are required at least five surgeries to have the "finished product", sometimes up to 20 . It starts by making a mastectomy to remove mammary glands, either in the same operation or after recovery, intervenes to give the breast aesthetics, placing and cutting the excess skin, even pectoral muscle.
Later (which is where the complexity starts) to create a penis and testicles or as close to them is necessary to make a "hollowing out" of all the female organ (uterus, ovaries and fallopian among others). After some weeks of practice a phalloplasty, which can be performed with pedicled flaps (using the skin near the genitals) or distant flaps (removing skin from the leg or arm). It consists of rolling a piece of skin from the English and muscle mass of the inner thigh, arm or abdomen, and subsequently implanted in the pubic area.
rose in the skin flap in the area to be implemented phallic structure is transposed onto the underside of the clitoral shaft. Cutaneous nerves join the dorsal nerve of the clitoris with the aim of recovering the erogenous sensitivity, which is not always achieved and is a price to be paid to undergo such procedures.
The urethra is evaluated after a while. If it shows good permeability, the patient becomes a candidate for placement of a silicone testicular prostheses and training of the bag where they will reside after the closure of the labia and vulva.
After a year at least, you can try the erogenous sensitivity. If the patient achieves sensitivity in the flap phallic and ran the "Urethral false" can be considered a prosthesis to allow you to have erectile erections.
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