Phalloplasty
Construction of a new penis (sometimes called a neophallus or neopenis)[6] typically involves taking a tissue flap from a donor site (such as the forearm).
[7] Temporary lengthening can also be gained by a procedure that releases the suspensory ligament where it is attached to the pubic bone, thereby allowing the penis to be advanced toward the outside of the body.
Therefore, the American Urological Association "considers the division of the suspensory ligament of the penis for increasing penile length in adults to be a procedure which has not been shown to be safe or efficacious.
Both types have a pair of cylinders implanted into the penis, replacing the non-erectile tissue in cisgender men and serving as the core for the neophallus in the phalloplasty procedure.
As advancements in the design and manufacturing process of the IPP improved its mechanical survival, infection has emerged as the leading cause of implant failure.
[23][24] Bacterial contamination of the device can occur during the surgery, and is caused by allowing direct or indirect contact of the prosthesis with the patient's skin.
The "No-Touch" technique is unique in that it aims to prevent bacterial contamination of the prosthesis by completely eliminating contact of the device with the skin.
A 3 cm (1.2 in) scrotal incision is made on the penoscrotal raphe and carried down through the subcutaneous tissue to the Buck's fascia.
A Scott retractor, a flexible device that holds open the skin of the surgical site, is applied to the area.
[29] At this stage of the "No-Touch" technique, after the incision has been made, all instruments, including surgical gloves, that have touched skin are discarded.
At this point, new instruments and equipment are replaced and the entire prosthesis is inserted through the small opening of the loose drape.
Implantation of the device continues with an incision and dilation of corpora, sizing and placing the penile cylinders, and placement of the pump in the scrotum and the reservoir in the retropubic space.
