ABSTRACT
Female-to-male transsexuals have been treated by the authors since the 1970's, using
different operative methods. Since 1981, these patients have received neophallus construction
with free sensate osteofasciocutaneous forearm flaps and, since 1993, with free sensate
osteofasciocutaneous fibula flaps. In order to evaluate the usefulness of these flaps,
the authors performed, in 24 patients (12 with forearm and 12 with fibula flaps),
the following examinations: clinical and radiologic evaluations of the neophallus
and its donor site, as well as patient questionnaires. In all patients, subjective
findings and clinical examinations showed no significant variations in neophallus
size and form. Patients with fibula flaps had better sexual intercourse, although
their neophallus sensibility was minor, when compared to the forearm flap patients.
Donor-site morbidity was moderate in both groups.
On radiologic examination, robust, calcified bone structure, and no fracture of the
neophallus bone and its donor site, as well as no instability of the ankle joint (in
the fibula flap patients) were found.
These findings further support the use of these free sensate osteofasciocutaneous
flaps for neophallus construction. In the authors' opinion, it is the patient who
must decide which method should be used for neophallus construction.
KEYWORD
construction - free sensate osteofasciocutaneous forearm - fibula flaps
