ALT Phalloplasty: What It Is, Procedure & Expectations
When considering gender-affirming surgeries, ALT phalloplasty stands out as an ption for many individuals seeking to align their physical appearance with their gender identity. ALT, or Anterolateral Thigh phalloplasty, offers a comprehensive solution for constructing a phallus using tissue from the thigh.
In this blog, we will delve into this type of phalloplasty, demystifying the procedure, exploring the step-by-step process, and setting clear, realistic expectations to guide those contemplating this transformative journey.
What is ALT Phalloplasty?
ALT Phalloplasty, also known as Anterolateral Thigh Flap phalloplasty, is a surgical procedure used to construct a phallus using tissue from the anterolateral thigh. This technique is often chosen for its ability to create a phallus with sufficient bulk and good aesthetic outcomes. The ALT flap includes skin, fat, and fascia, which are harvested from the thigh and then shaped into a phallus.
The ALT Phalloplasty Procedure
The ALT phalloplasty procedure involves several stages, each crucial for achieving the best results:
Harvesting the Flap: Tissue is carefully taken from the anterolateral thigh area. This process includes the skin, fat, and fascia necessary to construct the phallus. In this stage, our surgeons work to minimize the alt phalloplasty scar, making it as discreet as possible.
Shaping the Phallus: The harvested tissue is then meticulously shaped to form the phallus. Surgeons ensure the structure and appearance meet your expectations, balancing both functionality and aesthetics.
Additional procedures: If necessary, the surgeons may also perform a vaginectomy (which removes part or all of the vagina), urethral lengthening (which involves lengthening your existing urethra so you are able to stand to urinate), or sculpting the scrotum for optimal results.
Attachment: The shaped tissue is attached to the pubic area, ensuring a secure connection with adequate blood supply. This step is critical for the survival and integration of the flap.
Final Adjustments: Fine adjustments are made to ensure the phallus looks natural and functions well. Surgeons may also plan for future stages, such as the insertion of erectile devices if that aligns with your goals.
The entire procedure typically requires several hours of surgery, followed by a recovery period during which you must follow specific post-operative care instructions to ensure optimal healing and results. For more detailed information on the procedure, you can watch our Phalloplasty Procedure Video.
Comparing ALT Phalloplasty vs. RFF and MLD Phalloplasty
When choosing the best phalloplasty method, it's important to compare the 3 main types of phalophasty: ALT phalloplasty vs. RFF (Radial Forearm Flap) vs. MLD (Musculocutaneous Latissimus Dorsi Flap). Each method has unique advantages and considerations:
● ALT Phalloplasty: Uses tissue from the thigh, resulting in a minimal scar and a bulkier phallus. This method is ideal for patients who prefer thigh donor sites and those seeking more substantial tissue volume. The alt phalloplasty results are often praised for their natural appearance and durability.
● RFF Phalloplasty: Utilizes tissue from the forearm, which can produce a phallus with good tactile sensation but may leave a more noticeable scar on the forearm. RFF phalloplasty is known for its excellent sensitivity outcomes, which can be a deciding factor for some patients.
● MLD Phalloplasty: Harvests tissue from the back, creating a phallus with significant bulk but potentially more visible scarring on the back. This method is often chosen for patients who need larger tissue volumes and prefer not to use arm or thigh tissue.
Each method has its benefits and considerations, making it essential to discuss your goals and preferences with your surgical team. For a more in-depth information, you might find our Introduction to Phalloplasty video helpful.
Who’s The Ideal Candidate For ALT Bottom Surgery?
ALT bottom surgery can be an excellent option for many gender affirming patients, but it is important to understand who the ideal candidates are for this procedure. In this sense, the blood supply of the ALT flap is generally very good; however, the layout of the blood vessels can vary significantly from person to person. This variability can make the surgery complex. Therefore, a preoperative evaluation using a multidetector CT scan (MDCT) is highly recommended to assess the blood supply and ensure optimal surgical planning.
Additionally, it’s important to take into account that the thickness of the skin and subcutaneous fat in the thigh is another factor. For patients with thinner skin and less subcutaneous fat, the ALT flap can be quite thin, making it a good choice for sensation. On the other hand, those with thicker skin and more subcutaneous fat in the thigh may face challenges with ALT phalloplasty. ALT phalloplasties often require revisions to “thin out” the girth of the phallus so that it is compatible for intercourse.
ALT Phalloplasty Results and Expectations
The alt phalloplasty results are generally favorable, with many patients achieving a natural-looking and functional phallus. Here’s what you can expect in terms of outcomes:
● Size: Size: ALT phalloplasty is known for providing a substantial amount of tissue, which can result in a larger phallus compared to other methods like RFF. The amount of available donor tissue from the thigh allows for the construction of a phallus that is both aesthetically pleasing and proportional to your body.
● Functionality: Depending on your goals, the phallus can be designed to allow for urination through the urethra. Additionally, erectile devices can be implanted in later stages to enhance sexual function. These devices are typically inserted during follow-up surgeries once the initial healing is complete.
● Scarring: The alt phalloplasty scar is typically minimal and located on the thigh, making it less visible than scars from other donor sites. Surgeons use advanced techniques to minimize scarring and promote better healing.
● Sensation: Sensation in the phallus can vary depending on the nerve connections made during surgery. Many patients report satisfactory levels of sensation, particularly when nerve grafts are used to enhance tactile feedback.
Recovery from ALT phalloplasty involves several weeks of rest and careful monitoring of the surgical site. It's important to follow your surgeon’s post-operative care instructions closely to ensure the best possible outcome. For tips on post-surgery recovery, you can read our Post-Op FTM Surgery Recovery and Care Guide.
Schedule An Appointment At Reconstructive Surgical Arts
ALT phalloplasty offers a viable and effective option for gender affirming patients seeking phalloplasty. With careful planning and a skilled surgical team, you can achieve both functional and aesthetic results that align with your goals. This type of surgery provides a balance of appearance, sensation, and functionality, making it a popular choice among many patients.
If you're considering alt bottom surgery and want to learn more about your options, get in touch with our team at Reconstructive Surgical Arts to start your journey. We're here to guide you through every step of the process, ensuring you receive the best possible care and outcomes.
By understanding your options and discussing them with experienced surgeons, you can make an informed decision that aligns with your needs and desires.
