Surgical text descriptions enhanced by new anatomic illustrations.

Surgical Outcomes and Patients' Satisfaction with Suprapubic Phalloplasty
Terrier, J.-É., Courtois, F., Ruffion, A. and Morel-Journel, N. (2014), Journal of Sexual Medicine, 11: 288–298. doi: 10.1111/jsm.12297
The aim of this study was to assess the outcomes and satisfaction of patients offered the choice between metaidioplasty, forearm free flap, and suprapubic phalloplasty. Suprapubic phalloplasty, despite the lack of urethroplasty, offers an interesting alternative for patients concerned with the stigmatizing scar on the donor site.

Pedicled pubic phalloplasty in females with gender dysphoria.
Bettocchi C, Ralph DJ, Pryor JP. BJU Int. 2005 Jan;95(1):120-4.
Between 1989 and 2000, 85 female-to-male transsexual patients had a phalloplasty fashioned from suprapubic abdominal wall flap that was tubed to form the phallus, and which incorporated the neourethra made from a pedicled tube of labial skin.

Related: Bird-Wing Abdominal Phalloplasty, Kim Phalloplasty

Last updated: 02/15/24