A phalloplasty (phallo) involves moving tissue from another location of the body to the genital region in order to create a larger sized penis, relative to what can be obtained with a meta. Options for “donor site” are radial forearm, outside of the thigh (ALT), or the back (latissimus dorsi). In general, the radial forearm allows for better nerve connection (and hence sensation), blood supply, and appropriate girth relative to the other flaps. As with a meta, a vaginectomy, urethral lengthening and scrotoplasty are done at the same time. Glans shaping (glansplasty), testicular implant insertion, and penile implant insertion are generally done after the healing from the initial surgery. Penile implant insertion allows the penis to have erectile function and for patients to have penetrative intercourse. Dr. McClung works closely with Dr. Santosh Kale to perform these surgeries.